Cargando…
COVID-19 Vaccination Delivery in Long-Term-Care using the CARD (Comfort Ask Relax Distract) System: Mixed Methods study of Implementation Drivers
OBJECTIVES: CARD (comfort, ask, relax, distract) is a vaccine delivery framework that includes interventions to improve the patient’s experience. CARD has not been previously implemented in long-term care (LTC) settings. This study evaluated drivers to implementation for COVID-19 vaccinations in an...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9586631/ https://www.ncbi.nlm.nih.gov/pubmed/36278249 http://dx.doi.org/10.1080/24740527.2022.2115880 |
_version_ | 1784813728150061056 |
---|---|
author | Taddio, Anna McGilton, Katherine S. Zheng, Nancy Yeung, Lydia Lafleur, Benoit Fung, Jollee S.T. MacDonald, Noni E. Andrew, Melissa K. Verschoor, Chris P. |
author_facet | Taddio, Anna McGilton, Katherine S. Zheng, Nancy Yeung, Lydia Lafleur, Benoit Fung, Jollee S.T. MacDonald, Noni E. Andrew, Melissa K. Verschoor, Chris P. |
author_sort | Taddio, Anna |
collection | PubMed |
description | OBJECTIVES: CARD (comfort, ask, relax, distract) is a vaccine delivery framework that includes interventions to improve the patient’s experience. CARD has not been previously implemented in long-term care (LTC) settings. This study evaluated drivers to implementation for COVID-19 vaccinations in an LTC facility. METHODS: Postimplementation interpretive evaluation including qualitative interviews and quantitative surveys with eight participants. The Consolidated Framework for Implementation Research (CFIR) was used for analysis. Adverse reactions to vaccinations and CARD interventions, including local reactogenicity and systemic reactions, were abstracted from medical charts of residents. RESULTS: Eight CFIR constructs emerged. Staff perceived CARD was complex because it added steps to vaccination delivery. Motivated to meet residents’ needs, a receptive implementation climate of support among staff led to using strategies within CARD, such as administering topical anesthetics and omitting alcohol skin antisepsis prior to injections. Having an effective network like the residents council positively influenced implementation by allowing residents to voice their opinions. Facilitators to implementation included staff knowledge and beliefs and staff’s commitment to their organization, which was focused on person-centered care. Barriers included lack of available resources (inadequate staffing), insufficient communication between management and staff and lack of awareness of CARD, and external policies not aligned with CARD. Chart reviews conducted for 93 vaccinated residents corroborated perceptions of vaccination and CARD intervention safety, revealing a low rate of local and systemic adverse reactions and no cases of skin infection. DISCUSSION: We identified positive and negative implementation drivers. Future research is recommended to expand the strategies employed and involve residents more directly. |
format | Online Article Text |
id | pubmed-9586631 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-95866312022-10-22 COVID-19 Vaccination Delivery in Long-Term-Care using the CARD (Comfort Ask Relax Distract) System: Mixed Methods study of Implementation Drivers Taddio, Anna McGilton, Katherine S. Zheng, Nancy Yeung, Lydia Lafleur, Benoit Fung, Jollee S.T. MacDonald, Noni E. Andrew, Melissa K. Verschoor, Chris P. Can J Pain Research Article OBJECTIVES: CARD (comfort, ask, relax, distract) is a vaccine delivery framework that includes interventions to improve the patient’s experience. CARD has not been previously implemented in long-term care (LTC) settings. This study evaluated drivers to implementation for COVID-19 vaccinations in an LTC facility. METHODS: Postimplementation interpretive evaluation including qualitative interviews and quantitative surveys with eight participants. The Consolidated Framework for Implementation Research (CFIR) was used for analysis. Adverse reactions to vaccinations and CARD interventions, including local reactogenicity and systemic reactions, were abstracted from medical charts of residents. RESULTS: Eight CFIR constructs emerged. Staff perceived CARD was complex because it added steps to vaccination delivery. Motivated to meet residents’ needs, a receptive implementation climate of support among staff led to using strategies within CARD, such as administering topical anesthetics and omitting alcohol skin antisepsis prior to injections. Having an effective network like the residents council positively influenced implementation by allowing residents to voice their opinions. Facilitators to implementation included staff knowledge and beliefs and staff’s commitment to their organization, which was focused on person-centered care. Barriers included lack of available resources (inadequate staffing), insufficient communication between management and staff and lack of awareness of CARD, and external policies not aligned with CARD. Chart reviews conducted for 93 vaccinated residents corroborated perceptions of vaccination and CARD intervention safety, revealing a low rate of local and systemic adverse reactions and no cases of skin infection. DISCUSSION: We identified positive and negative implementation drivers. Future research is recommended to expand the strategies employed and involve residents more directly. Taylor & Francis 2022-10-19 /pmc/articles/PMC9586631/ /pubmed/36278249 http://dx.doi.org/10.1080/24740527.2022.2115880 Text en © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Taddio, Anna McGilton, Katherine S. Zheng, Nancy Yeung, Lydia Lafleur, Benoit Fung, Jollee S.T. MacDonald, Noni E. Andrew, Melissa K. Verschoor, Chris P. COVID-19 Vaccination Delivery in Long-Term-Care using the CARD (Comfort Ask Relax Distract) System: Mixed Methods study of Implementation Drivers |
title | COVID-19 Vaccination Delivery in Long-Term-Care using the CARD (Comfort Ask Relax Distract) System: Mixed Methods study of Implementation Drivers |
title_full | COVID-19 Vaccination Delivery in Long-Term-Care using the CARD (Comfort Ask Relax Distract) System: Mixed Methods study of Implementation Drivers |
title_fullStr | COVID-19 Vaccination Delivery in Long-Term-Care using the CARD (Comfort Ask Relax Distract) System: Mixed Methods study of Implementation Drivers |
title_full_unstemmed | COVID-19 Vaccination Delivery in Long-Term-Care using the CARD (Comfort Ask Relax Distract) System: Mixed Methods study of Implementation Drivers |
title_short | COVID-19 Vaccination Delivery in Long-Term-Care using the CARD (Comfort Ask Relax Distract) System: Mixed Methods study of Implementation Drivers |
title_sort | covid-19 vaccination delivery in long-term-care using the card (comfort ask relax distract) system: mixed methods study of implementation drivers |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9586631/ https://www.ncbi.nlm.nih.gov/pubmed/36278249 http://dx.doi.org/10.1080/24740527.2022.2115880 |
work_keys_str_mv | AT taddioanna covid19vaccinationdeliveryinlongtermcareusingthecardcomfortaskrelaxdistractsystemmixedmethodsstudyofimplementationdrivers AT mcgiltonkatherines covid19vaccinationdeliveryinlongtermcareusingthecardcomfortaskrelaxdistractsystemmixedmethodsstudyofimplementationdrivers AT zhengnancy covid19vaccinationdeliveryinlongtermcareusingthecardcomfortaskrelaxdistractsystemmixedmethodsstudyofimplementationdrivers AT yeunglydia covid19vaccinationdeliveryinlongtermcareusingthecardcomfortaskrelaxdistractsystemmixedmethodsstudyofimplementationdrivers AT lafleurbenoit covid19vaccinationdeliveryinlongtermcareusingthecardcomfortaskrelaxdistractsystemmixedmethodsstudyofimplementationdrivers AT fungjolleest covid19vaccinationdeliveryinlongtermcareusingthecardcomfortaskrelaxdistractsystemmixedmethodsstudyofimplementationdrivers AT macdonaldnonie covid19vaccinationdeliveryinlongtermcareusingthecardcomfortaskrelaxdistractsystemmixedmethodsstudyofimplementationdrivers AT andrewmelissak covid19vaccinationdeliveryinlongtermcareusingthecardcomfortaskrelaxdistractsystemmixedmethodsstudyofimplementationdrivers AT verschoorchrisp covid19vaccinationdeliveryinlongtermcareusingthecardcomfortaskrelaxdistractsystemmixedmethodsstudyofimplementationdrivers |