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The Safe Hands Study: Implementing aseptic techniques in the operating room: Facilitating mechanisms for contextual negotiation and collective action
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Göteborgs universitet; Karolinska institutet.
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2018 (English)In: American Journal of Infection Control, ISSN 0196-6553, E-ISSN 1527-3296Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Even though hand hygiene and aseptic techniques are essential to provide safe care in the operating room, several studies have found a lack of successful implementation. The aim of this study was to describe facilitative mechanisms supporting the implementation of hand hygiene and aseptic techniques.

METHODS: This study was set in a large operating room suite in a Swedish university hospital. The theory-driven implementation process was informed by the literature on organizational change and dialogue. Data were collected using interviews and participant observations and analyzed using a thematic approach. The normalization process theory served as a frame of interpretation during the analysis.

RESULTS: Three facilitating mechanisms were identified: (1) commitment through a sense of urgency, requiring extensive communication between the managers, operating room professionals, and facilitators in building commitment to change and putting the issues on the agenda; (2) dialogue for co-creation, increasing and sustaining commitment and resource mobilization; and (3) tailored management support, including helping managers to develop their leadership role, progressively involving staff, and retaining focus during the implementation process.

CONCLUSIONS: The facilitating mechanisms can be used in organizing implementation processes. Putting the emphasis on help and support to managers seems to be a crucial condition in complex implementation processes, from preparation of the change process to stabilization of the new practice.

Place, publisher, year, edition, pages
2018.
Keywords [en]
Aseptic technique, Co-creation, Complex intervention, Contextual restructuring, Hand hygiene, Implementation process
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-28915DOI: 10.1016/j.ajic.2018.08.024PubMedID: 30449454Scopus ID: 2-s2.0-85056694740OAI: oai:DiVA.org:du-28915DiVA, id: diva2:1265391
Available from: 2018-11-23 Created: 2018-11-23 Last updated: 2018-12-04Bibliographically approved

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Wallin, Lars

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Citation style
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