دورية أكاديمية
أعرض في EDS

Pediatric head injury guideline use in Sweden: a cross-sectional survey on determinants for successful implementation of a clinical practice guideline.

التفاصيل البيبلوغرافية
العنوان: Pediatric head injury guideline use in Sweden: a cross-sectional survey on determinants for successful implementation of a clinical practice guideline.
المؤلفون: Wickbom F; Department of Operation and Intensive Care, Halland Hospital, Halmstad, Sweden. fredrik.wickbom@med.lu.se.; Lund University, Lund, Sweden. fredrik.wickbom@med.lu.se., Berghog W; Department of Operation and Intensive Care, Halland Hospital, Halmstad, Sweden., Bernhardsson S; Region Västra Götaland, Research, Education, Development, and Innovation Primary Health Care, Gothenburg, Sweden.; School of Public Health and Community Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.; Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Unit of Physiotherapy, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden., Persson L; Department of Orthopedics, Halland Hospital, Halmstad, Sweden., Kunkel S; Department of Medicine, Växjö Hospital, Växjö, Sweden., Undén J; Department of Operation and Intensive Care, Halland Hospital, Halmstad, Sweden.; Lund University, Lund, Sweden.
المصدر: BMC health services research [BMC Health Serv Res] 2024 Aug 21; Vol. 24 (1), pp. 965. Date of Electronic Publication: 2024 Aug 21.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Craniocerebral Trauma*/therapy , Guideline Adherence*/statistics & numerical data , Practice Guidelines as Topic*, Humans ; Cross-Sectional Studies ; Sweden ; Female ; Male ; Surveys and Questionnaires ; Emergency Service, Hospital/standards ; Emergency Service, Hospital/statistics & numerical data ; Child ; Practice Patterns, Physicians'/statistics & numerical data ; Adult ; Middle Aged
مستخلص: Background: The Scandinavian Neurotrauma Committee guideline (SNC-16) was developed and published in 2016, to aid clinicians in management of pediatric head injuries in Scandinavian emergency departments (ED). The objective of this study was to explore determinants for use of the SNC-16 guideline by Swedish ED physicians.
Methods: This is a nationwide, cross-sectional, web-based survey in Sweden. Using modified snowball sampling, physicians managing children in the ED were invited via e-mail to complete the validated Clinician Guideline Determinants Questionnaire between February and May, 2023. Baseline data, data on enablers and barriers for use of the SNC-16 guideline, and preferred routes for implementation and access of guidelines in general were collected and analyzed descriptively and exploratory with Chi-square and Fisher's tests.
Results: Of 595 invitations, 198 emergency physicians completed the survey (effective response rate 33.3%). There was a high reported use of the SNC-16 guideline (149/195; 76.4%) and a strong belief in its benefits for the patients (188/197; 95.4% agreement). Respondents generally agreed with the guideline's content (187/197; 94.9%) and found it easy to use and navigate (188/197; 95.4%). Some respondents (53/197; 26.9%) perceived a lack of organizational support needed to use the guideline. Implementation tools may be improved as only 58.9% (116/197) agreed that the guideline includes such. Only 37.6% (74/197) of the respondents agreed that the guideline clearly describes the underlying evidence supporting the recommendation. Most respondents prefer to consult colleagues (178/198; 89.9%) and guidelines (149/198; 75.3%) to gain knowledge to guide clinical decision making. Four types of enablers for guideline use emerged from free-text answers: ease of use and implementation, alignment with local guidelines and practice, advantages for stakeholders, and practicality and accessibility. Barriers for guideline use were manifested as: organizational challenges, medical concerns, and practical concerns.
Conclusions: The findings suggest high self-reported use of the SNC-16 guideline among Swedish ED physicians. In updated versions of the guideline, focus on improving implementation tools and descriptions of the underlying evidence may further facilitate adoption and adherence. Measures to improve organizational support for guideline use and involvement of patient representatives should also be considered.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Children; Guidelines; Implementation; Sweden; mTBI
تواريخ الأحداث: Date Created: 20240821 Date Completed: 20240821 Latest Revision: 20240824
رمز التحديث: 20240826
مُعرف محوري في PubMed: PMC11340051
DOI: 10.1186/s12913-024-11423-z
PMID: 39169324
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-6963
DOI:10.1186/s12913-024-11423-z