51. Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians.
- Author
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Flenady, Tracy, Dwyer, Trudy, Sobolewska, Agnieszka, Lagadec, Danielle Le, Connor, Justine, Kahl, Julie, Signal, Tania, and Browne, Matthew
- Subjects
PATIENT monitoring ,NURSE-patient ratio ,PUBLIC hospitals ,SOCIOCULTURAL factors ,THEMATIC analysis ,SEMI-structured interviews - Abstract
Background: Early warning systems (EWS) are most effective when clinicians monitor patients' vital signs and comply with the recommended escalation of care protocols once deterioration is recognised.Objectives: To explore sociocultural factors influencing acute care clinicians' compliance with an early warning system commonly used in Queensland public hospitals in Australia.Methods: This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia.Results: This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication.Conclusions: The overarching organisational context including the hospital's embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians' and teams' compliance or non-compliance with early warning system's monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff. [ABSTRACT FROM AUTHOR]- Published
- 2020
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