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Published VersionCC BY V4.0, Open Access
Journal article
Overcoming barriers to evidence-based patient blood management: a restricted review
Implementation Science, Vol.15, pp.1-13
2020
PMCID: PMC6969479
PMID: 31952514
Abstract
Background
Blood transfusions are associated with a range of adverse patient outcomes, including coagulopathy, immunomodulation and haemolysis, which increase the risk of morbidity and mortality. Consideration of these risks and potential benefits are necessary when deciding to transfuse. Patient blood management (PBM) guidelines exist to assist in clinical decision-making, but they are underutilised. Exploration of barriers to the implementation and utilisation of the PBM guidelines is required. This study aimed to identify common barriers and implementation strategies used to implement PBM guidelines, with a comparison against current expert opinion.
Methods
A restricted review approach was used to identify the barriers to PBM guideline implementation as reported by health professionals and to review which implementation strategies have been used. Searches were undertaken in MEDLINE/PubMed, CINAHL, Embase, Scopus and the Cochrane library. The Consolidated Framework for Implementation Research (CFIR) was used to code barriers. The Expert Recommendations for Implementing Change (ERIC) tool was used to code implementation strategies, and subsequently, develop recommendations based on expert opinion.
Results
We identified 14 studies suitable for inclusion. There was a cluster of barriers commonly reported: access to knowledge and information (n = 7), knowledge and beliefs about the intervention ( = 7) and tension for change (n = 6). Implementation strategies used varied widely (n = 25). Only one study reported the use of an implementation theory, model or framework. Most studies (n = 11) had at least 50% agreement with the ERIC recommendations.
Conclusions
There are common barriers experienced by health professionals when trying to implement PBM guidelines. There is currently no conclusive evidence to suggest which implementation strategies are most effective. Further research using validated implementation approaches and improved reporting is required.
Details
- Title
- Overcoming barriers to evidence-based patient blood management: a restricted review
- Authors
- Alana Delaforce (Corresponding Author) - University of Newcastle AustraliaJed Duff (Author) - University of Newcastle AustraliaJudy Munday (Author) - Queensland University of TechnologyJanet Hardy (Author) - Mater Health Services
- Publication details
- Implementation Science, Vol.15, pp.1-13
- Publisher
- BioMed Central Ltd.
- Date published
- 2020
- DOI
- 10.1186/s13012-020-0965-4
- ISSN
- 1748-5908
- PMID
- 31952514; PMC6969479
- Copyright note
- This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Data Availability
- All data generated or analysed during this study are included in this published article.
- Organisation Unit
- School of Health - Nursing
- Language
- English
- Record Identifier
- 99991064502621
- Output Type
- Journal article
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