Related Experiment Video
Updated: Oct 30, 2025
09:52
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
17.4K
Planning Implementation Success of Syncope Clinical Practice Guidelines in the Emergency Department Using CFIR
Jing Li1,2, Susan S Smyth2, Jessica M Clouser1
1Center for Health Services Research, University of Kentucky, Waller Health Care Annex, 304A, Lexington, KY 40536, USA.
Medicina (Kaunas, Lithuania)
|July 2, 2021
Summary
Implementing multifaceted strategies improved adherence to syncope clinical practice guidelines (CPG) by addressing barriers in emergency department (ED) care. This approach enhances patient outcomes and optimizes resource utilization.
Area of Science:
- Implementation Science
- Healthcare Management
- Clinical Practice Guidelines
Background:
- Overuse of testing and hospital admission is prevalent in syncope evaluation despite available guidelines.
- Current clinical guidelines have not significantly improved resource utilization in emergency department (ED) syncope management.
- Tailoring implementation strategies to local contexts is crucial for guideline adoption.
Purpose of the Study:
- To develop and test a stakeholder-based implementation strategy for syncope clinical practice guidelines (CPGs).
- To address barriers to CPG implementation and align with patient expectations in syncope care.
Main Methods:
- Applied implementation science principles and the CFIR-ERIC Implementation Strategy Matching Tool.
- Conducted surveys and interviews with patients, caregivers, clinicians, and administrators across four health systems.
- Co-designed and pilot-tested the MISSION (Multilevel, Multicomponent Implementation Strategy) approach.
Main Results:
- Identified key barriers: low guideline awareness, communication issues, lack of workflow integration, and organizational resistance.
- Patients and caregivers desire clarity on diagnosis, care plans, and feeling cared for.
- The MISSION strategy, incorporating educational materials, mentoring, and a mobile app, showed feasibility, acceptability, and success in appropriate testing.
Conclusions:
- Multifaceted implementation strategies targeting individuals, teams, and healthcare systems are effective for promoting adherence to syncope CPGs.
- Successful implementation requires addressing identified barriers and aligning with patient and caregiver expectations.
- This approach can optimize syncope care and resource utilization in the ED setting.
More Related Videos
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
69
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
69
01:26Acute Coronary Syndrome V: Nursing Management
91
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
91
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
159
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
159
01:21Planning Nursing Care I
5.2K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
5.2K
01:26Aneurysm III: Interprofessional Care
68
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
68
01:15Methods of Documentation VI: Case Management Model
670
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
670