scholarly journals Barriers and Facilitators to Discussing Goals of Care among Nephrology Trainees: A Qualitative Analysis and Novel Educational Intervention

2020 ◽  
Vol 23 (8) ◽  
pp. 1045-1051
Author(s):  
Devika Nair ◽  
Maie El-Sourady ◽  
Kemberlee Bonnet ◽  
David G. Schlundt ◽  
Joseph B. Fanning ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Educational Intervention ◽  
Barriers And Facilitators ◽  
Goals Of Care

Implementation of ultrasound after central venous catheter insertion: A qualitative study in early adopters

2021 ◽  
pp. 112972982110534
Author(s):  
Enyo A Ablordeppey ◽  
Shannon M Keating ◽  
Katherine M Brown ◽  
Daniel L Theodoro ◽  
Richard T Griffey ◽  
...  
Keyword(s):  
Focus Group ◽  
Central Venous Catheter ◽  
Qualitative Analysis ◽  
Focus Groups ◽  
Venous Catheter ◽  
Barriers And Facilitators ◽  
Central Venous ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Post Procedure

Background: The adoption rate of point of care ultrasound (POCUS) for the confirmation of central venous catheter (CVC) positioning and exclusion of post procedure pneumothorax is low despite advantages in workflow compared to traditional chest X-ray (CXR). To explore why, we convened focus groups to address barriers and facilitators of implementation for POCUS guided CVC confirmation and de-implementation of post-procedure CXR. Methods: We conducted focus groups with emergency medicine and critical care providers to discuss current practices in POCUS for CVC confirmation. The semi-structured focus group interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). We performed qualitative content analysis of the resulting transcripts using a consensual qualitative research approach (NVivo software), aiming to identify priority categories that describe the barriers and facilitators of POCUS guided CVC confirmation. Results: The coding dictionary of barriers and facilitators consisted of 21 codes from the focus group discussions. Our qualitative analysis revealed that 12 codes emerged spontaneously (inductively) within the focus group discussions and aligned directly to CFIR constructs. Common barriers included provider influences (e.g. knowledge and beliefs about POCUS for CVC confirmation), external network (e.g. societal guidelines, ancillary staff, and consultants), and inertia (habit or reflexive processes). Common facilitators included ultrasound protocol advantage and champions. Time and provider outcomes (cognitive offload, ownership, and independence) emerged as early barriers but late facilitators. Conclusion: Our qualitative analysis demonstrates real and perceived barriers against implementation of POCUS for CVC position confirmation and pneumothorax exclusion. Our findings discovered organizational and personal constructs that will inform development of multifaceted strategies toward implementation of POCUS after CVC insertion.

A psycho-educational intervention for depressed women: A qualitative analysis of the process

2004 ◽  
Vol 77 (4) ◽  
pp. 429-447 ◽  
Author(s):  
Ma. Asunción Lara ◽  
Claudia Navarro ◽  
Maricarmen Acevedo ◽  
Shoshana Berenzon ◽  
Liliana Mondragón ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Educational Intervention

scholarly journals Barriers and Facilitators to Implementation of Medication Decision Support Systems in Electronic Medical Records: Mixed Methods Approach Based on Structural Equation Modeling and Qualitative Analysis (Preprint)

2020 ◽  
Author(s):  
Se Young Jung ◽  
Hee Hwang ◽  
Keehyuck Lee ◽  
Ho-Young Lee ◽  
Eunhye Kim ◽  
...  
Keyword(s):  
Structural Equation Modeling ◽  
Decision Support ◽  
Quantitative Analysis ◽  
Qualitative Analysis ◽  
Structural Equation ◽  
Adverse Drug Events ◽  
Ease Of Use ◽  
Barriers And Facilitators ◽  
Equation Modeling ◽  
Successful Implementation

BACKGROUND Adverse drug events (ADEs) resulting from medication error are some of the most common causes of iatrogenic injuries in hospitals. With the appropriate use of medication, ADEs can be prevented and ameliorated. Efforts to reduce medication errors and prevent ADEs have been made by implementing a medication decision support system (MDSS) in electronic health records (EHRs). However, physicians tend to override most MDSS alerts. OBJECTIVE In order to improve MDSS functionality, we must understand what factors users consider essential for the successful implementation of an MDSS into their clinical setting. This study followed the implementation process for an MDSS within a comprehensive EHR system and analyzed the relevant barriers and facilitators. METHODS A mixed research methodology was adopted. Data from a structured survey and 15 in-depth interviews were integrated. Structural equation modeling was conducted for quantitative analysis of factors related to user adoption of MDSS. Qualitative analysis based on semistructured interviews with physicians was conducted to collect various opinions on MDSS implementation. RESULTS Quantitative analysis revealed that physicians’ expectations regarding ease of use and performance improvement are crucial. Qualitative analysis identified four significant barriers to MDSS implementation: alert fatigue, lack of accuracy, poor user interface design, and lack of customizability. CONCLUSIONS This study revealed barriers and facilitators to the implementation of MDSS. The findings can be applied to upgrade MDSS in the future.

scholarly journals Barriers and Facilitators for the Use of a Medical Mobile App to Prevent Work-Related Risks in Pregnancy: A Qualitative Analysis

2017 ◽  
Vol 6 (8) ◽  
pp. e163 ◽  
Author(s):  
Adeline V Velu ◽  
Monique DM van Beukering ◽  
Frederieke G Schaafsma ◽  
Monique HW Frings-Dresen ◽  
Ben WJ Mol ◽  
...  
Keyword(s):  
Qualitative Analysis ◽  
Mobile App ◽  
Barriers And Facilitators ◽  
Work Related ◽  
In Pregnancy
Sign in / Sign up

Export Citation Format

Share Document