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Published VersionCC BY-NC V4.0, Open Access
Journal article
A Theoretically Informed Approach to Support the Implementation of Pre-Operative Anemia and Iron Deficiency Screening, Evaluation, and Management Pathways: Protocol for a Type Two Hybrid-Effectiveness Study
Journal of Multidisciplinary Healthcare, Vol.14, pp.1037-1044
2021
PMCID: PMC8110260
PMID: 33986598
Abstract
Blood transfusions are a risk factor for increased morbidity, mortality, and length of hospital stay. Patient blood management guidelines provide guidance to reduce risk and improve patient outcomes. They outline steps to help prevent transfusions and considerations for when deciding to transfuse. One recommendation to prevent unnecessary transfusion is to optimize patients using Pre-operative Anemia and Iron Deficiency Screening, Evaluation and Management Pathways (PAIDSEM-P). The uptake of these recommendations is highly variable, and an effective approach to implementing them in a tailored and context-specific manner remains elusive.
A mixed-methods, interventional study, using a type two-hybrid effectiveness-implementation design, will evaluate the impact of a change package to improve the uptake of PAIDSEM-P. The change package consists of the intervention (PAIDSEM-P) supported by theoretically informed implementation strategies. Pre- and post-implementation, retrospective health record reviews will determine the effect of the change package on provider outcomes, including compliance with guideline recommendations as measured by the proportion of patients who have the appropriate tests performed, and, if required, appropriate treatment and/or referrals. Patient outcomes will be measured by checking for any difference in the proportion of patients with anemia on the day of surgery and the proportion of patients who receive a blood transfusion during the peri-operative period. An economic evaluation will be conducted to compare health outcomes and costs. The feasibility, acceptability and appropriateness of the PAIDSEM-P will be assessed using a quantitative, validated survey to measure implementation outcomes.
Testing of implementation theory is required to advance understanding of what works, in what context, and the impact on implementation success. This study aims to evaluate the impact of a theoretically informed change package on improving the uptake of PAIDSEM-P. If successful, it will also provide a framework for health care facilities to follow when addressing other evidence-practice gaps.
Details
- Title
- A Theoretically Informed Approach to Support the Implementation of Pre-Operative Anemia and Iron Deficiency Screening, Evaluation, and Management Pathways: Protocol for a Type Two Hybrid-Effectiveness Study
- Authors
- Alana Delaforce (Corresponding Author) - University of Newcastle AustraliaJed Duff (Author) - Queensland University of TechnologyJudy Munday (Author) - University of AgderShannon Farmer (Author) - The University of Western AustraliaKristin Miller (Author) - Mater Health ServicesLynne Glover (Author) - Mater Health ServicesChristopher Corney (Author) - Mater Health ServicesCameron Hurst (Author) - QIMR Berghofer Medical Research InstituteGareth Ansell (Author) - The University of QueenslandNaadir Gutta (Author) - The University of QueenslandHaitham Tuffaha (Author) - The University of QueenslandJanet Hardy (Author) - Mater Health Services
- Publication details
- Journal of Multidisciplinary Healthcare, Vol.14, pp.1037-1044
- Publisher
- Dove Medical Press Ltd.
- Date published
- 2021
- DOI
- 10.2147/JMDH.S313309
- ISSN
- 1178-2390
- PMID
- 33986598; PMC8110260
- Copyright note
- © 2021 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
- Organisation Unit
- School of Health - Nursing
- Language
- English
- Record Identifier
- 99991176702621
- Output Type
- Journal article
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