Speaker
Description
Objective: To identify barriers and facilitators to the implementation of prevention of central line associated bloodstream infections (CLABSI) in intensive care units (ICU) based on the Consolidated Framework for Implementation Research (CFIR).
Methods: We conducted a descriptive qualitative study. The semistructured face-to-face interviews were performed to collect data, guided by the Consolidated Framework for Implementation Research (CFIR). Doctors and nurses involved in CLABSI prevention in four types of ICUs were selected to participate in this study. The interview data was analyzed using a qualitative content analysis (QCA) method.
Results: Four domains of 'Innovation’, ‘Outer Setting’, ‘Inner Setting’, and ‘Individuals’ have an impact on implementation. The findings highlighted 21 implementation determinants of the prevention of CLABSI in ICUs, including 8 barriers and 13 facilitators. Barriers mainly included the uncertain feasibility of recommended measures, lack of consistency and updating in local policies, and lack of the recommended medical supplies, knowledge, and skills. Facilitators mainly included the atmosphere of positive innovation, the attention, and support from the leader, the professional multidisciplinary implementation team, and receptive patients.
Conclusion: Based on the CFIR theoretical framework, we identified barriers and facilitators to the successful implementation of CLABSI prevention through a system thinking approach. Tailored interventions should be developed to overcome barriers. Leaders should fully assess the feasibility of the items in the local context before implementation, develop the relevant local policies to improve rationality, and provide the necessary supplies, training, and supervision to improve adherence. Meanwhile, incentives should be developed to reinforce facilitators.
What RNAO BPG or tool/toolkit is this work related to:
REGISTERED NURSES’ ASSOCIATION OF ONTARIO Toolkit: Implementation of Best Practice Guidelines
Keywords
Barrier, Consolidated Framework for Implementation Research, Facilitator, Intensive care unit, Prevention of central line associated bloodstream infection
Author(s) Credentials and Title
Hourui Ge, a Graduate student at the Peking University School of Nursing
Jing Li, chief superintendent nurse at the Peking University First Hospital
| Organization Name | Peking University School of Nursing |
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