Safe Hands at the Sharp End- Implementing Aseptic Technique in the Operating Room, A Prospective Controlled Study With an Embedded Process Evaluation

PROJECT DESCRIPTION

Aim The aim of this iKT study is to develop and test a multifaceted implementation intervention for feasibility, acceptability and effectiveness.The intervention will be tailored to fit the inner context of the operating department, to promote anaesthetic providers use of aseptic techniques.

Theory In designing the present study, the investigators followed the four iterative phases as identified by the UK Medical Research Council (MRC) framework for developing and evaluating complex interventions(1): *Review of the theoretical basis for the innovation and the context *Conducting pre studies and designing the intervention,*The exploratory trial i.e. the intervention implementation and evaluation.

The aim of the leadership intervention is to support the leaders in developing a participatory and effective leadership behaviours that promote the OR team's use of aseptic techniques and facilitate inter professional learning. The middle and front-line leaders of the study OR will participate in an intervention based on an iKT model inspired by person-centeredness (2) social construction and complexity thinking (3). The care professionals participating in this in this study are considered active partners and co-creators of the implementation process and activities. This type of collaborative approach means that the researchers, leaders and the OR team work closely together throughout the research process in order to produce findings that are relevant for users and context (4). Using this innovative approach represents a major departure from the concept of 'compliance' and a shift towards change as a result of a participatory and mindful processes (5). In the inter-professional dialogues, the following principles will underpin the process:

• All partners are experts with various professional experiences,
• Power differentials among partners are acknowledged and sensitively addressed,
• All partners discuss potential benefits and harm of the innovation, research and implementation strategy,
• The process is capacity-building for everyone and encompasses opportunities for mutual learning (4).