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Enablers of the Implementation of Tissue Plasminogen Activator in Acute Stroke Care: A Cross-Sectional Survey

OBJECTIVE: To assess emergency physicians’ perceptions of individual and system enablers to the use of tissue Plasminogen Activator in acute stroke. METHOD: Australian fellows and trainees of Australasian College for Emergency Medicine completed a 57-item online survey assessing enablers to implemen...

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Detalles Bibliográficos
Autores principales: Grady, Alice, Bryant, Jamie, Carey, Mariko, Paul, Chris, Sanson-Fisher, Rob
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260942/
https://www.ncbi.nlm.nih.gov/pubmed/25490546
http://dx.doi.org/10.1371/journal.pone.0114778
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author Grady, Alice
Bryant, Jamie
Carey, Mariko
Paul, Chris
Sanson-Fisher, Rob
author_facet Grady, Alice
Bryant, Jamie
Carey, Mariko
Paul, Chris
Sanson-Fisher, Rob
author_sort Grady, Alice
collection PubMed
description OBJECTIVE: To assess emergency physicians’ perceptions of individual and system enablers to the use of tissue Plasminogen Activator in acute stroke. METHOD: Australian fellows and trainees of Australasian College for Emergency Medicine completed a 57-item online survey assessing enablers to implementation of evidence-based practice across six domains: knowledge, skills, modelling, monitoring, feedback, and maintenance. Demographic and workplace characteristics were obtained. Descriptive statistics were calculated to describe demographic and workplace characteristics of responders, and survey responses. Each domain received an overall score (%) based on the number of responders agreeing with all items within the domain. RESULTS: A total of 429 (13%) Australasian College for Emergency Medicine members responded. 17.7% of respondents reported they and/or their workplace met all knowledge-related enablers, however only 2.3% had all skill-related enablers in place. Of respondents who decide which patients receive tissue Plasminogen Activator treatment, 18.1% agreed that all maintenance-related enablers are in place at their hospital, compared to 6.6% for those who do not decide which patients receive tissue Plasminogen Activator treatment. None of the respondents had all items in place cross all domains. CONCLUSIONS: Even when allowing for the low response rate, it seems likely there is a lack of individual and system enablers supporting the implementation of best-practice stroke care in a number of Australian hospitals. Quality improvement programs could target all domains, particularly the skills-training and feedback emergency physicians receive, to aid implementation of tissue Plasminogen Activator treatment for acute stroke.
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spelling pubmed-42609422014-12-15 Enablers of the Implementation of Tissue Plasminogen Activator in Acute Stroke Care: A Cross-Sectional Survey Grady, Alice Bryant, Jamie Carey, Mariko Paul, Chris Sanson-Fisher, Rob PLoS One Research Article OBJECTIVE: To assess emergency physicians’ perceptions of individual and system enablers to the use of tissue Plasminogen Activator in acute stroke. METHOD: Australian fellows and trainees of Australasian College for Emergency Medicine completed a 57-item online survey assessing enablers to implementation of evidence-based practice across six domains: knowledge, skills, modelling, monitoring, feedback, and maintenance. Demographic and workplace characteristics were obtained. Descriptive statistics were calculated to describe demographic and workplace characteristics of responders, and survey responses. Each domain received an overall score (%) based on the number of responders agreeing with all items within the domain. RESULTS: A total of 429 (13%) Australasian College for Emergency Medicine members responded. 17.7% of respondents reported they and/or their workplace met all knowledge-related enablers, however only 2.3% had all skill-related enablers in place. Of respondents who decide which patients receive tissue Plasminogen Activator treatment, 18.1% agreed that all maintenance-related enablers are in place at their hospital, compared to 6.6% for those who do not decide which patients receive tissue Plasminogen Activator treatment. None of the respondents had all items in place cross all domains. CONCLUSIONS: Even when allowing for the low response rate, it seems likely there is a lack of individual and system enablers supporting the implementation of best-practice stroke care in a number of Australian hospitals. Quality improvement programs could target all domains, particularly the skills-training and feedback emergency physicians receive, to aid implementation of tissue Plasminogen Activator treatment for acute stroke. Public Library of Science 2014-12-09 /pmc/articles/PMC4260942/ /pubmed/25490546 http://dx.doi.org/10.1371/journal.pone.0114778 Text en © 2014 Grady et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Grady, Alice
Bryant, Jamie
Carey, Mariko
Paul, Chris
Sanson-Fisher, Rob
Enablers of the Implementation of Tissue Plasminogen Activator in Acute Stroke Care: A Cross-Sectional Survey
title Enablers of the Implementation of Tissue Plasminogen Activator in Acute Stroke Care: A Cross-Sectional Survey
title_full Enablers of the Implementation of Tissue Plasminogen Activator in Acute Stroke Care: A Cross-Sectional Survey
title_fullStr Enablers of the Implementation of Tissue Plasminogen Activator in Acute Stroke Care: A Cross-Sectional Survey
title_full_unstemmed Enablers of the Implementation of Tissue Plasminogen Activator in Acute Stroke Care: A Cross-Sectional Survey
title_short Enablers of the Implementation of Tissue Plasminogen Activator in Acute Stroke Care: A Cross-Sectional Survey
title_sort enablers of the implementation of tissue plasminogen activator in acute stroke care: a cross-sectional survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260942/
https://www.ncbi.nlm.nih.gov/pubmed/25490546
http://dx.doi.org/10.1371/journal.pone.0114778
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