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dc.contributor.authorPearse, Bronwyn L
dc.contributor.authorKeogh, Samantha
dc.contributor.authorRickard, Claire M
dc.contributor.authorFung, Yoke L
dc.date.accessioned2021-06-15T23:28:27Z
dc.date.available2021-06-15T23:28:27Z
dc.date.issued2021
dc.identifier.issn1472-6963
dc.identifier.doi10.1186/s12913-021-06269-8
dc.identifier.urihttp://hdl.handle.net/10072/405156
dc.description.abstractBACKGROUND: Bleeding during cardiac surgery is a common complication that often requires the transfusion of blood products. The combination of bleeding and blood product transfusion incrementally increases adverse outcomes including infection and mortality. Following bleeding management guideline recommendations could assist with minimising risk but adherence is not high, and the cause for lack of adherence is not well understood. This study aimed to identify barriers and facilitators to practicing and implementing evidenced-based intra-operative, bleeding management in Australian cardiac surgery units. METHODS: We used a qualitative descriptive design to conduct semi-structured interviews with Australian cardiac surgeons, anaesthetists and perfusionists. The Theoretical Domains Framework (TDF) was utilised to guide interviews and thematically analyse the data. Categorised data were then linked with the three key domains of the COM-B model (capability, opportunity, motivation - behaviour) to explore and understand behaviour. RESULTS: Seventeen interviews were completed. Nine of the 14 TDF domains emerged as significant. Analysis revealed key themes to improving capability included, standardisation, monitoring, auditing and feedback of data and cross discipline training. Opportunity for change was improved with interpersonal and interdepartmental collaboration through shared goals, and more efficient and supportive processes allowing clinicians to navigate unfamiliar business and financial models of health care. Results suggest as individuals, clinicians had the motivation to make change and healthcare organisations have an obligation and a responsibility to partner with clinicians to support change and improve goal directed best practice. CONCLUSION: Using a theory-based approach it was possible to identify factors which may be positively or negatively influence clinicians ability to implement best practice bleeding management in Australian cardiac surgical units.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.relation.ispartofpagefrom550
dc.relation.ispartofissue1
dc.relation.ispartofjournalBMC Health Services Research
dc.relation.ispartofvolume21
dc.subject.fieldofresearchLibrary and Information Studies
dc.subject.fieldofresearchNursing
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchcode0807
dc.subject.fieldofresearchcode1110
dc.subject.fieldofresearchcode1117
dc.subject.keywordsAustralia
dc.subject.keywordsBarriers
dc.subject.keywordsBleeding
dc.subject.keywordsCOM-B model
dc.subject.keywordsCardiac surgery
dc.titleBarriers and facilitators to implementing evidence based bleeding management in Australian Cardiac Surgery Units: a qualitative interview study analysed with the theoretical domains framework and COM-B model.
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationPearse, BL; Keogh, S; Rickard, CM; Fung, YL, Barriers and facilitators to implementing evidence based bleeding management in Australian Cardiac Surgery Units: a qualitative interview study analysed with the theoretical domains framework and COM-B model., BMC Health Services Research, 2021, 21 (1), pp. 550
dcterms.dateAccepted2021-03-10
dc.date.updated2021-06-15T04:00:40Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
gro.hasfulltextFull Text
gro.griffith.authorRickard, Claire
gro.griffith.authorPearse, Bronwyn L.
gro.griffith.authorKeogh, Samantha J.


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