NDLI: A qualitative study to understand barriers to implementation of national guidelines for prehospital termination of unsuccessful resuscitation efforts.

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Year: 2010 Volume: 14 Issue: 1

Year: 2010 Volume: 14 Issue: Supplementary 1

Year: 2009 Volume: 13

Year: 2008 Volume: 12

A qualitative study to understand barriers to implementation of national guidelines for prehospital termination of unsuccessful resuscitation efforts.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Sasson, Comilla Forman, Jane Krass, David Macy, Michelle Hegg, A. J. McNally, Bryan F. Kellermann, Arthur L.
Description	Country affiliation: United States Author Affiliation: Sasson C ( Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA. comilla@umich.edu)
Abstract	BACKGROUND: The American Heart Association's (AHA's) Advanced Cardiac Life Support guidelines act as the national standards for termination of resuscitation (TOR) in cases of refractory out-of-hospital cardiac arrest. However, local emergency medical services (EMS) implementation of these guidelines has been nonuniform. OBJECTIVE: To identify the operational issues within local EMS systems that may serve as barriers or facilitators to full acceptance of national guidelines for prehospital TOR in appropriate circumstances. Methods. We conducted three focus groups at the January 2008 National Association of EMS Physicians (NAEMSP) annual meeting. Snowball sampling was used to recruit 19 physicians, two EMS providers, one research director, one nurse, and one medical student attending the conference. Two reviewers analyzed the data in an iterative process to identify recurrent and unifying themes. RESULTS: We identified three distinct stakeholder groups whose current beliefs and practices may influence local implementation of TOR: EMS providers with variations in education and work culture; EMS medical directors with responsibility but little authority; and online medical control physicians who do not communicate effectively with the other groups. Our focus group participants suggested that national organizations, such as the AHA and the American College of Emergency Physicians, may serve a role in overcoming the overarching barriers of communication, standardized educational requirements, and coordination of local services. CONCLUSION: We have identified operational barriers that may impede implementation of TOR guidelines. Three influential stakeholder groups will need to work with national organizations to overcome these local barriers.
File Format	HTM / HTML
ISSN	10903127
Issue Number	2
Volume Number	14
e-ISSN	15450066
Journal	Prehospital Emergency Care
Language	English
Publisher	Taylor & Francis
Publisher Date	2010-04-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency Medicine Emergency Medical Services Guideline Adherence Resuscitation Orders Advanced Cardiac Life Support Focus Groups Guidelines As Topic Humans Journal Article
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine Emergency Nursing

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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