Facilitators and Barriers to Implementation of Perineal Techniques: A Scoping Review Applying the Consolidated Framework for Implementation Research

Abstract

AimTo summarise the barriers and facilitators to the clinical implementation of perineal techniques and to provide evidence‐based insights for decision‐making based on existing research.DesignA scoping review.Data SourcesNine electronic databases (PubMed, Cochrane Library, Embase, CINAHL, ProQuest, CNKI, WanFang, VIP and SinoMed) were systematically searched on 4 February 2024.Review MethodsThis study followed Joanna Briggs Institute's scoping review methodology. The barriers and facilitators identified in the included studies were mapped to the domains of the Consolidated Framework for Implementation Research (CFIR): intervention characteristics, outer setting, inner setting, characteristics of individuals and process.ResultsA total of 18 studies were finally included and analysed. The most frequently identified facilitator was theoretical education for midwives (inner setting). Common barriers included: lack of time to implement perineal techniques (intervention characteristics); labour pain and women's stress due to insufficient understanding of the birthing process, as well as women's reluctance to receive the perineal techniques (outer setting); risk factors for OASIS (inner setting); insufficient theoretical education for midwives and inadequate prenatal education for pregnant women (inner setting) and concerns about potential medical disputes among performers (characteristics of individuals).ConclusionsMany of the factors influencing the implementation of perineal techniques identified in this review are modifiable. Developing implementation strategies based on these factors can promote the successful implementation of these perineal techniques in clinical settings.Implications for the ProfessionThis scoping review could serve as a reference framework for health authorities in developing strategies to promote the use of perineal techniques in clinical practice.ImpactExisting research has primarily focused on the outer setting, inner setting and characteristics of individuals implementing perineal techniques. Therefore, there is a need for more high‐quality studies focusing on intervention characteristics and the implementation process.Reporting MethodThis study followed the PRISMA extension for scoping reviews.Patient and Public ContributionNot applicable.