Emergency Department management of early pregnancy bleeding: facilitators and barriers to evidence-based practice
Tracks
Concurrent Stream 1
| Friday, October 18, 2024 |
| 12:00 PM - 12:20 PM |
| Ionic Room |
Overview
Baylie Trostian
Speaker
Ms Baylie Trostian
Phd Candidate
University Of Sydney
Emergency Department management of early pregnancy bleeding: facilitators and barriers to evidence-based practice.
12:00 PM - 12:20 PMAbstract
Background: Bleeding is a common early pregnancy complication, and its management in the Emergency Department (ED) can impact immediate and long-term health outcomes. We developed a practice guideline based on the best available evidence to guide ED management for early pregnancy. Facilitators and barriers to any new intervention should be identified and understood to inform a feasible, successful, and sustainable implementation strategy.
Aim: To evaluate ED clinicians’ perceptions of current ED management of early pregnancy bleeding, and to identify facilitators and barriers to use of an evidence-based practice guideline.
Methods: A 20-item survey was distributed to 476 ED clinicians from four EDs and one Urgent Care Centre, across a regional health district. Quantitative data were analysed using Jamovi (Version 2.3.28) and qualitative data analysis was supported with NVivoTM v12 software. Quantitative and qualitative results were integrated, and facilitators and barriers were identified and mapped to the theoretical domains framework (TDF) to enable future development of an implementation strategy.
Results: Ninety-seven ED clinicians completed the survey (response rate 20.3%), and all 5 facilities surveyed were represented. Nurse practitioners reported the highest mean confidence when caring for women with early pregnancy bleeding (mean 3.88, SD 0.98), compared to nurses (3.27, SD 1.06) and medical officers (3.67, SD 0.88). The proposed practice guideline received positive feedback from ED clinicians (median score >4.0, range= 1-6) for content, structure, usability, and relevance. The six barriers and 14 facilitators to evidence-based practice mapped to seven domains of the TDF environmental context and resources, beliefs and consequences, emotion, skills, behavioural regulation, knowledge and social influences.
Conclusion: Multiple facilitators and barriers were identified that may affect the implementation of evidence-based practice for the ED management of early pregnancy bleeding. An evidence informed implementation strategy will be developed on these findings.
Aim: To evaluate ED clinicians’ perceptions of current ED management of early pregnancy bleeding, and to identify facilitators and barriers to use of an evidence-based practice guideline.
Methods: A 20-item survey was distributed to 476 ED clinicians from four EDs and one Urgent Care Centre, across a regional health district. Quantitative data were analysed using Jamovi (Version 2.3.28) and qualitative data analysis was supported with NVivoTM v12 software. Quantitative and qualitative results were integrated, and facilitators and barriers were identified and mapped to the theoretical domains framework (TDF) to enable future development of an implementation strategy.
Results: Ninety-seven ED clinicians completed the survey (response rate 20.3%), and all 5 facilities surveyed were represented. Nurse practitioners reported the highest mean confidence when caring for women with early pregnancy bleeding (mean 3.88, SD 0.98), compared to nurses (3.27, SD 1.06) and medical officers (3.67, SD 0.88). The proposed practice guideline received positive feedback from ED clinicians (median score >4.0, range= 1-6) for content, structure, usability, and relevance. The six barriers and 14 facilitators to evidence-based practice mapped to seven domains of the TDF environmental context and resources, beliefs and consequences, emotion, skills, behavioural regulation, knowledge and social influences.
Conclusion: Multiple facilitators and barriers were identified that may affect the implementation of evidence-based practice for the ED management of early pregnancy bleeding. An evidence informed implementation strategy will be developed on these findings.
Biography
Baylie Trostian has been a nurse since 2008 and midwife from 2014, working as both at Wollongong Hospital, and a lecturer at the University of Wollongong. Baylie is currently a PhD candidate, at the University of Sydney researching Emergency care of early pregnancy bleeding, and recipient of the Skellern Family Foundation Scholarship, that provides financial assistance to an outstanding PhD scholar. Baylie has worked as an emergency nurse and midwife nationally and internationally in Nepal and Guatemala. She is an early career researcher, with publications and conference presentations about education, and emergency care.
