REVERSE (pREVention and management tools for rEducing antibiotic Resistance in high prevalence Settings) – WP5 Implementation

REVERSE (pREVention and management tools for rEducing antibiotic Resistance in high prevalence Settings) is a European stepped wedge hybrid type 2 cluster randomized trial involving a consortium of 12 institutions, coordinated by PD Dr. med. Walter Zingg. The implementation work package (WP5) is lead by Prof. Lauren Clack

Increasing healthcare-associated infections (HAIs) are a significant healthcare problem. Contributing to this issue are the globally rising antimicrobial resistance rates – a public health challenge that limits the therapeutic options for treatment. The REVERSE study is aimed at reducing HAIs due to multidrug-resistant organisms in 24 acute care hospitals located in Greece, Italy, Romania, and Spain by combining the implementation of two clinical practice bundles: Infection Prevention and Control (IPC) and Antibiotic Stewardship (ABS).

Next to assessing the effectiveness of IPC and ABS in reducing HAI in these hospitals, the REVERSE WP5 implementation research team, based at the Institute for Implementation Science in Health Care at the University of Zurich, focuses on the effectiveness of externally facilitated tailoring as the central implementation strategy for IPC and ABS implementation, and its influence on IPC and ABS feasibility, usability, fidelity, and sustainability. In REVERSE, tailoring is described as the prospective identification of implementation determinants, deliberate selection of implementation strategies that match these determinants, resulting in continuous adjustment of implementation work to integrate IPC and ABS into routine practice.

REVERSE will contribute to the scarce knowledge base of tailoring effectiveness for the implementation of clinical practice bundles into routine health care. Additionally, by braiding IPC and ABS interventions, and integrating their implementation to reduce HAI, REVERSE may inform future efforts in reducing antibiotic resistance in European acute care hospitals.