Lessons learned from a failed implementation: Effective communication with patients in transmission-based precautions - 20/05/23
, Reginaldo A. Luz, RN, MSc, PhD b, Adriana M.da Silva Felix, RN, PhD b, Stephen Timmons, PhD c, Maria Clara Padoveze, RN, MSc, PhD aHighlights |
• | Effective communication in transmission-based precautions can avoid adverse events. |
• | Study showed that the effective communication is a concept not always understood. |
• | Lessons learned allowed us to propose suggestions for future implementations. |
• | When planning implementation, consider political-economic status of institution. |
• | Identify whether intervention fits the organization's culture in terms of demands. |
Abstract |
Background |
Patient engagement with transmission-based precautions can be an important strategy to prevent adverse events related to isolation. Most patient education is still highly prescriptive and is thus unlikely to help. Effective communication requires behavior change, leading to a meaningful dialog between the parties involved.
Objective |
evaluate implementation process of a protocol for effective communication with patients in transmission-based precautions (Com-Efe).
Methods |
Implementation research using qualitative methods in 4 sequential phases: (1) nonparticipant observation in inpatient wards; (2) design of the intervention for implementation; (3) adaptation of the Com-Efe through workshops with nurses; (4) final assessment of the implementation results through interviews with nurses. Study was performed in a public, secondary, teaching hospital. Consolidated Framework for Implementation Research was used as the reference for interview design and data analysis, aiming to identify barriers and enablers of the implementation process.
Results |
Main factors that could have facilitated adherence were beliefs and perceived advantages in using the Com-Efe by nurses. Main barriers that may have contributed to the failure were the unfavorable climate for implementation, insufficient individual and leadership commitment, and the lack of understanding of the concepts underpinning effective communication.
Conclusions |
Despite using a systematic approach, the Com-Efe protocol was not fully implemented. The lessons learned in this study allowed us to propose suggestions for future protocol implementations in similar contexts.
Le texte complet de cet article est disponible en PDF.Key Words : Health communication, Implementation science, Transmission-based precautions
Abbreviations : Com-Efe, SP, TBP, MO, HAI, HCW, CFIR, COVID-19
Plan
| Conflicts of interest: None to report. |
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| Funding/Support: This study was partially financed by the “Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brazil (CAPES)” (Finance code: 001). |
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| Author contributions: LFJ: carried out the research as her doctoral project, which was the basis for this article. She worked on research planning, data collection, data analysis, and writing the article; RL: contribution to the writing and critical review of the article; AMF: contribution to the writing and critical review of the article; ST: contribution to the writing and critical review of the article; MCP: general advisor of the research, contributed to the planning and guided the collection and interpretation of data, as well as discussion and critical review of the article. |
Vol 51 - N° 6
P. 687-693 - juin 2023 Retour au numéro
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