Files and links (1)
Published VersionCC BY V4.0, Open Access
Journal article
Perceived barriers and facilitators to implementing a consensus-based same-day discharge post-percutaneous coronary intervention clinical pathway in Queensland, Australia
Intensive and Critical Care Nursing, Vol.91, pp.1-8
2025
PMID: 40749356
Abstract
Objectives
To identify perceived barriers and facilitators to an intended adoption of aconsensus-based same-day discharge (SDD) clinical guideline for patients undergoing elective percutaneous coronary intervention (PCI).
Methods
This qualitative study was conducted in six cardiac catheterisation suites of public hospitals in Queensland, Australia. Semi-structured interviews were undertaken with clinicians, patients, and carers between July and October 2024. Interviews were recorded and transcribed. Inductive content analysis was performed before themes were mapped deductively against the Theoretical Domains Framework (TDF).
Results
A total of 22 participants (doctors [n = 10], nurses [n = 8], patients [n = 2], and carers [n = 2]) participated in interviews. Six domains, including knowledge, social/professional role and identity, environmental contexts and resources, beliefs about consequences, memory, attention, and decision-making, and beliefs about capabilities, were strongly related to the factors that influenced the implementation. The findings revealed perceived main barriers to the implementation, including logistical (e.g., geographical considerations), professional (e.g., resistance to change), and hospital reimbursement models that unfavoured SDD. The main drivers were effective leadership, benchmarking among hospitals, inter-hospital consultation and collaboration, having a designated champion, and targeted education sessions for clinicians, patients, and carers.
Conclusion
Findings suggest that adopting this consensus-based SDD clinical guideline has multifactorial and interrelated influences. The identification of the barriers across various TDF domains provides opportunities to develop effective implementation strategies to facilitate SDD implementation.
Implications for clinical practice
This study highlights the need for multifaceted approach to implementing SDD. Leaders in public health policy and organisations must consider a range of interconnected influences for effective implementation and sustained adherence.
Details
- Title
- Perceived barriers and facilitators to implementing a consensus-based same-day discharge post-percutaneous coronary intervention clinical pathway in Queensland, Australia
- Authors
- Yingyan Chen (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health - NursingJacqueline Peet - University of the Sunshine Coast, Queensland, School of Health - NursingNatalie Hausin - Cairns HospitalDavid Hinds - Townsville HospitalRohan Jayasinghe - Gold Coast HospitalWendy Kennedy - Princess Alexandra HospitalSuzanne Morris - Gold Coast HospitalRohan Poulter - Sunshine Coast University HospitalGregory Starmer - Cairns HospitalYash Singbal - Princess Alexandra HospitalAnna Townsend - Mackay Base HospitalPaul Wallis - Sunshine Coast University HospitalRaibhan Yadav - Townsville HospitalZhihua Michael Zhang - Mackay Base HospitalKaren WardropJunel Padigos - Central Queensland UniversityFrances Fengzhi Lin - University of the Sunshine Coast, Queensland, School of Health - Nursing
- Publication details
- Intensive and Critical Care Nursing, Vol.91, pp.1-8
- Publisher
- Elsevier Ltd
- Date published
- 2025
- DOI
- 10.1016/j.iccn.2025.104169
- ISSN
- 1532-4036; 0964-3397
- PMID
- 40749356
- Copyright note
- © 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- Grants
- Co-designing and developing a same-day discharge guideline for patients undergoing elective percutaneous coronary intervention, 0980028114, University of the Sunshine Coast (Australia, Sunshine Coast) - UniSC
- Organisation Unit
- School of Health - Nursing
- Language
- English
- Record Identifier
- 991149340202621
- Output Type
- Journal article
Metrics
1 File views/ downloads
15 Record Views