HOMEFREE : Scaling‐Up Evidence‐Based Guidelines for IV ‐to‐Oral Antibiotic Switch in Hospitalised Children, an Implementation Study Protocol

Le résumé fourni par la source

BACKGROUND: Around half of children admitted to hospital receive intravenous (IV) antibiotics, contributing to higher costs, vascular access complications and longer hospital stays. A single-site pilot in a tertiary Australian paediatric hospital implemented nationally endorsed Australasian Stewardship of Antimicrobials in Paediatrics (ANZPID-ASAP) IV-to-oral antibiotic switch guidelines, improving timely switch rates from 64% to 82%. Following this success, a broader study is planned to assess the feasibility of scaling this approach across hospitals of varying types and sizes within NSW, Australia. AIMS: The HOMEFREE study hypothesises that implementation of an IV-to-oral antibiotic switch programme based on endorsed guidelines and supported by audit and feedback will increase the proportion of hospitalised children transitioned to oral therapy or antibiotic cessation within 24 h of meeting eligibility criteria. The study will evaluate both effectiveness and implementation feasibility across tertiary paediatric and general hospitals in metropolitan and rural/regional settings. This paper presents the study protocol. METHODS: Participating sites will select context-appropriate interventions to support guideline-concordant prescribing, informed by shared learning during the prospective phase. Effectiveness will be assessed using prospective audits, with key outcomes including timely guideline-concordant IV-to-oral switch and hospital length of stay. Implementation feasibility will be evaluated using the Consolidated Framework for Implementation Research through surveys of local project committee members conducted before and after 12 months of audit and feedback. CONCLUSIONS: This study will assess the effectiveness and feasibility of translating and scaling best-practice IV-to-oral antibiotic switch guidelines for children in real-world hospital settings.

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