An interventional study of NOST in Infections, Respiratory and Healthcare Worker Patient Transmission, sponsored by Norwegian Institute of Public Health. Status unknown at 1 site in Norway. Per ClinicalTrials.gov, last updated 2023-02-21.
Sponsored by Norwegian Institute of Public Health · Not applicable, Interventional, and Prevention
The Norwegian Institute of Public Health (NIPH) is introducing a new electronic tool for direct observation of compliance with recommended infection prevention and control measures in healthcare. The solution is called the National Tool for Observation of Infection Prevention Measures (NOST). NOST is a quality improvement tool that includes a web-based solution for observing compliance with recommendations for hand hygiene and other IPC measures. Through NOST, healthcare personnel will be able to identify the local level of compliance, which in turn can reveal areas for improvement.
This protocol includes the evaluation of NOST in hospitals. The evaluation is designed as a cluster-randomized controlled trial with two arms where eligible wards in hospitals are randomly allocated into an intervention and a control arm. NOST is implemented in the intervention wards at the start of the evaluation period, and compliance with hand hygiene and other outcomes are measured in both the interventions and control wards one year later.
The objective of evaluating NOST is to:
The evaluation og NOST is designed as a cluster-randomized controlled trial with two arms where eligible wards in hospitals are randomly allocated into an intervention and a control arm. NOST is implemented in the intervention wards at the start of the evaluation period, and compliance with hand hygiene and other outcomes are measured in both the interventions and control wards one year later.
Intervention
The intervention in the study is to implement NOST, which includes:
Thus, the intervention includes both observation of compliance and any additional improvement measures initiated as a result of the introduced NOST.
Observations of hand hygiene will be carried out in sessions of 20-30 minutes. During this period, all situations where hand hygiene is indicated (recommended) and whether hand hygiene is performed or not, are recorded. The number of hand hygiene indications during a session varies but will often be between 10 and 20.
When the intervention group has implemented and followed NOST for a year, the investigators will measure compliance with hand hygiene recommendations and reported HAIs, in wards that have had NOST and in wards that have not introduced NOST.
The intervention arm will be followed over time with repeated measurements of both compliance with hand hygiene and other outcome measures, to see if the effect increases in line with implemented observations and quality improvement measures, or if the effect decreases during the study period.
6,687 studies on the registry are indexed under Infections; 807 are open to participants now.
This study's planned enrollment of 600 is above the median of 120 across 4,200 interventional studies indexed under Infections.
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Exclusion Criteria:
The intervention is to implement NOST, which includes: observation and recording of compliance with hand hygiene recommendations identification of areas for improvement training or other actions taken to improve IPC in general or compliance with hand hygiene. Thus, the intervention includes both observation of compliance and any additional improvement measures initiated as a result of the introduced NOST. When the intervention group has implemented and followed NOST for a year, the investigators will measure compliance with hand hygiene recommendations and reported HAIs, in wards that have had NOST and in wards that have not introduced NOST. The intervention arm will be followed over time with repeated measurements of both compliance with hand hygiene and other outcome measures, to see if the effect increases in line with implemented observations and quality improvement measures, or if the effect decreases during the study period.
Behavioral: NOST
Participants in the no intervention arm arm are asked not to implement NOST.
The intervention is to implement NOST, which includes: observation and recording of compliance with hand hygiene recommendations identification of areas for improvement training or other actions taken to improve IPC in general or compliance with hand hygiene. Thus, the intervention includes both observation of compliance and any additional improvement measures initiated as a result of the introduced NOST. When the intervention group has implemented and followed NOST for a year, the investigators will measure compliance with hand hygiene recommendations and reported HAIs, in wards that have had NOST and in wards that have not introduced NOST. The intervention arm will be followed over time with repeated measurements of both compliance with hand hygiene and other outcome measures, to see if the effect increases in line with implemented observations and quality improvement measures, or if the effect decreases during the study period.
Hand hygiene observations
Self-reported proportion of correct compliance, in total and by occupation
Time frame: Day 1 to one year later
Outbreaks of infectious diseases
Proportion of outbreaks per ward and secondary attack rate by inpatients and staff. Data collected from VESUV
Time frame: Day 1 to one year later
Surveillance of healthcare-associated infections
Proportion of infected inpatients by type of infections. Data collected from NOIS
Time frame: Day 1 to one year later
Surveillance of postoperative site infections
Proportion of infected patients by type of surgery and type of infections. Data collected from NOIS and POSI
Time frame: Day 1 to one year later
Length of stay
Mean and median bed-days per stay. Data collected from NRP
Time frame: Day 1 to one year later
Plan to share: No — In this project, the investigators will not register or collect direct identifiable personal data. In the hand hygiene observations, only the events and occupation are recorded, but not personal data on the people observed. Furthermore, the investigators will only ask for statistics from VESUV and NOIS/NOIS-POSI. This data will include the number of people infected in outbreaks per ward distributed by employees and inpatients, as well as the number of inpatients with relevant types of infection in the surveillance of HAI. These data are regularly published at the hospital level. The investigators will apply for data from NPR that includes information on each patient admitted to the relevant wards in the period from 1 January 2022 to mid-2024. However, the investigators will ask for data without directly personally identifiable information (data without name and social security number).
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This study is status unknown, as verified in Feb 2023. You cannot join it, but the record below documents what was studied.
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Norwegian Institute of Public Health