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The 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 approximately 4050 patients per month. The study aims to improve quality and safety by reducing adverse events, improving patient experiences, and strengthening clinical communication.

Last updated: Aug 26, 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

Implementation of standardized HIRAID® Inpatient framework
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Nurses use structured assessment and decision-making tools
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Improved recognition and response to clinical deterioration
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Reduction in preventable adverse events and complications

Limitations

  • ⚠Results are not yet available as this is a protocol paper
  • ⚠Stepped-wedge design may introduce temporal confounding or contamination between clusters

Frequently Asked Questions

What is the HIRAID® Inpatient framework?▼

It is a standardized, evidence-informed 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 study?▼

The study involves 10 hospitals, 35 inpatient wards, and 1259 nurses across three health services in two Australian states.

What outcomes will be measured to evaluate the framework?▼

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

Is this study a randomized controlled trial?▼

Yes, it uses a stepped-wedge cluster randomized controlled trial design (Type II hybrid effectiveness-implementation) with four clusters determined by geography and clinical governance.

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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.