Table 1 Powell and colleagues’ Expert Recommendations for Implementing Change (ERIC) framework strategies concordant with those emerging from PVI administration in the studied orthopedic trauma surgery setting

Conducting educational outreach visits

Have a trained person meet with providers in their practice settings to educate providers about the clinical innovation with the intent of changing the provider’s practice.

The research team facilitated the intervention by conducting outreach visits to the DOSA and the hospital units at the beginning of the study and modeling appropriate PVI administration procedures for staff.

Distributing educational materials

Distribute educational materials (including guidelines, manuals, and toolkits) in person, by mail, and/or electronically.

A poster hanging in the medication room, which showed how to apply PVI to patients’ nares, served as a quick reference for the nurses.

Evidence-based justification for nasal PVI facilitated implementation.

Involving patients/consumers and family members in the intervention

Engage or include patients/consumers and families in the implementation effort

Interviewees suggested that patients would be less apprehensive about using PVI swabs in the COVID-19 context if patients had the option to self-administer the PVI.

Remind clinicians

Develop reminder systems designed to help clinicians to recall information and/or prompt them to use the clinical innovation.

The PVI order in the medication section of the EMR reminded nurses to administer the PVI.

Promote adaptability

Identify the ways a clinical innovation can be tailored to meet local needs and clarify which elements of the innovation must be maintained to preserve fidelity.

The preloaded PVI swabs facilitated easy, rapid, and non-invasive application in patients’ nares and, thereby, facilitated its integration into existing infection prevention protocols included in the nurses’ workflow.