Trial design {8}
This study is a stepped wedge randomised controlled study, conducted in 10 wards of one acute Australian hospital over 36 weeks. A stepped wedge design allows all wards to receive the intervention at different times, with each ward acting as its own control. Each cluster will comprise two wards. One cluster will switch to the intervention every 6 weeks. This study design reduces the influences of confounders such as variations in size and case mix and supports feasibility while maintaining rigour. This design also allows research staff to work with individual wards as they adopt the intervention, maximising consistency of intervention and aiding implementation (Fig. The stepped wedge study design. Green (dotted) = control, blue (striped) = intervention