Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians.
BMC Health Serv Res
; 20(1): 736, 2020 Aug 11.
Article
em En
| MEDLINE
| ID: mdl-32782002
ABSTRACT
BACKGROUND:
Early warning systems (EWS) are most effective when clinicians monitor patients' vital signs and comply with the recommended escalation of care protocols once deterioration is recognised.OBJECTIVES:
To explore sociocultural factors influencing acute care clinicians' compliance with an early warning system commonly used in Queensland public hospitals in Australia.METHODS:
This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia.RESULTS:
This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication.CONCLUSIONS:
The overarching organisational context including the hospital's embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians' and teams' compliance or non-compliance with early warning system's monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Recursos Humanos em Hospital
/
Fidelidade a Diretrizes
/
Cuidados Críticos
/
Escore de Alerta Precoce
/
Monitorização Fisiológica
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Qualitative_research
Aspecto:
Equity_inequality
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
Oceania
Idioma:
En
Revista:
BMC Health Serv Res
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Austrália