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Table 2 Implementation stages and fidelity criteria of the process based on Glasziou and Haynes et al. [72])a

From: Study protocol for a cluster randomised controlled trial to assess the effectiveness of user-driven intervention to prevent aggressive events in psychiatric services

Implementation stage Fidelity criteria
Acceptance
A one-day workshop (X2) for ward managers and contact persons will be organised by the trial team; the results of the information collected at baseline will be shared; preliminary action plans for units will be designed; queries from the staff will be answered.
A local ward meeting will be organised by the senior ward manager and a contact person on each intervention ward. House rules for patients will be collected and analysed from each ward.
At least one ward manager/contact person in each intervention unit will attend the one-day workshops (1st and 2nd workshop) (80%).
The first local meetings will be organised and documented on each ward (100%).
House rules will be analysed (100%).
Applicable
A series of local meetings with staff members, patients, and relatives will be organised by the trial team; areas to be developed and specific steps to be taken will be identified; barriers and facilitating factors for change will be described; strengths, weaknesses, opportunities, and threats related to the educational intervention will be identified through a SWOT analysis.
The first outreach visit on each ward will be organised (100%).
At least 50% of staff on each ward will attend the first outreach visit.
Available
An information package of an intervention to support staff’s competence will be available.
An Action Plan for each ward will be developed (100%); the content of the information package will be shared with the staff (100%).
Able
Monthly monitoring/support calls/emails by the trial team will prompt and encourage changes on the wards.
Ward managers/contact persons or senior ward managers will report the progress of the changes (including harms) by email/telephone (12 calls or email/12 months; 100%).
Acted on
The trial team will visit each ward to give hands-on support to staff members, ward managers and contact persons so that they will gain confidence in implementing the new ideas on the wards. The Action Plan will be revised if needed.
A one-day workshop for an Interim Evaluation Seminar will be organised.
The second outreach visit on each ward will be organised. At least 50% of the staff on the ward will attend the visits.
The third workshop will be organised to review the implementation process; at least one person from each unit will attend (Interim Evaluation) (95%).
Agreed on
Outcome assessment and house rules will be analysed by staff members and the trial team; possible differences in previous and current actions will be identified.
Patient coercive methods and house rules will be analysed (100%).
Adhered to
Daily practices will be monitored by the trial team.
The final workshop will be organised.
Daily practices will be monitored and outcomes of the intervention will be evaluated in a meeting on each ward.
The third outreach visit on each ward will be organised. At least 50% of the staff on the ward will attend the visits.
At least one senior ward manager/contact person in each intervention unit will attend (95%) the fourth workshop.
  1. aKillaspy et al. [74]