- Title
- Enablers of the implementation of tissue plasminogen activator in acute stroke care: a cross-sectional survey
- Creator
- Grady, Alice; Bryant, Jamie; Carey, Mariko; Paul, Chris; Sanson-Fisher, Rob
- Relation
- PLoS ONE Vol. 9, Issue 12
- Publisher Link
- http://dx.doi.org/10.1371/journal.pone.0114778
- Publisher
- Public Library of Science
- Resource Type
- journal article
- Date
- 2014
- 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 bestpractice 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.
- Subject
- stroke; ischemic stroke; physicians; human performance; critical care and emergency medicine; treatment guidelines; health care providers; surveys
- Identifier
- http://hdl.handle.net/1959.13/1060692
- Identifier
- uon:16810
- Identifier
- ISSN:1932-6203
- Language
- eng
- Full Text
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