Prehospital providers’ perspectives for clinical practice guideline implementation and dissemination : strengthening guideline uptake in South Africa
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science
Abstract
Background: In 2016 the first African emergency care clinical practice guideline (CPG) was developed for national uptake in the prehospital sector in South Africa, with implementation starting in 2018. Comprehensive uptake of CPGs post development is not a given, as this requires effective and efficient dissemination and implementation strategies that take into account
the perceptions, barriers and facilitators of the local end-users. This study aimed to identify prehospital end-users’ perceptions of the emergency care guidelines, including barriers and
facilitators for national decision makers, to strengthen CPG uptake in South Africa.
Methods: Our study employed a descriptive qualitative research design, including nine focus groups with 56 operational emergency care providers across four major provinces in South Africa.
Data was analysed using thematic analysis in ATLAS.ti. Ethics approval was provided by Stellenbosch University.
Results: Themes related to provider perceptions, expectations and guideline uptake emerging from the data was unofficial and unclear communication, broadening versus limiting guideline
expectations, conflicted personal reactions and spreading the word. Challenges to dissemination and implementation included poor communication, changes to scope of practice, and limited capacity to upskill existing providers. Facilitators included using technology for enduser documents, local champions to support change, establishing online and modular training,
and implementation by independent decision makers.
Conclusion: This study provides an overview of the perceptions of operational emergency care providers and how their experiences of hearing about and engaging with the guidelines, in their industry, can contribute to the dissemination, implementation and uptake of emergency care guidelines. In order to disseminate and implement an emergency care CPG, decision makers must take into account the perceptions, barriers, and facilitators of local end-users.
Description
CITATION: McCaul, M., Hendricks, L. & Naidoo, R. 2019. Prehospital providers’ perspectives for clinical practice guideline implementation and dissemination : strengthening guideline uptake in South Africa. PLoS ONE, 14(7):e0219761, doi:10.1371/journal.pone.0219761.
The original publication is available at https://journals.plos.org/plosone
Publication of this article was funded by the Stellenbosch University Open Access Fund
The original publication is available at https://journals.plos.org/plosone
Publication of this article was funded by the Stellenbosch University Open Access Fund
Keywords
Emergency medicine -- Practice -- South Africa, Medical protocols -- South Africa
Citation
McCaul, M., Hendricks, L. & Naidoo, R. 2019. Prehospital providers’ perspectives for clinical practice guideline implementation and dissemination : strengthening guideline uptake in South Africa. PLoS ONE, 14(7):e0219761, doi:10.1371/journal.pone.0219761