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dc.contributor.authorDebono, D
dc.contributor.authorTaylor, N
dc.contributor.authorLipworth, W
dc.contributor.authorGreenfield, D
dc.contributor.authorTravaglia, J
dc.contributor.authorBlack, D
dc.contributor.authorBraithwaite, J
dc.date.accessioned2020-01-13T03:59:40Z
dc.date.available2020-01-13T03:59:40Z
dc.date.issued2017
dc.identifier.citationDebono, D., Taylor, N., Lipworth, W. et al. Applying the Theoretical Domains Framework to identify barriers and targeted interventions to enhance nurses’ use of electronic medication management systems in two Australian hospitals. Implementation Sci 12, 42 (2017) doi:10.1186/s13012-017-0572-1en_AU
dc.identifier.urihttps://hdl.handle.net/2123/21657
dc.identifier.urihttps://doi.org/10.1186/s13012-017-0572-1
dc.description.abstractBackground Medication errors harm hospitalised patients and increase health care costs. Electronic Medication Management Systems (EMMS) have been shown to reduce medication errors. However, nurses do not always use EMMS as intended, largely because implementation of such patient safety strategies requires clinicians to change their existing practices, routines and behaviour. This study uses the Theoretical Domains Framework (TDF) to identify barriers and targeted interventions to enhance nurses’ appropriate use of EMMS in two Australian hospitals. Methods This qualitative study draws on in-depth interviews with 19 acute care nurses who used EMMS. A convenience sampling approach was used. Nurses working on the study units (N = 6) in two hospitals were invited to participate if available during the data collection period. Interviews inductively explored nurses’ experiences of using EMMS (step 1). Data were analysed using the TDF to identify theory-derived barriers to nurses’ appropriate use of EMMS (step 2). Relevant behaviour change techniques (BCTs) were identified to overcome key barriers to using EMMS (step 3) followed by the identification of potential literature-informed targeted intervention strategies to operationalise the identified BCTs (step 4). Results Barriers to nurses’ use of EMMS in acute care were represented by nine domains of the TDF. Two closely linked domains emerged as major barriers to EMMS use: Environmental Context and Resources (availability and properties of computers on wheels (COWs); technology characteristics; specific contexts; competing demands and time pressure) and Social/Professional Role and Identity (conflict between using EMMS appropriately and executing behaviours critical to nurses’ professional role and identity). The study identified three potential BCTs to address the Environmental Context and Resources domain barrier: adding objects to the environment; restructuring the physical environment; and prompts and cues. Seven BCTs to address Social/Professional Role and Identity were identified: social process of encouragement; pressure or support; information about others’ approval; incompatible beliefs; identification of self as role model; framing/reframing; social comparison; and demonstration of behaviour. It proposes several targeted interventions to deliver these BCTs. Conclusions The TDF provides a useful approach to identify barriers to nurses’ prescribed use of EMMS, and can inform the design of targeted theory-based interventions to improve EMMS implementation.
dc.publisherBMCen_AU
dc.rightsOpen Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_AU
dc.subjectImplementationen_AU
dc.subjectTheoretical Domains Frameworken_AU
dc.subjectBehaviour changeen_AU
dc.subjectElectronic Medication Management Systemsen_AU
dc.subjectMedication administrationen_AU
dc.subjectWorkaroundsen_AU
dc.titleApplying the Theoretical Domains Framework to identify barriers and targeted interventions to enhance nurses’ use of electronic medication management systems in two Australian hospitalsen_AU
dc.typeArticleen_AU
dc.subject.asrc2201 Applied ethicsen_AU
dc.subject.asrc1117 Public Health and Health Sciencesen_AU
dc.identifier.doi10.1186/s13012-017-0572-1
dc.type.pubtypePublisher versionen_AU


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