The influence of adaptive challenge on engagement of multidisciplinary staff in standardising aseptic technique in an emergency department: A qualitative study
Aims and objectives To explore the challenge of engaging multidisciplinary staff in standardising aseptic technique (AT) in an emergency department (ED) in an Australian tertiary hospital, and to better understand the enablers and barriers to implementing practice change within this setting. Backgro...
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Veröffentlicht in: | Journal of clinical nursing 2020-02, Vol.29 (3-4), p.459-467 |
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creator | Towell‐Barnard, Amanda Slatyer, Susan Cadwallader, Helen Harvey, Michelle Davis, Susan |
description | Aims and objectives
To explore the challenge of engaging multidisciplinary staff in standardising aseptic technique (AT) in an emergency department (ED) in an Australian tertiary hospital, and to better understand the enablers and barriers to implementing practice change within this setting.
Background
Healthcare‐associated infections are the most common complication for patients in acute care. A clinical practice framework developed in the United Kingdom (UK) standardised AT practice to reduce potential infection risk. One Australian tertiary hospital drew upon this framework to similarly improve clinical practice. It was understood that standardising practice would require some practitioners only to revisit and demonstrate AT principles already embedded in their practice, while others would be challenged to adopt a new approach.
Design
Qualitative, descriptive research design.
Methods
Data were collected through focus groups held before and after implementation of the AT programme. Data were analysed using the framework method. The (COREQ) checklist was followed.
Results
Four emergent themes described the influence of motivation on individuals' beliefs and attitudes towards practice change, relationships within the ED context, delivery of education and management directives.
Conclusion
Implementing practice change is more than just providing technical knowledge and includes changing individuals' beliefs and attitudes. An understanding of adaptive challenge can assist in implementing practice change that involves the multidisciplinary team.
Relevance to clinical practice
Results provide evidence as to how the adaptive challenge framework could be a suitable approach to manage potential enablers and barriers to implementing change within a multidisciplinary team in an acute hospital. |
doi_str_mv | 10.1111/jocn.15109 |
format | Article |
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To explore the challenge of engaging multidisciplinary staff in standardising aseptic technique (AT) in an emergency department (ED) in an Australian tertiary hospital, and to better understand the enablers and barriers to implementing practice change within this setting.
Background
Healthcare‐associated infections are the most common complication for patients in acute care. A clinical practice framework developed in the United Kingdom (UK) standardised AT practice to reduce potential infection risk. One Australian tertiary hospital drew upon this framework to similarly improve clinical practice. It was understood that standardising practice would require some practitioners only to revisit and demonstrate AT principles already embedded in their practice, while others would be challenged to adopt a new approach.
Design
Qualitative, descriptive research design.
Methods
Data were collected through focus groups held before and after implementation of the AT programme. Data were analysed using the framework method. The (COREQ) checklist was followed.
Results
Four emergent themes described the influence of motivation on individuals' beliefs and attitudes towards practice change, relationships within the ED context, delivery of education and management directives.
Conclusion
Implementing practice change is more than just providing technical knowledge and includes changing individuals' beliefs and attitudes. An understanding of adaptive challenge can assist in implementing practice change that involves the multidisciplinary team.
Relevance to clinical practice
Results provide evidence as to how the adaptive challenge framework could be a suitable approach to manage potential enablers and barriers to implementing change within a multidisciplinary team in an acute hospital.</description><identifier>ISSN: 0962-1067</identifier><identifier>EISSN: 1365-2702</identifier><identifier>DOI: 10.1111/jocn.15109</identifier><identifier>PMID: 31793117</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>adaptive challenge ; aseptic technique ; Australia ; Clinical medicine ; Cross Infection - prevention & control ; Descriptive research ; Disease control ; Disease prevention ; emergency department ; Emergency medical care ; Emergency Service, Hospital - organization & administration ; engagement of multidisciplinary team ; Focus Groups ; Humans ; Hygiene ; Leadership ; Nosocomial infections ; Nursing ; Organizational Innovation ; qualitative ; Qualitative Research ; Quality Improvement ; Quality standards ; Sterilization ; Tertiary Care Centers ; Training ; Western Australia</subject><ispartof>Journal of clinical nursing, 2020-02, Vol.29 (3-4), p.459-467</ispartof><rights>2019 John Wiley & Sons Ltd</rights><rights>2019 John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3939-596708b1e2b61b47af06db58deef7376f3a839c3014d63bed28c5b24638361b3</citedby><cites>FETCH-LOGICAL-c3939-596708b1e2b61b47af06db58deef7376f3a839c3014d63bed28c5b24638361b3</cites><orcidid>0000-0002-2475-7724</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjocn.15109$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjocn.15109$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31793117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Towell‐Barnard, Amanda</creatorcontrib><creatorcontrib>Slatyer, Susan</creatorcontrib><creatorcontrib>Cadwallader, Helen</creatorcontrib><creatorcontrib>Harvey, Michelle</creatorcontrib><creatorcontrib>Davis, Susan</creatorcontrib><title>The influence of adaptive challenge on engagement of multidisciplinary staff in standardising aseptic technique in an emergency department: A qualitative study</title><title>Journal of clinical nursing</title><addtitle>J Clin Nurs</addtitle><description>Aims and objectives
To explore the challenge of engaging multidisciplinary staff in standardising aseptic technique (AT) in an emergency department (ED) in an Australian tertiary hospital, and to better understand the enablers and barriers to implementing practice change within this setting.
Background
Healthcare‐associated infections are the most common complication for patients in acute care. A clinical practice framework developed in the United Kingdom (UK) standardised AT practice to reduce potential infection risk. One Australian tertiary hospital drew upon this framework to similarly improve clinical practice. It was understood that standardising practice would require some practitioners only to revisit and demonstrate AT principles already embedded in their practice, while others would be challenged to adopt a new approach.
Design
Qualitative, descriptive research design.
Methods
Data were collected through focus groups held before and after implementation of the AT programme. Data were analysed using the framework method. The (COREQ) checklist was followed.
Results
Four emergent themes described the influence of motivation on individuals' beliefs and attitudes towards practice change, relationships within the ED context, delivery of education and management directives.
Conclusion
Implementing practice change is more than just providing technical knowledge and includes changing individuals' beliefs and attitudes. An understanding of adaptive challenge can assist in implementing practice change that involves the multidisciplinary team.
Relevance to clinical practice
Results provide evidence as to how the adaptive challenge framework could be a suitable approach to manage potential enablers and barriers to implementing change within a multidisciplinary team in an acute hospital.</description><subject>adaptive challenge</subject><subject>aseptic technique</subject><subject>Australia</subject><subject>Clinical medicine</subject><subject>Cross Infection - prevention & control</subject><subject>Descriptive research</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>emergency department</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital - organization & administration</subject><subject>engagement of multidisciplinary team</subject><subject>Focus Groups</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Leadership</subject><subject>Nosocomial infections</subject><subject>Nursing</subject><subject>Organizational Innovation</subject><subject>qualitative</subject><subject>Qualitative Research</subject><subject>Quality Improvement</subject><subject>Quality standards</subject><subject>Sterilization</subject><subject>Tertiary Care Centers</subject><subject>Training</subject><subject>Western Australia</subject><issn>0962-1067</issn><issn>1365-2702</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EosPAhgdAltigSin-mdgJu2pE-VFFN7OPHPtmxiPHSe2kaJ6GV-WmU1iwwF5cy_58zrUPIW85u-I4Ph4HG694yVn9jKy4VGUhNBPPyYrVShScKX1BXuV8ZIxLIeRLciG5riXnekV-7Q5AfezCDNECHTpqnBkn_wDUHkwIEPe4GylWs4ce4rQw_Rwm73y2fgw-mnSieTJdh0LLIjqT8NDHPTUZUMzSCewh-vt58aIG5XpIe3Q8UQejSdMi_Ile0_vZBD-ZR_88ze70mrzoTMjw5qmuye7m8277tbi9-_Jte31bWFnLuihrpVnVchCt4u1Gm44p15aVA-i01KqTppK1lYxvnJItOFHZshUbJSuJF-SafDjLjmnALvPU9Pg6CMFEGObcCClYpaXCuSbv_0GPw5wiNoeU3DCFJhqpyzNl05Bzgq4Zk-_xpxrOmiW1ZkmteUwN4XdPknPbg_uL_okJAX4GfvoAp_9INd_vtj_Oor8BeRSk3Q</recordid><startdate>202002</startdate><enddate>202002</enddate><creator>Towell‐Barnard, Amanda</creator><creator>Slatyer, Susan</creator><creator>Cadwallader, Helen</creator><creator>Harvey, Michelle</creator><creator>Davis, Susan</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2475-7724</orcidid></search><sort><creationdate>202002</creationdate><title>The influence of adaptive challenge on engagement of multidisciplinary staff in standardising aseptic technique in an emergency department: A qualitative study</title><author>Towell‐Barnard, Amanda ; Slatyer, Susan ; Cadwallader, Helen ; Harvey, Michelle ; Davis, Susan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3939-596708b1e2b61b47af06db58deef7376f3a839c3014d63bed28c5b24638361b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>adaptive challenge</topic><topic>aseptic technique</topic><topic>Australia</topic><topic>Clinical medicine</topic><topic>Cross Infection - prevention & control</topic><topic>Descriptive research</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>emergency department</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital - organization & administration</topic><topic>engagement of multidisciplinary team</topic><topic>Focus Groups</topic><topic>Humans</topic><topic>Hygiene</topic><topic>Leadership</topic><topic>Nosocomial infections</topic><topic>Nursing</topic><topic>Organizational Innovation</topic><topic>qualitative</topic><topic>Qualitative Research</topic><topic>Quality Improvement</topic><topic>Quality standards</topic><topic>Sterilization</topic><topic>Tertiary Care Centers</topic><topic>Training</topic><topic>Western Australia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Towell‐Barnard, Amanda</creatorcontrib><creatorcontrib>Slatyer, Susan</creatorcontrib><creatorcontrib>Cadwallader, Helen</creatorcontrib><creatorcontrib>Harvey, Michelle</creatorcontrib><creatorcontrib>Davis, Susan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical nursing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Towell‐Barnard, Amanda</au><au>Slatyer, Susan</au><au>Cadwallader, Helen</au><au>Harvey, Michelle</au><au>Davis, Susan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The influence of adaptive challenge on engagement of multidisciplinary staff in standardising aseptic technique in an emergency department: A qualitative study</atitle><jtitle>Journal of clinical nursing</jtitle><addtitle>J Clin Nurs</addtitle><date>2020-02</date><risdate>2020</risdate><volume>29</volume><issue>3-4</issue><spage>459</spage><epage>467</epage><pages>459-467</pages><issn>0962-1067</issn><eissn>1365-2702</eissn><abstract>Aims and objectives
To explore the challenge of engaging multidisciplinary staff in standardising aseptic technique (AT) in an emergency department (ED) in an Australian tertiary hospital, and to better understand the enablers and barriers to implementing practice change within this setting.
Background
Healthcare‐associated infections are the most common complication for patients in acute care. A clinical practice framework developed in the United Kingdom (UK) standardised AT practice to reduce potential infection risk. One Australian tertiary hospital drew upon this framework to similarly improve clinical practice. It was understood that standardising practice would require some practitioners only to revisit and demonstrate AT principles already embedded in their practice, while others would be challenged to adopt a new approach.
Design
Qualitative, descriptive research design.
Methods
Data were collected through focus groups held before and after implementation of the AT programme. Data were analysed using the framework method. The (COREQ) checklist was followed.
Results
Four emergent themes described the influence of motivation on individuals' beliefs and attitudes towards practice change, relationships within the ED context, delivery of education and management directives.
Conclusion
Implementing practice change is more than just providing technical knowledge and includes changing individuals' beliefs and attitudes. An understanding of adaptive challenge can assist in implementing practice change that involves the multidisciplinary team.
Relevance to clinical practice
Results provide evidence as to how the adaptive challenge framework could be a suitable approach to manage potential enablers and barriers to implementing change within a multidisciplinary team in an acute hospital.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31793117</pmid><doi>10.1111/jocn.15109</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2475-7724</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | adaptive challenge aseptic technique Australia Clinical medicine Cross Infection - prevention & control Descriptive research Disease control Disease prevention emergency department Emergency medical care Emergency Service, Hospital - organization & administration engagement of multidisciplinary team Focus Groups Humans Hygiene Leadership Nosocomial infections Nursing Organizational Innovation qualitative Qualitative Research Quality Improvement Quality standards Sterilization Tertiary Care Centers Training Western Australia |
title | The influence of adaptive challenge on engagement of multidisciplinary staff in standardising aseptic technique in an emergency department: A qualitative study |
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