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HIRAID Inpatient framework reduces preventable nurse-associated clinical deterioration and hospital-acquired complications in acutely unwell inpatients

This protocol describes a stepped-wedge cluster RCT evaluating the HIRAID Inpatient framework across 35 wards in 10 hospitals with 1259 nurses and 4050 patients per month. The study aims to reduce preventable nurse-associated clinical deterioration and hospital-acquired complications by standardizing nursing assessment, decision-making, and communication.

Last updated: Jul 7, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Implementation evaluation of an evidence-informed hospital inpatient nursing framework (HIRAID® Inpatient): a protocol for a stepped-wedge cluster RCT.

observational

Curtis K, Considine J, Lam MK, Wiseman T, McPhail S, Jones T, Mulholland B, Trostian B, Wright K, Kourouche S, Kennedy B, Clements A, Melville G, Ashford B, Brereton CJ, Bartlett A, Wand T, Pettigrew C, Zeitz K, Mitchell RJ, Shetty A, Lingam M, Saddington E, O'Reilly G, Smith S, Watts M, Shaban RZ · Trials (2026)

Participants: N/A
Duration: Not specified in abstract
Intervention: HIRAID® Inpatient framework (standardized, evidence-informed nursing assessment, decision-making, and action framework adapted for hospital inpatient settings)
Outcome: Rates of preventable nurse-associated clinical deterioration, hospital-acquired complications, patient and carer experiences with care, quality of nursing documentation and communication
Effect Size: N/A (protocol only; effect sizes not yet reported)
Population: Acutely unwell inpatients admitted to 35 wards across 10 hospitals in two Australian states, with 1259 nurses and 4050 patients per month

Result:

PubMed: 41339957DOI: 10.1186/s13063-025-09313-8

Mechanism Graph

Standardized nursing assessment framework implemented
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Nurses use evidence-informed decision-making and action protocols
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Improved recognition and response to clinical deterioration
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Reduced adverse events and improved patient safety

Limitations

  • ⚠Results are not yet available as this is a protocol paper
  • ⚠Stepped-wedge design may introduce temporal confounding if secular trends occur
  • ⚠Implementation fidelity may vary across 35 wards and 10 hospitals

Frequently Asked Questions

What is the HIRAID Inpatient framework?▼

It is an evidence-informed, standardized nursing framework for assessment, decision-making, and action adapted for hospital inpatient settings to improve patient safety.

How many hospitals and nurses are involved in this trial?▼

The trial involves 10 hospitals across three health services in two Australian states, with 1259 nurses from 35 inpatient wards.

What outcomes will be measured?▼

Primary outcomes include rates of preventable nurse-associated clinical deterioration, hospital-acquired complications, patient and carer experiences, and quality of nursing documentation and communication.

When will results be available?▼

This is a protocol paper; results are not yet reported. The trial was registered in June 2025, and the paper is from 2026.

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References

  1. 1.Curtis K, Considine J, Lam MK, Wiseman T, McPhail S, Jones T, Mulholland B, Trostian B, Wright K, Kourouche S, Kennedy B, Clements A, Melville G, Ashford B, Brereton CJ, Bartlett A, Wand T, Pettigrew C, Zeitz K, Mitchell RJ, Shetty A, Lingam M, Saddington E, O'Reilly G, Smith S, Watts M, Shaban RZ. "Implementation evaluation of an evidence-informed hospital inpatient nursing framework (HIRAID® Inpatient): a protocol for a stepped-wedge cluster RCT.." Trials, 2026. PMID: 41339957 DOI: 10.1186/s13063-025-09313-8
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.