Developing an implementation intervention for managing acute vertigo in the emergency department.

Area of Science:

• Implementation Science
• Emergency Medicine
• Clinical Diagnostics

Background:

• Evidence-based bedside tests exist for acute vertigo diagnosis.
• Lack of evidence-based strategies hinders clinician implementation of these tests.
• Implementation science principles were used to address this gap.

Purpose of the Study:

• To design an implementation strategy for acute vertigo diagnosis.
• To examine facilitators and barriers to using bedside tests in the Emergency Department (ED).

Main Methods:

• A survey using the Theoretical Domains Framework and Consolidated Framework for Implementation Research was developed.
• Surveys and semistructured interviews were conducted with Emergency Clinicians (ECs) in a UK teaching hospital.
• Implementation strategies were selected using the Expert Recommendations for Implementing Change framework.

Main Results:

• Less than half of surveyed ECs reported using bedside tests for diagnosis.
• Common barriers included perceived complexity, lack of materials, memory issues, and negative experiences.
• ECs expressed a strong desire for change in acute vertigo management.

Conclusions:

• Barriers such as memory, inadequate materials, and training impede acute vertigo management.
• A robust desire for change exists among clinicians.
• An initial implementation strategy phase was described and requires further testing.