Search

Objective: This study tested a 'wise' intervention (quick prompt of a specific psychological mec) in acute care hospital units to improve nurses' hand hygiene compliance (HHC). Design: A multiple baseline design in two medical-surgical teaching hospitals in the United States. Measurements: Hand hygiene data was collected using an electronic compliance monitoring system with sensors placed in doorways and on corresponding soap and alcohol-based hand rub dispensers. The outcome measure was the proportion of opportunities in which HH was undertaken by staff per week in each unit. Intervention: A quick-and-easy psychological prime to reinvigorate professional identity. Methods: Interrupted time series analysis using a quasi-Poisson regression model with statistical process control charts for each unit. Results: A statistically significant increase in HHC rates that was sustained for months post-intervention. However, the patterns by unit were not statistically significant once temporal trends were considered. Other factors, such as the unit type and the use of incentives could have impacted the results. Conclusions: These analyses suggest that the aggregate impact should not be taken as evidence of intervention effectiveness. This study therefore cannot be considered to have provided a strong foundation for use of a 'wise' intervention, despite its relatively small financial, logistical and psychological cost., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Accurate information on context and implementation of public health interventions is necessary to replicate, adapt, and scale effective interventions and to interpret evaluations. Reporting the context and implementation of water, sanitation, and hygiene (WASH) interventions has been inconsistent and incomplete., Methods: To improve the reporting of WASH interventions, we developed the Template for Intervention Description and Replication for WASH (TIDieR-WASH) checklist and guide, by adapting and expanding the original TIDieR guide. We performed a scoping review of existing implementation reporting guidelines, and of current implementation reporting in WASH evaluations, to develop a list of candidate items to include in this checklist. We then used a 4-stages of review by international experts to reach consensus., Results: The resulting 14-item checklist comprises: a ) name, b ) theory of change, c ) prior evidence, d ) location and setting, e ) context, f ) suitability, g ) implementers, h ) recipients, i ) targeting, j ) activities, k ) intervention dose, l ) fidelity, m ) costs, and n ) materials. Definitions, explanations, examples, and instructions for use are reported in this article., Discussion: The checklist can be applied to all types of evaluations of WASH interventions, including direct service provision, behavior change, and systems strengthening interventions. We deliberately developed this guidance document to be accessible and relevant to practitioners and researchers. Adoption of this checklist will support transparent reporting of WASH implementation for research and practice. As with other sectors that have used TIDieR checklists, clear implementation reporting can assist with evidence synthesis, adaptation, and policy guidance. https://doi.org/10.1289/EHP14780.

Background: As part of an effort to rigorously apply behavioral science to child protection efforts, a behavior change model called Nurturing Care Groups (NCGs) was tested for effectiveness in changing child abuse and corporal punishment behaviors., Objective: The primary research question was to what degree NCGs could change child protection knowledge, attitudes, and practices among caregivers in a low-cost program with broad reach, which could feasibly be scaled., Participants and Setting: The NCG project was implemented in two distinct ecological zones in Ghana, reaching 73,959 caregivers of children under 5 across 41 communities; while 20 communities were control sites with no NCG intervention., Methods: Stratified random sampling was used to select intervention area respondents. Cluster sampling was utilized in control areas, using the Probability Proportional to Size method. Standard measures were used to assess changes in practices of violence and abuse, stress experience and management, parenting techniques, and the household environment. Difference-in-difference linear regression was used to compare intervention and control results., Results: Intervention areas demonstrated statistically-significant and substantial changes in reported knowledge, attitudes and behaviors related to physical abuse and corporal punishment. Knowledge of negative impacts of stress on parenting, as well as stress reduction techniques increased in intervention areas, as did positive discipline and parenting practices., Conclusions: The NCG model demonstrated important promising results for changing child protection behaviors in this descriptive study. Statistically-significant decreases in reported physical and psychological punishment and corresponding increases in reported positive discipline indicate that this may be an effective and low-cost intervention for child protection behavior change., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The purpose of this study was to identify parents' self-reported stressors as they experience their baby's course in the neonatal intensive care unit (NICU). Miles, Funk & Carlson (1993) Parental Stressor Scale: Neonatal Intensive Care Unit was used to survey 119 parents of neonatal infants, born at 24 weeks to full term, in the 28-bed level 3 NICU of a mid-Atlantic, Magnet-designated acute care hospital with 665 licensed beds. The newly developed Grosik, Snyder, Cleary and Tidwell NICU External Stressors and Stress Reduction Scale (2006), a 5-point Likert scale, was also used. Intrapersonal and interpersonal stressors were categorized as internal (occurring within the NICU) and extrapersonal (occurring outside the NICU) as external stressors. The findings were used to develop a new practice in the NICU to help reduce parental stressors.

Nutritional deficits have long been recognized as contributing factors to morbidity and mortality of hospitalized patients. A multi-disciplinary team approach to nutritional support has been shown to be superior to non-team approaches. A formal consultive nutritional support team has been active at St. Dominic Hospital since 1991. The benefits of our nutritional support team at St. Dominic Hospital are described. Acquisition of an Indirect calorimeter has improved measurements of caloric and substrate requirements. Individualized nutritional prescriptions more closely meet assessed patient needs. Utilization of less expensive, more physiologic enteral feeding routes have increased. Also, the number of total parenteral nutrition (TPN) bags admixed and wasted have decreased, despite an increase in the percent of patients with moderate to severe nutritional risk. The nutritional support service at St. Dominic Hospital has improved patient care while reducing cost to both the institutional and patient.