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Published VersionCC BY-NC V4.0, Open Access
Journal article
Preoperative Anemia and Iron Deficiency Screening, Evaluation and Management: Barrier Identification and Implementation Strategy Mapping
Journal of Multidisciplinary Healthcare, Vol.13, pp.1759-1770
2020
PMCID: PMC7718960
PMID: 33293819
Abstract
Introduction and aims: Patients undergoing major surgery risk significant blood loss and transfusion, which increases substantially if they have pre-existing anemia. Preoperative Anemia and Iron Deficiency Screening, Evaluation and Management Pathways (PAIDSEM-P) outline recommended blood tests and treatment to optimize patients before surgery. Documented success using PAIDSEM-P to reduce transfusions and improve patient outcomes exists, but the reporting quality of such studies is suboptimal. It remains unclear what implementation strategies best support the implementation of PAIDSEM-P.
Method: Maximum variation, purposive sampling was used to recruit a total of 15 participants, including a range of health professionals and patients for semi-structured interviews. Data analysis utilized a deductive approach informed by the Consolidated Framework for Implementation Research (CFIR) for barrier identification and the Expert Recommendations for Implementing Change (ERIC) for reporting recommended implementation strategies. A modified version of the Action, Actor, Context, Target and Time (AACTT) framework assisted with conceptualisation and targeted strategy selection.
Results: The analysis revealed five barriers: access to knowledge and information, patient needs and resources, knowledge and beliefs about the intervention, available resources, and networks and communications, which had strong ERIC recommendations, including conduct educational meetings, develop educational materials, distribute educational materials, obtain and use patients/consumers family feedback, involve patients/consumers/family members, conduct a local needs assessment, access new funding, promote network weaving, and organize clinician implementation team meetings.
Conclusions: Mapping the barriers and strategies using the ERIC framework on the basis of individual actor categories proved to be useful in identifying a pragmatic number of implementation strategies that may help in supporting the utilisation of the PAIDSEM-P and other evidence-based healthcare implementation problems more broadly.
Details
- Title
- Preoperative Anemia and Iron Deficiency Screening, Evaluation and Management: Barrier Identification and Implementation Strategy Mapping
- Authors
- Alana Delaforce (Corresponding Author) - University of Newcastle AustraliaJed Duff (Author) - Queensland University of TechnologyJudy Munday (Author) - Queensland University of TechnologyJanet Hardy (Author) - Mater Health Services
- Publication details
- Journal of Multidisciplinary Healthcare, Vol.13, pp.1759-1770
- Publisher
- Dove Medical Press Ltd
- Date published
- 2020
- DOI
- 10.2147/JMDH.S282308
- ISSN
- 1178-2390
- PMID
- 33293819; PMC7718960
- Copyright note
- © 2020 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.
- Data Availability
- All data generated or analysed during this study are available in the published article and the attached file.
- Grant note
- AD gratefully acknowledges the financial support received from the University of Newcastle that assisted with transcription costs. AD also gratefully acknowledges the support received from the Mater Foundation.
- Organisation Unit
- School of Health - Nursing
- Language
- English
- Record Identifier
- 99991177002621
- Output Type
- Journal article
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