Contextual Factors Influencing Implementation of Evidence-Based Care for Children Hospitalized With Asthma.

Autor:	Nkoy FL; Department of Pediatrics University of Utah, Salt Lake City, Utah; flory.nkoy@hsc.utah.edu., Wilkins VL; Department of Pediatrics University of Utah, Salt Lake City, Utah., Fassl BA; Department of Pediatrics University of Utah, Salt Lake City, Utah., Johnson JM; Intermountain Healthcare, Salt Lake City, Utah; and., Uchida DA; Department of Pediatrics University of Utah, Salt Lake City, Utah., Poll JB; Intermountain Healthcare, Salt Lake City, Utah; and., Greene TH; Department of Pediatrics University of Utah, Salt Lake City, Utah., Koopmeiners KJ; Intermountain Healthcare, Salt Lake City, Utah; and., Reynolds CC; Intermountain Healthcare, Salt Lake City, Utah; and., Valentine KJ; Intermountain Healthcare, Salt Lake City, Utah; and., Savitz LA; Intermountain Healthcare, Salt Lake City, Utah; and., Maloney CG; Children's Hospital and Medical Center, Omaha, Nebraska., Stone BL; Department of Pediatrics University of Utah, Salt Lake City, Utah.
Jazyk:	angličtina
Zdroj:	Hospital pediatrics [Hosp Pediatr] 2019 Dec; Vol. 9 (12), pp. 949-957. Date of Electronic Publication: 2019 Nov 06.
DOI:	10.1542/hpeds.2019-0050
Abstrakt:	Background and Objectives: The translation of research findings into routine care remains slow and challenging. We previously reported successful implementation of an asthma evidence-based care process model (EB-CPM) at 8 (1 tertiary care and 7 community) hospitals, leading to a high health care provider (HCP) adherence with the EB-CPM and improved outcomes. In this study, we explore contextual factors perceived by HCPs to facilitate successful EB-CPM implementation. Methods: Structured and open-ended questions were used to survey HCPs ( n = 260) including physicians, nurses, and respiratory therapists, about contextual factors perceived to facilitate EB-CPM implementation. Quantitative analysis was used to identify significant factors (correlation coefficient ≥0.5; P ≤ .05) and qualitative analysis to assess additional facilitators. Results: Factors perceived by HCPs to facilitate EB-CPM implementation were related to (1) inner setting (leadership support, adequate resources, communication and/or collaboration, culture, and previous experience with guideline implementation), (2) intervention characteristics (relevant and applicable to the HCP's practice), (3) individuals (HCPs) targeted (agreement with the EB-CPM and knowledge of supporting evidence), and (4) implementation process (participation of HCPs in implementation activities, teamwork, implementation team with a mix of expertise and professional's input, and data feedback). Additional facilitators included (1) having appropriate preparation and (2) providing education and training. Conclusions: Multiple factors were associated with successful EB-CPM implementation and may be used by others as a guide to facilitate implementation and dissemination of evidence-based interventions for pediatric asthma and other chronic diseases in the hospital setting. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2019 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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