Work

From plan to practice: a structured report on implementation strategies for preventing non-ventilator hospital-acquired pneumonia (nvHAP)

Year: 2026

Type: article

Abstract: BACKGROUND: There is increasing evidence on the effectiveness of prevention bundles against non-ventilator hospital-acquired pneumonia (nvHAP), but detailed reports on their implementation are lacking. This study aims to describe and structure the implementation activities undertaken in a single-center multimodal intervention that achieved a 31% reduction in nvHAP incidence. DESIGN: Longitudinal descriptive qualitative study. SETTING: Nine medical and surgical departments of a Swiss university hospital. PARTICIPANTS: Healthcare professionals and implementation teams in study departments. METHODS: We collected longitudinal data on implementation activities using (1) implementation activity logs, (2) drop-in interviews and observations, (3) "action plan meetings," (4) focus groups, and (5) unstructured recall sessions among the project team. Data were deductively coded using the "Expert Recommendations for Implementing Change" taxonomy, specified using Proctor et al.'s "Recommendations for specifying and reporting implementation strategies" and mapped to the "Exploration, Preparation, Implementation, Sustainment" framework phases. RESULTS: A total of 174 activities were undertaken. Activities varied by implementation phase, most frequently involving "evaluative and iterative strategies," "develop stakeholder interrelationship strategies" and "training and education of stakeholders" during Exploration, Preparation, and Implementation, respectively. During Implementation, 54% of activities were initiated by department nurses, and 27% were initiated by the institutional implementation team. Activities included interdisciplinary kick-off events, education in various formats, posters, informational stickers for patients, provision of new equipment (e.g., toothbrushes), and electronic medical records order sets. CONCLUSIONS: This report offers valuable insights for future implementation efforts by providing a structured overview of the concrete implementation activities performed in a successful one-hospital multimodal nvHAP prevention project.

Source: Infection Control and Hospital Epidemiology

DOI: 10.1017/ice.2026.10422

Authors: Aline Wolfensberger, Mirjam Faes Hesse, Hugo Sax, Lauren Clack

Institutions: University of Zurich, University Hospital Zurich, University of Bern, University Hospital of Bern

Language: English

Topic: Health Policy Implementation Science

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,550