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Ways to improve guideline adherence in the emergency department: an interview study on the management of traumatic brain injuries

Vestlund, Sebastian LU ; Vedin, Tomas LU ; Edelhamre, Marcus LU ; Lindén, Magnus LU and Larsson, Per-Anders LU (2022) In European Journal of Trauma and Emergency Surgery 48(6). p.4499-4508
Abstract
Purpose

The aim was to explore factors affecting guideline adherence among doctors in the emergency department and to explore the general perception about local guidelines for traumatic brain injuries.
Methods

Thirty semi-structured interviews were conducted with doctors with experience working in the emergency department regarding different aspects of guideline use, with emphasis on the management of traumatic brain injuries. Twenty-eight interviews were included for analysis. The interviews were recorded, transcribed, and analysed iteratively. Emergent codes were identified and organised into themes and subthemes.
Results

Eight themes were identified. Barriers were centred on low availability of local... (More)
Purpose

The aim was to explore factors affecting guideline adherence among doctors in the emergency department and to explore the general perception about local guidelines for traumatic brain injuries.
Methods

Thirty semi-structured interviews were conducted with doctors with experience working in the emergency department regarding different aspects of guideline use, with emphasis on the management of traumatic brain injuries. Twenty-eight interviews were included for analysis. The interviews were recorded, transcribed, and analysed iteratively. Emergent codes were identified and organised into themes and subthemes.
Results

Eight themes were identified. Barriers were centred on low availability of local guidelines and guideline document design. Facilitating factors included a concise document, appropriate visual aids, high accessibility, and encouragement by management and senior peers. The local guidelines on traumatic brain injuries were regarded as distinct, but it was occasionally difficult to determine when they were applicable. Mandatory admission of patients on anticoagulants was sometimes perceived as excessive. Biomarker S100b was believed to sometimes lead to delayed care.
Conclusion

The participants believed that guideline adherence would increase by facilitating guideline availability, by providing concise, easy-to-understand, and well-illustrated guidelines available in printed form, as well as establishing a culture that promotes guideline use. The local guidelines for traumatic brain injuries were appreciated, but could be improved. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Trauma and Emergency Surgery
volume
48
issue
6
pages
4499 - 4508
publisher
Urban & Vogel
external identifiers
  • scopus:85124161561
  • pmid:35113171
ISSN
1863-9933
DOI
10.1007/s00068-021-01853-3
language
English
LU publication?
yes
id
649eae39-83d4-476a-a4e1-faa21d95cac4
date added to LUP
2022-02-04 11:04:29
date last changed
2023-01-16 10:17:33
@article{649eae39-83d4-476a-a4e1-faa21d95cac4,
  abstract     = {{Purpose<br/><br/>The aim was to explore factors affecting guideline adherence among doctors in the emergency department and to explore the general perception about local guidelines for traumatic brain injuries.<br/>Methods<br/><br/>Thirty semi-structured interviews were conducted with doctors with experience working in the emergency department regarding different aspects of guideline use, with emphasis on the management of traumatic brain injuries. Twenty-eight interviews were included for analysis. The interviews were recorded, transcribed, and analysed iteratively. Emergent codes were identified and organised into themes and subthemes.<br/>Results<br/><br/>Eight themes were identified. Barriers were centred on low availability of local guidelines and guideline document design. Facilitating factors included a concise document, appropriate visual aids, high accessibility, and encouragement by management and senior peers. The local guidelines on traumatic brain injuries were regarded as distinct, but it was occasionally difficult to determine when they were applicable. Mandatory admission of patients on anticoagulants was sometimes perceived as excessive. Biomarker S100b was believed to sometimes lead to delayed care.<br/>Conclusion<br/><br/>The participants believed that guideline adherence would increase by facilitating guideline availability, by providing concise, easy-to-understand, and well-illustrated guidelines available in printed form, as well as establishing a culture that promotes guideline use. The local guidelines for traumatic brain injuries were appreciated, but could be improved.}},
  author       = {{Vestlund, Sebastian and Vedin, Tomas and Edelhamre, Marcus and Lindén, Magnus and Larsson, Per-Anders}},
  issn         = {{1863-9933}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{4499--4508}},
  publisher    = {{Urban & Vogel}},
  series       = {{European Journal of Trauma and Emergency Surgery}},
  title        = {{Ways to improve guideline adherence in the emergency department: an interview study on the management of traumatic brain injuries}},
  url          = {{http://dx.doi.org/10.1007/s00068-021-01853-3}},
  doi          = {{10.1007/s00068-021-01853-3}},
  volume       = {{48}},
  year         = {{2022}},
}