Abstract：
OBJECTIVE: To explore the implementation contexts and strategies that influence the uptake and selection of alternative peripherally inserted central catheter (PICC) materials and design.
METHODS: Qualitative evaluation of end user perspectives within a randomized control trial of different PICC materials and design.
METHODS: Semi-structured interviews with key stakeholders were undertaken via an adapted, rapid-analytic approach using the Consolidated Framework for Implementation Research. Outcomes were mapped against the Expert Recommendations for Implementing Change (ERIC) tool for strategies to guide innovation in PICC practice.
RESULTS: Participants (n = 23) represented a combination of users and inserters/purchasers, from adult and paediatric settings. Dominant themes included intervention characteristics (intervention source), inner setting (structural characteristics) and individuals involved (self-efficacy). Strategies emerging to support a change from ERIC mapping (n = 16) included promotion of intervention adaptability, inclusion of staff and consumer perspectives and sufficient funding. Implementation contexts such as inner setting and individuals involved equally impacted PICC success and implementation effectiveness and enabled a greater understanding of barriers and facilitators to intervention implementation in this trial.
CONCLUSIONS: Trial evidence is important, but healthcare decision-making requires consideration of local contexts especially resourcing. Implementation contexts for Australian healthcare settings include a practical, strategic toolkit for the implementation of alternative PICC materials and designs.
UNASSIGNED: This study adhered to COREQ guidelines.
UNASSIGNED: No patient or public contribution.
METHODS: Qualitative evaluation of end user perspectives within a randomized control trial of different PICC materials and design.
METHODS: Semi-structured interviews with key stakeholders were undertaken via an adapted, rapid-analytic approach using the Consolidated Framework for Implementation Research. Outcomes were mapped against the Expert Recommendations for Implementing Change (ERIC) tool for strategies to guide innovation in PICC practice.
RESULTS: Participants (n = 23) represented a combination of users and inserters/purchasers, from adult and paediatric settings. Dominant themes included intervention characteristics (intervention source), inner setting (structural characteristics) and individuals involved (self-efficacy). Strategies emerging to support a change from ERIC mapping (n = 16) included promotion of intervention adaptability, inclusion of staff and consumer perspectives and sufficient funding. Implementation contexts such as inner setting and individuals involved equally impacted PICC success and implementation effectiveness and enabled a greater understanding of barriers and facilitators to intervention implementation in this trial.
CONCLUSIONS: Trial evidence is important, but healthcare decision-making requires consideration of local contexts especially resourcing. Implementation contexts for Australian healthcare settings include a practical, strategic toolkit for the implementation of alternative PICC materials and designs.
UNASSIGNED: This study adhered to COREQ guidelines.
UNASSIGNED: No patient or public contribution.
摘要：
目的：探讨影响外周置入中心静脉导管（PICC）材料和设计的摄取和选择的实施环境和策略。
方法：在一项针对不同PICC材料和设计的随机对照试验中，对最终用户观点进行定性评估。
方法：与主要利益相关者的半结构化访谈是通过改编的，使用实施研究综合框架的快速分析方法。结果是根据“实施变更专家建议”（ERIC）工具绘制的，以指导PICC实践中的创新。
结果：参与者（n=23）代表用户和插入者/购买者的组合，从成人和儿科设置。主导主题包括干预特征(干预来源)，内在环境(结构特征)和参与的个体(自我效能)。为支持ERIC映射(n=16)的变化而出现的策略包括促进干预适应性，包括员工和消费者的观点和足够的资金。诸如内部环境和涉及的个人等实施环境同样影响了PICC的成功和实施有效性，并使人们能够更好地了解本试验中干预实施的障碍和促进者。
结论：试验证据很重要，但是医疗决策需要考虑当地情况，尤其是资源。澳大利亚医疗机构的实施环境包括一个实用的，用于实施替代PICC材料和设计的战略工具包。
■这项研究遵循了COREQ指南。
■没有患者或公众捐款。
方法：在一项针对不同PICC材料和设计的随机对照试验中，对最终用户观点进行定性评估。
方法：与主要利益相关者的半结构化访谈是通过改编的，使用实施研究综合框架的快速分析方法。结果是根据“实施变更专家建议”（ERIC）工具绘制的，以指导PICC实践中的创新。
结果：参与者（n=23）代表用户和插入者/购买者的组合，从成人和儿科设置。主导主题包括干预特征(干预来源)，内在环境(结构特征)和参与的个体(自我效能)。为支持ERIC映射(n=16)的变化而出现的策略包括促进干预适应性，包括员工和消费者的观点和足够的资金。诸如内部环境和涉及的个人等实施环境同样影响了PICC的成功和实施有效性，并使人们能够更好地了解本试验中干预实施的障碍和促进者。
结论：试验证据很重要，但是医疗决策需要考虑当地情况，尤其是资源。澳大利亚医疗机构的实施环境包括一个实用的，用于实施替代PICC材料和设计的战略工具包。
■这项研究遵循了COREQ指南。
■没有患者或公众捐款。
