Kate Browne1,2, Philip Russo3,4, Nicole White5, Andrew Stewardson3,6, Peta Tehan3, Rhonda Wilson7, Helen Rawson3, Sonja Dawson1, Jenny Sim7, Allen Cheng3,6, Julee McDonagh8, Auxillia Madhuvu3, Brett Mitchell1,2
1Avondale University, Wahroonga, NSW, Australia
2Central Coast Local Health District, Gosford, NSW, Australia
3Monash University, Monash, VIC, Australia
4Cabrini Health, Melbourne, VIC, Australia
5Queensland University of Technology, Brisbane, QLD, Australia
6Alfred Health, Melbourne, VIC, Australia
7University of Newcastle, Newcastle, NSW, Australia
8University of Wollongong, Wollongong, NSW, Australia
Background
Hospital-acquired pneumonia (HAP), the most common complication in Australian public hospitals, affects over 50,000 patients in Australia annually. Patients typically acquire HAP due to aspiration of their own oropharyngeal material – yet oral care in hospitals is suboptimal or neglected altogether. To address this gap, a robust clinical trial that informs clinical practice, policy, and education is needed. Thus, we will undertake the world’s first multi-centre clinical trial aiming to evaluate an intervention for preventing HAP.
Methods
Phase 1 consists of assessing knowledge, practice and developing educational material (co-design). In Phase 2, we will conduct a multi-centre stepped-wedge cluster randomised trial in three Australian hospitals over 52-weeks. The intervention will consist of improving the quality and frequency of oral care. Oral care will be administered a minimum of twice daily. Electronic point-of-care reminders will prompt and remind patients and staff to perform oral care. Face-to-face education and resources developed in Phase 1 will be used and evaluated. Monthly feedback on HAP cases and compliance with the intervention will be given to nursing staff, integrated into ongoing feedback, education, and training sessions. The evaluation of the trial (Phase 3) will include making resources developed open source.
Results
Phase 1 will commence late 2023, Phase 2 in 20244, with results (Phase 3) available in 2026. Here, we present the methodology for this study.
Conclusion
This study will generate new evidence and knowledge will aid in allocating scarce healthcare resources through cost-effectiveness design and the development of resources for widespread translation.
Biography
Professor Brett Mitchell is Editor-in-Chief of Infection, Disease in Health. He works at the Central Coast Local Health District in NSW and is Professor of Nursing at Avondale University. Brett is a Fellow of ACIPC and the Australian College of Nursing. Brett has worked in the area of infection control for many years, including leading infection control programs in hospitals and at a State level.