Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Healthcare Infection Healthcare Infection Society
Official Journal of the Australasian College for Infection Prevention and Control
RESEARCH ARTICLE

How can implementing an infection prevention and control (IPC) technology transform healthcare practices and outcomes for patients?

Randa Attieh A E , Marie-Pierre Gagnon A B and Sarah L. Krein C D
+ Author Affiliations
- Author Affiliations

A Research Centre of the Centre Hospitalier Universitaire de Québec, Hôpital St-François d’Assise, Québec City, Quebec, Canada.

B Faculty of Nursing, Université Laval, Québec, Canada.

C Veteran’s Affairs Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, MI, USA.

D Department of General Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.

E Corresponding author. Email: randa.attieh.1@ulaval.ca

Healthcare Infection 19(3) 81-88 https://doi.org/10.1071/HI14003
Submitted: 19 December 2013  Accepted: 19 March 2014   Published: 5 June 2014

Abstract

Implementing polymerase chain reaction (PCR) technology in the context of infection prevention and control (IPC) at Centre Hospitalier Universitaire (CHU) de Québec necessitated organisational change involving new infection prevention and control (IPC) procedures, the organisation of hospital services and attribution of new roles within a network of actors, at the macro, meso and micro levels. Understanding how the adoption of IPC technology can transform healthcare practices and outcomes for patients will remain a challenge as long as the process lacks a theoretical basis. This paper discusses a conceptual framework that will make it possible to understand the dynamics involved in implementing practice change. To identify the outcomes of such a process, both from the point of view of the nursing staff and that of patients, an integrated model was developed based on the Translating Research Into Practice (TRIP) model and on the Actor-Network Theory (ANT). The TRIP-ANT model provides a basis for exploring the complexity of implementing technology in the context of IPC and illustrates the dynamic nature of healthcare organisation in the real world. It identifies how new technology integration can translate into different responses to change and into the practices of a network of actors involved directly or indirectly in the new intra- and inter-organisational processes surrounding the handling of IPC practices. Furthermore, this model could also be applied to other innovations in healthcare organisations.

Additional keywords: Actor-Network, adoption, polymerase chain reaction, theoretical model/framework, TRIP framework.


References

[1]  Klevens RM, Edwards JR, Richards CL, Horan TC, Gaynes RP, Pollock DA, et al Estimating health care-associated infections and deaths in U.S. hospitals. Public Health Rep 2002; 122 160–6.

[2]  Smyth ETM, Mcllvenry G, Enstone JE, Emmerson AM, Humphreys H, Ftizpatrick F, et al Four country healthcare associated infection prevalence survey 2006: overview of the results. J Hosp Infect 2008; 69 230–48.
Four country healthcare associated infection prevalence survey 2006: overview of the results.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1cngsVWnsA%3D%3D&md5=3d303df34da8d387aa4b1c7638be0cf8CAS |

[3]  Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan P. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol 2011; 32 101–14.
Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs.Crossref | GoogleScholarGoogle Scholar | 21460463PubMed |

[4]  WHO. Prevention of hospital-acquired infections: a practical guide. 2nd edn. Geneva, Switzerland: World Health Organization; 2002.

[5]  Vergis EN, Hayden MK, Chow JW, Snydman DR, Zervos MJ, Linden PK, et al Determinants of vancomycin resistance and mortality rates in enterococcal bacteremia. A prospective multicenter study. Ann Intern Med 2001; 135 484–92.
Determinants of vancomycin resistance and mortality rates in enterococcal bacteremia. A prospective multicenter study.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3MXns1KitL4%3D&md5=1366feec3a0d45a1ad29bb29231efe41CAS | 11578151PubMed |

[6]  Phaneuf M, Gadbois C. Les infections nosocomiales – Agir ensemble pour des milieux cliniques sains et sécuritaires. La gestion des risques 1ère partie. Infiressources; 2010.

[7]  Vigeant P, Lévesque S, Bourgault A. Surveillance provinciale de nouveaux cas d’entérocoque résistant à la vancomycine (ERV): septembre 2009-août 2010. Quebec: Institut National de Santé Publique du Québec; 2010.

[8]  Thibault M. Les infections nosocomiales: L’importance d’un suivi épidémiologique et de l’identification rapide des bactéries en cause: Exemple de quelques techniques de diagnostic permettant cette identification précoce, in Faculté de Pharmacie, Université Joseph Fourier: Grenoble; 2011

[9]  Diekema D, Dodgson K, Sigurdardottir B, Pfaller M. Rapid detection of antimicrobial-resistant organism carriage: an unmet clinical need. J Clin Microbiol 2004; 42 2879–83.
Rapid detection of antimicrobial-resistant organism carriage: an unmet clinical need.Crossref | GoogleScholarGoogle Scholar | 15243032PubMed |

[10]  Cloutier J. Qu’est ce que l’innovation sociale? Collection Working Papers. Montréal: Cahiers du CRISES . Université du Québec à Montréal; 2003.

[11]  Osborne S. Naming the beast: defining and classifying service innovations in social policy. Hum Relat 1998; 51 1133–54.
Naming the beast: defining and classifying service innovations in social policy.Crossref | GoogleScholarGoogle Scholar |

[12]  Rogers EM. Diffusion of innovations. 5th edn. New York: Free Press: 2003.

[13]  Djellal F, Gallouj F. Mapping innovations dynamics in hospitals. Res Policy 2005; 34 817–35.
Mapping innovations dynamics in hospitals.Crossref | GoogleScholarGoogle Scholar |

[14]  Pierre-Seguin A. Les discours d’accompagnement du changement: Comment passer de la persuasion à la création d’un contexte favorable à l’appropriation? in Département des sciences de l’information et de la communication. Université Rennes 2: Haute Bretagne; 2007.

[15]  Simpson DD, Flynn PM. Moving innovations into treatment: a stage-based approach to program change. J Subst Abuse Treat 2007; 33 111–20.
Moving innovations into treatment: a stage-based approach to program change.Crossref | GoogleScholarGoogle Scholar | 17434704PubMed |

[16]  Atun R, De Jongh T, Secci F, Ohiri K, Adeyi O. Integration of targeted health interventions into health systems: a conceptual framework for analysis. Health Policy Plan 2010; 25 104–11.
Integration of targeted health interventions into health systems: a conceptual framework for analysis.Crossref | GoogleScholarGoogle Scholar | 19917651PubMed |

[17]  Drolet B, Lorenzi N. Translational research: understanding the continuum from bench to bedside. Transl Res 2011; 157 1–5.
Translational research: understanding the continuum from bench to bedside.Crossref | GoogleScholarGoogle Scholar | 21146144PubMed |

[18]  Gagnon F, Turgeon J, Dallaire C. Health public policy: a conceptual cognitive framework. Health Policy 2007; 81 42–55.
Health public policy: a conceptual cognitive framework.Crossref | GoogleScholarGoogle Scholar | 16793169PubMed |

[19]  Sudsawad P. A conceptual framework to increase usability of outcome research for evidence-based practice. Am J Occup Ther 2005; 59 351–5.
A conceptual framework to increase usability of outcome research for evidence-based practice.Crossref | GoogleScholarGoogle Scholar | 15969283PubMed |

[20]  Biron A, Richer M, Ezer H. A conceptual framework contributing to nursing administration and research. J Nurs Manag 2007; 15 188–96.
A conceptual framework contributing to nursing administration and research.Crossref | GoogleScholarGoogle Scholar | 17352702PubMed |

[21]  Zimmerman PA, Yeatman H, Jones M. Frameworks to assist adoption of infection prevention and control programmes. Does the literature exist? Healthc Infect 2011; 16 129–34.
Frameworks to assist adoption of infection prevention and control programmes. Does the literature exist?Crossref | GoogleScholarGoogle Scholar |

[22]  Mitchell BG, Gardner A. Addressing the need for an infection prevention and control framework that incorporates the role of surveillance: a discussion paper. J Adv Nurs 2013; 70 533–42.
Addressing the need for an infection prevention and control framework that incorporates the role of surveillance: a discussion paper.Crossref | GoogleScholarGoogle Scholar | 23789617PubMed |

[23]  Eliott P. Infection control: a psychosocial approach to changing practice. Oxford: Radcliffe Publishing Ltd; 2009.

[24]  Krein SL, Olmsted RN, Hofer TP, Kowalski C, Forman J, Banszak-Holl J, et al Translating infection prevention evidence into practice using quantitative and qualitative research. Am J Infect Control 2006; 34 507–12.
Translating infection prevention evidence into practice using quantitative and qualitative research.Crossref | GoogleScholarGoogle Scholar | 17015156PubMed |

[25]  Saint S, Howell JD, Krein SL. How to jumpstart infection prevention. Infect Control Hosp Epidemiol 2010; 31 S14–7.
How to jumpstart infection prevention.Crossref | GoogleScholarGoogle Scholar | 20929360PubMed |

[26]  Chau P, Tam K. Factors affecting the adoption of open systems: an exploratory study. Manage Inf Syst Q 1997; 21 1–24.
Factors affecting the adoption of open systems: an exploratory study.Crossref | GoogleScholarGoogle Scholar |

[27]  Lapointe L. L’adoption de systèmes d’information cliniques par les médecins et les infirmières: Une étude des variables individuelles, socio-politiques et organisationnelles, in École des HEC. Montréal: Université de Montréal;1999.

[28]  Arena L. Adoption, implantation et généralisation d’une nouvelle technologie: une interprétation en termes de changement stratégique.In Sciences de gestion. Nice:Université de Nice Sophia-Antipolis; 2009.

[29]  Rye C, Kimberly J. The adoption of innovations by provider organizations in health care. Med Care Res Rev 2007; 64 235–78.
The adoption of innovations by provider organizations in health care.Crossref | GoogleScholarGoogle Scholar | 17507458PubMed |

[30]  Robert G, Greenhalgh T, MacFarlane F, Peacock R. Adopting and assimilating new non-pharmaceutical technologies into health care: a systematic review. J Health Serv Res Policy 2010; 15 243–50.
Adopting and assimilating new non-pharmaceutical technologies into health care: a systematic review.Crossref | GoogleScholarGoogle Scholar | 20592046PubMed |

[31]  Ferlie E, Fitzgerald L, Woods M. Getting evidence into clinical practice: an organizational behaviour perspective. J Health Serv Res Policy 2000; 5 96–102.
| 1:STN:280:DC%2BD3M%2FgsVGgug%3D%3D&md5=184ff681a931930beaa1c05bf82eda2cCAS | 10947554PubMed |

[32]  Denis JL, Hébert Y, Langley A, Lozeau D, Trottier LH. Explaining diffusion patterns for complex health care innovations. Health Care Manage Rev 2002; 27 60–73.
Explaining diffusion patterns for complex health care innovations.Crossref | GoogleScholarGoogle Scholar | 12146784PubMed |

[33]  Tremblay D. La traduction d’une innovation organisationnelle dans les pratiques professionnelles de réseau: l’infirmière pivot en oncologie, in Sciences infirmières: Administration des services infirmiers 2007. Montréal: Université de Montréal; 2007.

[34]  Callon M. Éléments pour une sociologie de la traduction – La domestication des coquilles Saint-Jacques et des marins-pêcheurs en baies de Saint-Brieuc. Annee Sociol 1986; 36 169–208.

[35]  Latour B. Science in action. Milton Keynes: Open University Press; 1987.

[36]  Callon M, Latour B. Les paradoxes de la modernité: comment concevoir les innovations? Prospect Sante 1986; 36 13–25.

[37]  Robert G, Greenhalgh T, MacFarlane F, Peacock R. Organizational factors influencing technology adoption and assimilation in the NHS: a systematic literature review . London: National Institute for Health Research Service Delivery and Organisation; 2009.

[38]  Latour B. La Science en action. Paris: La Découverte; 1989.

[39]  Rouleau L. Théories des organisations: approches classiques, contemporaines et de l’avant-garde. Sainte-Foy: Presses de l’Université du Québec; 2007.

[40]  Lehoux P. La contribution de la théorie des réseaux d’actants à l’évaluation des technologies de la santé. Montréal: Université de Montréal; 1996.

[41]  Akrich M, Callon M, Latour B. The key to success in innovation part I. The art of interessement. Int J Innov Manage 2002a; 6 187–206.
The key to success in innovation part I. The art of interessement.Crossref | GoogleScholarGoogle Scholar |

[42]  Akrich M, Callon M, Latour B. The key to success in innovation part II. The art of choosing good spokespersons. Int J Innov Manage 2002b; 6 207–25.
The key to success in innovation part II. The art of choosing good spokespersons.Crossref | GoogleScholarGoogle Scholar |

[43]  Akrich M, Callon M, Latour B. À quoi tient le succès des innovations. Gérer et comprendre 1988b; 97 14–29.

[44]  Aubry F, Potvin L. Construire l’espace sociosanitaire: expériences et pratiques de recherche dans la production locale de la santé . Montréal: Les Presses de l’Université de Montréal; 2012.

[45]  Akrich M, Callon M, Latour B. Sociologie de la traduction-Textes fondateurs. Paris: Presses de l’École des mines; 2006.

[46]  Landry R, Becheikh N, Amara N, Halilem N, Jbilou J, Mosconi E, et al. Innovation dans les services publics et parapublics à vocation sociale: Rapport de la revue systématique des écrits, in Transfert des connaissances et l’innovation. Québec: C FCRSS/IRSC; 2007.

[47]  Bernoux P. Théories sociologiques et transformations des organisations, in Les sciences économiques et sociales; 2006.

[48]  Latour B. La science en action. Introduction à la sociologie des sciences. Paris: La Découverte; 2005a.

[49]  Reix R. Changements organisationnels et technologies de l’information, cahiers du GREGO (Montpellier 2), no. 12. Conference 2002, October 28. University Saint-Joseph. Beirut, Lebanon; 2002.

[50]  Murray E, Holmes A. Addressing healthcare-associated infections and antimicrobial resistance from an organizational perspective: progress and challenges. J Antimicrob Chemother 2012; 67 i29–36.
Addressing healthcare-associated infections and antimicrobial resistance from an organizational perspective: progress and challenges.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhtFCktL7P&md5=6a1a1b7d2b8f27765e25f847287f7572CAS | 22855876PubMed |

[51]  Bradley E, Webster T, Baker D, Schlesinger M, Inouye S, Barth M, et al Translating research into practice: speeding the adoption of innovative health care programs. Issue Brief (Commonw Fund) 2004; 724 1–12.
| 15270051PubMed |

[52]  Forman J, Creswell JW, Damschroder L, Kowalski CP, Krein SL. Qualitative research methods: key features and insights gained from use in infection prevention research. Am J Infect Control 2008; 36 764–71.
Qualitative research methods: key features and insights gained from use in infection prevention research.Crossref | GoogleScholarGoogle Scholar | 18834752PubMed |

[53]  McLean C, Hassard J. Symmetrical absence/symmetrical absurdity: critical notes on the production of actor network theory. J Manage Stud 2004; 41 493–519.
Symmetrical absence/symmetrical absurdity: critical notes on the production of actor network theory.Crossref | GoogleScholarGoogle Scholar |

[54]  Greenhalgh T, Robert G, Bate S, MacFarlane F, Kyriakidou O. Diffusion of innovations in health service organizations. Oxford: Blackwell: 2005.

[55]  Greenhalgh T, Stones R. Theorising big IT programmes in healthcare: strong structuration theory meets actor-network theory Soc Sci Med 2010; 70 1285–94.
Theorising big IT programmes in healthcare: strong structuration theory meets actor-network theoryCrossref | GoogleScholarGoogle Scholar | 20185218PubMed |

[56]  Brooks L, Atkinson C. StructurANTion in research and practice. In Kaplan B, Truex DP, Wastell D, Wood‐Harper AT, DeGross JI, eds. Information systems research. Norwell, MA: Kluwer Academic Publishers; 2004. pp. 389–409.

[57]  Samarawickrema G, Stacey E. Adopting web-based learning and teaching: a case study in higher education. Distance Educ 2007; 28 313–33.
Adopting web-based learning and teaching: a case study in higher education.Crossref | GoogleScholarGoogle Scholar |

[58]  Cresswell K, Worth A, Sheikh A. Implementing and adopting electronic health records: how actor‐network theory can support evaluation. Clin Gov 2011; 16 320–36.
Implementing and adopting electronic health records: how actor‐network theory can support evaluation.Crossref | GoogleScholarGoogle Scholar |