The views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study

Eilidh M. Duncan; Brian H. Cuthbertson; Maria E. Prior; Andrea P Marshall; Elisabeth C Wells; Laura E Todd; Denise Bolsover; Rumana S Newlands; Fiona Webster; Louise Rose; Marion K Campbell; Geoff Bellingan; Ian M Seppelt; Jill J Francis; SuDDICU International Study Group

doi:10.1016/j.jcrc.2014.03.013

The views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study

Eilidh M. Duncan, Brian H. Cuthbertson, Maria E. Prior, Andrea P Marshall, Elisabeth C Wells, Laura E Todd, Denise Bolsover, Rumana S Newlands, Fiona Webster, Louise Rose, Marion K Campbell, Geoff Bellingan, Ian M Seppelt, Jill J Francis, SuDDICU International Study Group

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Abstract

PURPOSE: Selective decontamination of the digestive tract (SDD) as a prophylactic intervention improves hospital-acquired infection and survival rates. Uptake of SDD is low and remains controversial. This study applied the theoretical domains framework to assess intensive care unit clinicians' views about SDD in regions with limited or no adoption of SDD.

MATERIALS AND METHODS: Participants were health professionals with "decisional authority" for the adoption of SDD. Semistructured interviews were conducted as the first round of a Delphi study. Views about SDD adoption, delivery, and further SDD research were explored. Directed content analysis of interview data identified subthemes, which informed item development for subsequent Delphi rounds. Linguistic features of interview data were also explored.

RESULTS: One hundred forty-one participants provided interview data. Fifty-six subthemes were identified; 46 were common across regions. Beliefs about consequences were the most widely elaborated theme. Linguistic features of how participants discussed SDD included caution expressed when discussing the risks and benefits and words such as "worry," "anxiety," and "fear" when discussing potential antibiotic resistance associated with SDD.

CONCLUSIONS: We identified salient beliefs, barriers, and facilitators to SDD adoption and delivery. What participants said about SDD and the way in which they said it demonstrated the degree of clinical caution, uncertainty, and concern that SDD evokes.

Original language	English
Pages (from-to)	634-640
Number of pages	7
Journal	Journal of Critical Care
Volume	29
Issue number	4
Early online date	21 Mar 2014
DOIs	https://doi.org/10.1016/j.jcrc.2014.03.013
Publication status	Published - Aug 2014

Bibliographical note

Keywords

antibiotic prophylaxis
theoretical domains framework
intensive care unit
qualitative research

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10.1016/j.jcrc.2014.03.013

Duncan 2014
NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Critical Care. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in JOURNAL OF CRITICAL CARE, VOL 29, ISSUE 4, (2014) DOI: 10.1016/j.jcrc.2014.03.013
Accepted author manuscript, 271 KB

Cite this

Duncan, E. M., Cuthbertson, B. H., Prior, M. E., Marshall, A. P., Wells, E. C., Todd, L. E., Bolsover, D., Newlands, R. S., Webster, F., Rose, L., Campbell, M. K., Bellingan, G., Seppelt, I. M., Francis, J. J., & SuDDICU International Study Group (2014). The views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study. Journal of Critical Care, 29(4), 634-640. https://doi.org/10.1016/j.jcrc.2014.03.013

Duncan, EM, Cuthbertson, BH, Prior, ME, Marshall, AP, Wells, EC, Todd, LE, Bolsover, D, Newlands, RS, Webster, F, Rose, L, Campbell, MK, Bellingan, G, Seppelt, IM, Francis, JJ & SuDDICU International Study Group 2014, 'The views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study', Journal of Critical Care, vol. 29, no. 4, pp. 634-640. https://doi.org/10.1016/j.jcrc.2014.03.013

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AU - Prior, Maria E.

AU - Marshall, Andrea P

AU - Wells, Elisabeth C

AU - Todd, Laura E

AU - Bolsover, Denise

AU - Newlands, Rumana S

AU - Webster, Fiona

AU - Rose, Louise

AU - Campbell, Marion K

AU - Bellingan, Geoff

AU - Seppelt, Ian M

AU - Francis, Jill J

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N2 - PURPOSE: Selective decontamination of the digestive tract (SDD) as a prophylactic intervention improves hospital-acquired infection and survival rates. Uptake of SDD is low and remains controversial. This study applied the theoretical domains framework to assess intensive care unit clinicians' views about SDD in regions with limited or no adoption of SDD.MATERIALS AND METHODS: Participants were health professionals with "decisional authority" for the adoption of SDD. Semistructured interviews were conducted as the first round of a Delphi study. Views about SDD adoption, delivery, and further SDD research were explored. Directed content analysis of interview data identified subthemes, which informed item development for subsequent Delphi rounds. Linguistic features of interview data were also explored.RESULTS: One hundred forty-one participants provided interview data. Fifty-six subthemes were identified; 46 were common across regions. Beliefs about consequences were the most widely elaborated theme. Linguistic features of how participants discussed SDD included caution expressed when discussing the risks and benefits and words such as "worry," "anxiety," and "fear" when discussing potential antibiotic resistance associated with SDD.CONCLUSIONS: We identified salient beliefs, barriers, and facilitators to SDD adoption and delivery. What participants said about SDD and the way in which they said it demonstrated the degree of clinical caution, uncertainty, and concern that SDD evokes.

AB - PURPOSE: Selective decontamination of the digestive tract (SDD) as a prophylactic intervention improves hospital-acquired infection and survival rates. Uptake of SDD is low and remains controversial. This study applied the theoretical domains framework to assess intensive care unit clinicians' views about SDD in regions with limited or no adoption of SDD.MATERIALS AND METHODS: Participants were health professionals with "decisional authority" for the adoption of SDD. Semistructured interviews were conducted as the first round of a Delphi study. Views about SDD adoption, delivery, and further SDD research were explored. Directed content analysis of interview data identified subthemes, which informed item development for subsequent Delphi rounds. Linguistic features of interview data were also explored.RESULTS: One hundred forty-one participants provided interview data. Fifty-six subthemes were identified; 46 were common across regions. Beliefs about consequences were the most widely elaborated theme. Linguistic features of how participants discussed SDD included caution expressed when discussing the risks and benefits and words such as "worry," "anxiety," and "fear" when discussing potential antibiotic resistance associated with SDD.CONCLUSIONS: We identified salient beliefs, barriers, and facilitators to SDD adoption and delivery. What participants said about SDD and the way in which they said it demonstrated the degree of clinical caution, uncertainty, and concern that SDD evokes.

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ER -

The views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study

Abstract

Bibliographical note

Keywords

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