Identifying Barriers to The Implementation of Communicating Narrative Concerns Entered by Registered Nurses, An Early...

Area of Science:

• Nursing Informatics
• Clinical Deterioration Detection
• Health Systems Implementation

Background:

• Nurses are crucial in identifying patient deterioration.
• Communicating Narrative Concerns Entered by Registered Nurses (CONCERN) is an early warning system using nursing data for risk prediction.
• CONCERN was previously implemented via a randomized clinical trial.

Purpose of the Study:

• To identify optimal resources for implementing CONCERN.
• To develop the CONCERN Implementation Toolkit for wider adoption.
• To facilitate the spread of CONCERN to additional hospital sites.

Main Methods:

• Qualitative interviews were conducted with nurses, prescribing providers, and IT experts.
• Thematic analysis, guided by the Donabedian model, was performed on interview data.
• The CONCERN Implementation Toolkit (alpha version) was updated based on findings.

Main Results:

• 32 participants were included in the study.
• 12 themes were identified, aligning with the Donabedian model's structure, process, and outcome domains.
• Eight new resources were incorporated into the CONCERN Implementation Toolkit.

Conclusions:

• The alpha version of the CONCERN Implementation Toolkit has been validated.
• Future research will focus on validating the beta version of the Toolkit.
• Findings offer insights for implementing early warning systems in acute care settings.