ArticleImplementation science : IS2009
Barriers and supports to implementation of MDI/spacer use in nine Canadian pediatric emergency departments: a qualitative study.
Article in Implementation science : IS, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02566902 (Comparison of Breath-Enhanced and T-Piece Nebulizers in Children With Acute Asthma), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Breath-Enhanced and T-Piece Nebulizers in Children With Acute Asthma
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Systematic review of knowledge translation strategies in the allied health professions.Implementation science : IS · 2012Pooled it
- Lessons Learned From a Practice-Based, Multisite Intervention Study With Nurse Participants.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2017Trial
- Trial
- Improving management of acute asthma in children through an integrated care pathway.BMJ paediatrics open · 2026Article
- Parental Knowledge, Self-confidence, and Usability Evaluation of a Web-Based Infographic for Pediatric Concussion: Multimethod Study.JMIR pediatrics and parenting · 2022Article
- Assessing and addressing barriers towards MDI use in acute asthma exacerbations at a tertiary pediatric ED in the United Arab Emirates.International journal of pediatrics & adolescent medicine · 2022Article
- Patient and provider perspectives on uptake of a shared decision making intervention for asthma in primary care practices.The Journal of asthma : official journal of the Association for the Care of Asthma · 2019Article
- Development and Usability Evaluation of an Art and Narrative-Based Knowledge Translation Tool for Parents With a Child With Pediatric Chronic Pain: Multi-Method Study.Journal of medical Internet research · 2017Article
- Article
- Developing a targeted, theory-informed implementation intervention using two theoretical frameworks to address health professional and organisational factors: a case study to improve the management of mild traumatic brain injury in the emergency department.Implementation science : IS · 2015Article
- Patients' perspective of barriers and facilitators to taking long-term controller medication for asthma: a novel taxonomy.BMC pulmonary medicine · 2015Article
- Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff.Journal of medical engineering & technology · 2015Article
- Experiences with capnography in acute care settings: a mixed-methods analysis of clinical staff.Journal of critical care · 2014Article
- Development and validation of questionnaires exploring health care professionals' intention to use wiki-based reminders to promote best practices in trauma.JMIR research protocols · 2014Article
- Healthcare professionals' intentions to use wiki-based reminders to promote best practices in trauma care: a survey protocol.Implementation science : IS · 2010Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite recent research supporting the use of metered dose inhalers with spacer devices (MDI/spacers) in pediatric emergency departments (PEDs) for acute exacerbations of asthma, uptake of this practice has been slow. The objectives of this study were to determine the barriers and supports to implementing MDI/spacer research and to identify factors associated with early and late adoption of MDI/spacers in Canadian PEDs.
methodsUsing a comparative case study design, we classified nine tertiary care pediatric hospital PEDs based on their stage of implementation. Data were collected using focus group interviews with physicians, registered nurses (RNs), and respiratory therapists (RTs), and individual interviews with both patient care and medical directors at each site. Initial coding was based on the Ottawa Model of Research Use (OMRU) categories of elements known to influence the uptake of innovations.
resultsOne hundred and fifty healthcare professionals from nine different healthcare institutions participated in this study. Lack of leadership in the form of a research champion, a lack of consensus about the benefits of MDI/spacers among staff, perceived resistance from patients/parents, and perceived increased cost and workload associated with MDI/spacer use were the most prevalent barriers to the adoption of the MDI/spacer. Common strategies used by early-adopting sites included the active participation of all professional groups in the adoption process in addition to a well-planned and executed educational component for staff, patients, and families. Early adopter sites were also more likely to have the MDI/spacer included in a clinical protocol/pathway.
conclusionPotential barriers and supports to implementation have been identified that will help EDs adopt MDI/spacer use. Future interventions intended to increase MDI/spacer use in PEDs will need to be sensitive to the barriers identified in this study.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.