Table 1 Characteristics of included studies
| Â | Larson | Kinjerski |
|---|---|---|
Study design | CBA | CBA |
Providers | Manager, medical and nurse leaders | RNs; LPNs; RNAs; other (admin, housekeeping, food service, physio) |
Patients | Adult and neonatal | Elderly long-term care residents |
Setting | Two hospitals in mid-Atlantic region | Two long-term care units, Canada |
Unit of allocation | Adult intensive care unit (ICU) and neonatal ICU | Long-term care unit |
Unit of analysis | Hospital | Long-term care unit |
Intervention | Top-level administrative intervention using a framework for changing organisational culture. Interventions included dissemination of key messages, marketing approaches (distribution of samples), education interventions, audit and feedback, opinion leaders (supervisors). | Organizational intervention through education sessions to 'boost morale' and improve provider satisfaction with their work, offering psychic rewards. - 1-day workshop on 'cultivating spirit at work in long-term care' - 1-hour booster sessions each week at shift changes |
Control | Standard care | Standard care |
Target behaviour | Handwashing practice | Employee spirit at work, employee wellness, job satisfaction, organizational commitment, turnover, absenteeism. |
Outcomes | a) Handwashing frequency b) Nosocomial infection associated with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). | a) Health professional outcomes/process measures: decrease in turnover and absenteeism; improved employee spirit at work, employee wellness, job satisfaction and organizational commitment. b) Patient outcomes: increased focus on residents with implications for Quality of Care (not stated as an outcome to be measured, but reported on as a result of the program). |
Risk of Bias assessment | ||
Allocation sequence adequately generated | NO | NO |
Allocation adequately concealed | NO | NO |
Baseline outcome measurements similar | NO | YES |
Baseline characteristics similar | UNCLEAR | UNCLEAR |
Incomplete outcome data adequately addressed | YES | YES |
Knowledge of the allocated interventions adequately prevented | NO | NO |
Protection against contamination | UNCLEAR | UNCLEAR |
Free from selective outcome reporting | YES | UNCLEAR |
Free from other risks of bias | NO (one site CBA) | NO (one site CBA) |