What drives change in Neonatal Intensive Care Units? A qualitative study with physicians and nurses in six European countries

Autor: Rolf F. Maier, Carina Rodrigues, Janet Willars, Asbjørn Hasselager, Agnès Lainé, Marina Cuttini, Ileana Croci, Elizabeth S Draper, Jennifer Zeitlin, Mercedes Bonet, Ana F. Martins, Emanuela Forcella
Přispěvatelé: Clinical Care and Management Innovation Research Area [Rome, Italy], Children's Hospital Bambino Gesù IRCCS [Rome], EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal, Department of Health Sciences [Leicester], University of Leicester, INSERM UMR1153 – Obstetrical, Perinatal and Paediatric Epidemiology (EPOPe research team), Institut des Mondes Africains (IMAF), Université Paris 1 Panthéon-Sorbonne (UP1)-Institut de Recherche pour le Développement (IRD)-École des hautes études en sciences sociales (EHESS)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Department of Health Sciences [Leicester, UK], Copenhagen University Hospital Hvidovre [Hvidovre, Danemark], University of Copenhagen = Københavns Universitet (UCPH), Philipps University Marburg, Children Hospital, Instituto de Saúde Pública da Universidade do Porto
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Pediatric Research
Pediatric Research, 2020, 88 (2), pp.257-264. ⟨10.1038/s41390-019-0733-9⟩
ISSN: 0031-3998
1530-0447
DOI: 10.1038/s41390-019-0733-9⟩
Popis: Background: Innovation is important to improve patient care, but few studies have explored the factors that initiate change in healthcare organizations. Methods: As part of the European project EPICE on evidence-based perinatal care, we carried out semi-structured interviews (N = 44) with medical and nursing staff from 11 randomly selected neonatal intensive care units in 6 countries. The interviews focused on the most recent clinical or organizational change in the unit relevant to the care of very preterm infants. Thematic analysis was performed using verbatim transcripts of recorded interviews. Results: Reported changes concerned ventilation, feeding and nutrition, neonatal sepsis, infant care, pain management and care of parents. Six categories of drivers to change were identified: availability of new knowledge or technology; guidelines or regulations from outside the unit; need to standardize practices; participation in research; occurrence of adverse events; and wish to improve care. Innovations originating within the unit, linked to the availability of new technology and seen to provide clear benefit for patients were more likely to achieve consensus and rapid implementation. Conclusions: Innovation can be initiated by several drivers that can impact on the success and sustainability of change. The EPICE project was funded by the European Union's Seventh Framework Programme [FP7/2007−2013] (grant no. 259882). In Portugal, this study was also funded by FEDER through the Operational Programme Competitiveness and Internationalization and from the Foundation for Science and Technology—FCT (Portuguese Ministry of Science, Technology and Higher Education), under the Unidade de Investigação em Epidemiologia—Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; ref.UID/DTP/04750/2013) and the Ph.D. Grant SFRH/BD/111794/2015 (Carina Rodrigues), co-funded by the FCT and the POCH/SE Program.
Databáze: OpenAIRE
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