About the project

Nurses have an important role in patient safety. Sub-optimal assessment and communication practices can lead to higher incidence of adverse events such as clinical deterioration, falls and pressure injuries. The ACCELERATE trial (a stepped-wedge cluster randomised controlled trial) aimed to implement and evaluate the effectiveness of an organisational ward-level intervention to facilitate early recognition and proactive prevention of clinical deterioration and reduce the incidence of the hospital-acquired complications (HACs) of falls and stage 2-4 pressure injuries.

Starting in early 2021, a stepped-wedge randomised controlled trial was sequentially implemented across nine cluster sites (wards) in three acute tertiary referral hospitals in Victoria and New South Wales. This theoretically informed intervention aimed to support nurses to implement comprehensive patient assessment and decision-making practices, and to maximise communication opportunities and accuracy of information to reduce incidence of unrecognised deterioration, falls and stage 2-4 pressure injuries.

The ACCELERATE intervention focused on proactive nursing assessment and clinical handover re-design. We engaged senior hospital nursing staff, ward nurses and the multidisciplinary team in our implementation plan. Facilitated workshops were conducted with nurses from intervention wards to explain purpose of the research, the interventions and identify barriers and local solutions. Regular follow-up meetings were conducted with each ward. Tailored local solutions were identified in response to barrier identification and we incorporated use of ward-based clinical facilitators, reminders, audit and feedback, and educational outreach visits.

As of 2022, while the intervention is ongoing, the ACCELERATE trial has been funded to expand to further sites in Northern NSW.

Publications

• Forthcoming, pending conclusion of the first phase of the project.

Project contact

Liza Goncharov
liza.goncharov@anu.edu.au