Barriers and Enablers to Implementing Clinical Treatment Protocols for Fever, Hyperglycaemia, and Swallowing Dysfunction in the Quality in Acute Stroke Care (QASC) Project—A Mixed Methods Study

ABSTRACT BackgroundThe Quality in Acute Stroke Care (QASC) trial evaluated systematic implementation of clinical treatment protocols to manage fever, sugar, and swallow (FeSS protocols) in acute stroke care. This cluster‐randomised controlled trial was conducted in 19 stroke units in Australia. AimTo describe perceived barriers and enablers preimplementation to the introduction of the FeSS protocols and, postimplementation, to determine which of these barriers eventuated as actual barriers. MethodsPreimplementation: Workshops were held at the intervention stroke units (n = 10). The first workshop involved senior clinicians who identified perceived barriers and enablers to implementation of the protocols, the second workshop involved bedside clinicians. Postimplementation, an online survey with stroke champions from intervention sites was conducted. ResultsA total of 111 clinicians attended the preimplementation workshops, identifying 22 barriers covering four main themes: (a) need for new policies, (b) limited workforce (capacity), (c) lack of equipment, and (d) education and logistics of training staff. Preimplementation enablers identified were: support by clinical champions, medical staff, nursing management and allied health staff; easy adaptation of current protocols, care‐plans, and local policies; and presence of specialist stroke unit staff. Postimplementation, only five of the 22 barriers identified preimplementation were reported as actual barriers to adoption o...
Source: Worldviews on Evidence-Based Nursing - Category: Nursing Authors: Tags: Original Article Source Type: research