Use of clinical guidelines: perspectives from clinicians in paediatric and maternity hospitals in Kabul, Afghanistan

Graham, Hamish; Tokhi, Mariam; Edward, Anbrasi; Salehi, Ahmad Shah; Turkmani, Sabera; Duke, Trevor; Bartlett, Linda

doi:10.26719/2015.21.2.100

Cited by 5 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The literature suggests that the passive dissemination of recommendations or guidelines is not generally effective in changing the behavior of health professionals [16][17][18] , and that active educational strategies are more likely to modify the behavior of clinicians 19,20 . The implementation of the PACK made use of such strategies and techniques, which motivated both trainers and trainees.…”

Section: Discussionmentioning

confidence: 99%

Formative Study Of The Implementation Of The Practical Approach To Care Kit In Brazil (PACK Brazil)

Davies

Nickel

Monteiro

et al. 2020

BJHR

View full text Add to dashboard Cite

Introduction: The Practical Approach to Care Kit (PACK) is a comprehensive clinical practice guideline created to qualify health professionals at primary care level. The objective of this research is to present the formative study of the initial implementation of the PACK in Brazil. Methodological Path: Qualitative study that used in-depth interviews, questionnaires and focus groups with the trainers responsible for introducing the PACK in the local health clinics. To analyse the data, a thematic matrix technique was used. Results: Four in-depth interviews were conducted; 22 trainers answered the questionnaires and 15 trainers participated in two focus groups. Four themes were identified: 1. Expectations / Feelings regarding the PACK and its training; 2. Use of the PACK; 3. After the PACK; 4. Suggestions. Final Considerations: Participants were very enthusiastic about the implementation of the PACK. Some effects of the training on health professionals were noted in relation to the use of the protocol, such as: it appears to have been more widely used by doctors and nurses, who are not only accustomed to the routine of teaching and research, but who often have a close professional relationship. In addition, the results of this study highlighted important issues that need to be explored in order to understand the implementation of the PACK, such as factors related to behaviour change in individual clinical practice and care sharing.

show abstract

Section: Discussionmentioning

confidence: 99%

Formative Study Of The Implementation Of The Practical Approach To Care Kit In Brazil (PACK Brazil)

Davies

Nickel

Monteiro

et al. 2020

BJHR

View full text Add to dashboard Cite

show abstract

“…Many of the 144 publications presented findings following the analysis of qualitative data to clarify stakeholder perceptions and attitudes re implementation, and/or the associated helpers and hindrances (54.2%) [43,44,46,48,49 . These studies largely involved maternity care clinicians and pregnant women (84.6%).…”

Section: Theories Models and Framework: Absentmentioning

confidence: 99%

“…They also involved those with expertise in research and/or program implementation whose knowledge served to contextualise a framework [112], like frameworks that are internationally recognised [188], to optimise local relevance. Despite the value of some of these findings-like identifying factors that 'helped' or 'hindered' implementation, like knowledge training; service provider motivation; effective multilevel coordination; leadership; and effective communication [43,46,48…”

Section: Theories Models and Framework: Absentmentioning

confidence: 99%

Implementation science in maternity care: a scoping review

Piper

Coates

2021

Implementation Sci

View full text Add to dashboard Cite

Background Despite wide recognition that clinical care should be informed by the best available evidence, this does not always occur. Despite a myriad of theories, models and frameworks to promote evidence-based population health, there is still a long way to go, particularly in maternity care. The aim of this study is to appraise the scientific study of methods to promote the systematic uptake of evidence-based interventions in maternity care. This is achieved by clarifying if and how implementation science theories, models, and frameworks are used. Methods To map relevant literature, a scoping review was conducted of articles published between January 2005 and December 2019, guided by Peters and colleagues’ (2015) approach. Specifically, the following academic databases were systematically searched to identify publications that presented findings on implementation science or the implementation process (rather than just the intervention effect): Business Source Complete; CINAHL Plus with Full Text; Health Business Elite; Health Source: Nursing/Academic Edition; Medline; PsycARTICLES; PsycINFO; and PubMed. Information about each study was extracted using a purposely designed data extraction form. Results Of the 1181 publications identified, 158 were included in this review. Most of these reported on factors that enabled implementation, including knowledge, training, service provider motivation, effective multilevel coordination, leadership and effective communication—yet there was limited expressed use of a theory, model or framework to guide implementation. Of the 158 publications, 144 solely reported on factors that helped and/or hindered implementation, while only 14 reported the use of a theory, model and/or framework. When a theory, model or framework was used, it typically guided data analysis or, to a lesser extent, the development of data collection tools—rather than for instance, the design of the study. Conclusion Given that models and frameworks can help to describe phenomenon, and theories can help to both describe and explain it, evidence-based maternity care might be promoted via the greater expressed use of these to ultimately inform implementation science. Specifically, advancing evidence-based maternity care, worldwide, will require the academic community to make greater explicit and judicious use of theories, models, and frameworks. Registration Registered with the Joanna Briggs Institute (registration number not provided).

show abstract

“…Furthermore, the presence of an influencer or champion of clinical guidelines or evidence-based practice was reported to change attitudes towards guideline adherence in the workplace 18. The use of guidelines or evidence-based care is positively influenced by peer support from senior colleagues,39 44 45 constructive hierarchical relationships (either between junior and senior colleagues or between doctors and nurses) that promotes teamwork17 18 20 35 and interdisciplinary collaboration 28 35…”

Section: Resultsmentioning

confidence: 99%

“…Of the factors relating to working condition, time constraints and heavy workloads, partly due to staff shortages and skills mix, are the most frequently cited constraints to the use of clinical guidelines by healthcare providers 12 14–16 20 22 25 26 28–33 35 36 38–40 42–48. Various studies suggest task-shifting among stakeholders, including healthcare professionals and community health workers, can contribute to mitigating issues associated with increasing workload in settings with limited availability of certain types of human resources for health 19 31 38 44. However, Puchalski Ritchie et al 28 highlight that role confusion may arise from task shifting and is associated with poor communication and a lack of intercadre collaboration.…”

Section: Resultsmentioning

confidence: 99%

Understanding factors influencing the use of clinical guidelines in low-income and middle-income settings: a scoping review

Orangi,

Kabubei

et al. 2023

BMJ Open

View full text Add to dashboard Cite

ObjectiveA scoping review was undertaken to determine the extent to which existing studies have examined factors influencing healthcare providers’ use of clinical guidelines in low and middle-income country (LMIC) settings and determine which factors constrain or facilitate the use of clinical guidelines by healthcare providers.DesignScoping review.Data sourcesThe literature search was conducted using PubMed in January 2021.Eligibility criteriaWe identified empirical studies, published between 2011–2021 in English, which included clinicians and/or nurses as healthcare providers, used a health facility as the study site, and were located in an LMIC.Data extraction and synthesisInformation extracted from the literature review was organised using themes and the findings synthesised using thematic analysis.ResultsThe review identified five types of interacting factors that influence healthcare providers’ use of and compliance with clinical guidelines. The factors identified are organisational factors, factors relating to individual healthcare providers, attributes of the clinical guidelines, patient-related factors and institutional factors. Organisational factors can be further divided into the physical work environment, organisational culture and working conditions. The effective use of clinical guidelines in LMIC settings is greatly impacted by the contextualisation of clinical guidelines, end-user engagement and alignment of the implementation of clinical guidelines with the institutional arrangements in the broader health system.ConclusionThe development and evaluation of concrete interventions is vital to facilitate the implementation of clinical guidelines and improve healthcare service quality. Further studies are necessary to examine the relative importance of the five identified factors on the effective use of clinical guidelines in different contexts.

show abstract

Use of clinical guidelines: perspectives from clinicians in paediatric and maternity hospitals in Kabul, Afghanistan

Cited by 5 publications

References 18 publications

Formative Study Of The Implementation Of The Practical Approach To Care Kit In Brazil (PACK Brazil)

Formative Study Of The Implementation Of The Practical Approach To Care Kit In Brazil (PACK Brazil)

Implementation science in maternity care: a scoping review

Understanding factors influencing the use of clinical guidelines in low-income and middle-income settings: a scoping review

Contact Info

Product

Resources

About