Saint Paul's hospital millennium medical college.
Jhpiego, Johns Hopkins.
Ethiop J Health Sci. 2023 Mar;33(2):183-192. doi: 10.4314/ejhs.v33i2.2.
Evidence-base practice needs to be supported by guidelines and decision-making protocols. This study aimed to look into the barriers and facilitators of adherence to national protocols in Ethiopia.
Exploratory qualitative method was implemented to explore adherence to protocol. The national COVID-19 case management guideline was used as this study's prototype reference. A total of five FGDS were conducted among 26 healthcare providers. A total of 14 physicians and 12 nurses participated in the FGDs. Semi-structured focus group discussions guides were used to facilitate the discussion among healthcare workers involved in COVID-19 case management. The FGDs were audio recorded, transcribed and analyzed thematically.
Three broad themes have emerged from the content analysis. These include individual factors, environmental factors and system factors. System factors barriers to utilization include unclear guidelines, discordant guidelines and a lack of live national guidelines, while the main facilitator was supportive management. The environmental factors that were barriers to adherence included limited infrastructure and shortages of drugs suggested in the protocols.
Outdated and discordant guidelines and a shortage of suggested managements were barriers. Future similar works should consider the identified barriers and need regular updates to facilitate effective implementation.
循证实践需要得到指南和决策方案的支持。本研究旨在探讨埃塞俄比亚遵循国家方案的障碍和促进因素。
采用探索性定性方法来探究对方案的遵循情况。将国家 COVID-19 病例管理指南用作本研究的原型参考。共进行了五次焦点小组讨论，参与者包括 26 名医疗保健提供者。共有 14 名医生和 12 名护士参加了 FGDs。使用半结构化焦点小组讨论指南来促进参与 COVID-19 病例管理的医护人员之间的讨论。对 FGDs 进行了录音、转录和主题分析。
内容分析产生了三个广泛的主题。这些主题包括个人因素、环境因素和系统因素。系统因素利用障碍包括指南不明确、指南不一致和缺乏实时国家指南，而主要的促进因素是支持性管理。环境因素中对遵循的障碍包括方案中建议的基础设施有限和药物短缺。
过时和不一致的指南以及管理建议的短缺是障碍。未来类似的工作应考虑到已确定的障碍，并需要定期更新以促进有效实施。
