Natalia Blanco1, Lyndsay M O'Hara2, Gwen L Robinson2, Jeanine Brown2, Emily Heil3, Clayton H Brown2, Brian D Stump4, Bryant W Sigler4, Anusha Belani4, Heidi L Miller5, Amber N Chiplinski5, Rebecca Perlmutter6, Lucy Wilson6, Daniel J Morgan7, Surbhi Leekha2. 1. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD. Electronic address: nblanco@som.umaryland.edu. 2. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD. 3. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD; Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD. 4. Frederick Memorial Hospital, Frederick, MD. 5. Meritus Health, Hagerstown, MD. 6. Emerging Infections Program, Maryland Department of Health, Baltimore, MD. 7. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD; VA Maryland Healthcare System, Baltimore, MD.
Abstract
BACKGROUND: Clostridium difficile infection (CDI) is associated with significant morbidity and mortality. Computerized clinical decision support (CCDS) tools can aid process improvement in infection prevention and antibiotic stewardship, but implementation and health care workers (HCWs) uptake of these tools is often variable. The objective of this study was to describe HCWs' perceptions of barriers and facilitators related to uptake of CCDS tools as part of a CDI reduction bundle. METHODS: We conducted a qualitative study among HCWs at 2 acute care hospitals in Maryland. Semi-structured interviews and structured surveys were completed by HCWs to evaluate their perception to CCDS tools at 2 different stages: predevelopment and preimplementation. Emergent themes and patterns in the data were identified and condensed. RESULTS: Gaps in CDI-related knowledge and in communication between HCWs were identified throughout the evaluation. HCWs agreed on the potential of the tools to improve CDI diagnosis, prevention, and control. An important barrier for uptake was the perceived loss of autonomy and clinical judgment, whereas standardization and error reduction were perceived advantages. CONCLUSIONS: These observations shaped the development and implementation of the CDI reduction bundle. Qualitative findings can provide valuable contextual information during the development stages of CCDS tools in infection prevention and antibiotic stewardship. Published by Elsevier Inc.
BACKGROUND:Clostridium difficileinfection (CDI) is associated with significant morbidity and mortality. Computerized clinical decision support (CCDS) tools can aid process improvement in infection prevention and antibiotic stewardship, but implementation and health care workers (HCWs) uptake of these tools is often variable. The objective of this study was to describe HCWs' perceptions of barriers and facilitators related to uptake of CCDS tools as part of a CDI reduction bundle. METHODS: We conducted a qualitative study among HCWs at 2 acute care hospitals in Maryland. Semi-structured interviews and structured surveys were completed by HCWs to evaluate their perception to CCDS tools at 2 different stages: predevelopment and preimplementation. Emergent themes and patterns in the data were identified and condensed. RESULTS: Gaps in CDI-related knowledge and in communication between HCWs were identified throughout the evaluation. HCWs agreed on the potential of the tools to improve CDI diagnosis, prevention, and control. An important barrier for uptake was the perceived loss of autonomy and clinical judgment, whereas standardization and error reduction were perceived advantages. CONCLUSIONS: These observations shaped the development and implementation of the CDI reduction bundle. Qualitative findings can provide valuable contextual information during the development stages of CCDS tools in infection prevention and antibiotic stewardship. Published by Elsevier Inc.
Authors: Clare Rock; Rebecca Perlmutter; David Blythe; Jacqueline Bork; Kimberly Claeys; Sara E Cosgrove; Kate Dzintars; Valeria Fabre; Anthony D Harris; Emily Heil; Yea-Jen Hsu; Sara Keller; Lisa L Maragakis; Aaron M Milstone; Daniel J Morgan; Prashila Dullabh; Petry S Ubri; Christina Rotondo; Richard Brooks; Surbhi Leekha Journal: BMJ Qual Saf Date: 2021-12-09 Impact factor: 7.035