loading page

An Exploration of the Enablers and Barriers to the Implementation of the Scottish Stroke Care Bundle.
  • Iona Lancaster,
  • Linda Martindale
Iona Lancaster
NHS Tayside
Author Profile
Linda Martindale
University of Dundee
Author Profile

Peer review status:UNDER REVIEW

03 May 2020Submitted to Journal of Evaluation in Clinical Practice
18 May 2020Assigned to Editor
18 May 2020Submission Checks Completed
20 May 2020Reviewer(s) Assigned
15 Jun 2020Review(s) Completed, Editorial Evaluation Pending

Abstract

Rationale, aims and objectives The Scottish Stroke Care Bundle (SSCB) aims to significantly improve patient outcomes and the consistency with which stroke patients are managed. The identification of key enablers and barriers to implementation will allow a future focus on the development of appropriate interventions to promote reliability of implementation. The aim of this study was to explore and describe the reasons why doctors and nurses in one Health Board area in Scotland feel that the SSCB is not being applied in a consistent and reliable way. The research objective was ‘to explore and describe the factors associated with compliance and non-compliance with the Scottish stroke care bundle’. Method A qualitative approach was used to understand the perspectives of medical and nursing staff involved in implementing the SSCB. Eight semi-structured interviews were undertaken across two sites. Cane et al’s Theoretical Domains Framework (TDF) guided data collection and analysis providing context-based explanations as to why reliable implementation of the SSCB is not being achieved.1 Results Three significant factors were identified that significantly influence the likelihood of patients receiving the SSCB: knowledge; resources; and organisational culture. The interrelationships between these factors revealed key enablers and barriers to the consistent application of the SSCB in this Health Board area. Conclusions Many of the findings are commonly identified as being crucial to the implementation of care bundles and potentially have national implications for SSCB implementation. Multifaceted quality improvement interventions, based on these findings, would improve the consistency of SSCB implementation in this Health Board area.