Evidence map›Paper›PMID 39953306›Full record

ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2025

Using the Theoretical Domains Framework to identify barriers and facilitators to peripheral nerve block use in older adult patients with a hip fracture: a national survey.

Yuqi Gu, Daniel I McIsaac, Emily Hladkowicz, Keely Barnes, Sylvain Boet, Colin McCartney, Reva Ramlogan

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Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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1 · What the graph read from it

What it found

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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.

2 · The registry

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3 · Its place in the literature

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4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Yuqi GuDepartment of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
Daniel I McIsaacDepartment of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
Emily HladkowiczClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Keely BarnesClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Sylvain BoetDepartment of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
Colin McCartneyDepartment of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Reva RamloganDepartment of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada. rramlogan@toh.ca.ORCID 0000-0002-4408-0060

Funding

Research Support, Non-US Gov’t
6 · The paper itself

Abstract

purposePeripheral nerve blocks (PNBs) in older adult patients with a hip fracture improve morbidity and mortality, reduce health care costs, and improve quality of care. Despite the benefits, PNB use rates remain low. We aimed to use the Theoretical Domains Framework to investigate the barriers and facilitators to PNB use in patients with a hip fracture from the perspective of Canadian anesthesiologists.

methodsWe created an online survey that collected both quantitative and qualitative responses. After research ethics board approval, the survey was distributed among all Canadian Anesthesiologists' Society (CAS) members. We present five-point Likert responses as medians and interquartile ranges [IQRs], conducted thematic analysis on the narrative feedback, and performed cluster analysis to explore patterns associated with survey responses.

resultsWe obtained responses from 256/2,498 (10.2%) CAS members. Of these respondents, 215 (84%) performed PNBs for patients with a hip fracture. The median [IQR] five-point Likert responses showed that participants felt confident placing a PNB (4 [4-5]) and agreed they possessed adequate knowledge and skills for PNB placement (4 [4-5]). Participants' responses showed lower ratings with greater variability for availability of adequate time (3 [3-4]), collaboration with the perioperative team (4 [2-4]), and adequate resources (4 [3-5]). Barriers to PNB use identified through thematic analysis included time pressure as well as inadequate human resources, training opportunities, and multidisciplinary collaboration with other health care professionals. Facilitators included more education, dedicated resources, and clinical care pathways.

conclusionOur results identified several barriers and facilitators related to physical resources, operational support, and educational factors that may inform future interventions to increase PNB use in older patients with a hip fracture. The results of this study may not be generalizable to all Canadian practice settings because of a low response rate and high proportion of respondents who performed PNBs at their local institution.

Indexed as

AnesthesiologistsHip FracturesNerve BlockAgedCanadaFemaleHumansMaleMiddle AgedSurveys and Questionnaireship fractureregional anesthesia barriersTheoretical Domains Framework

Identifiers

PMID39953306

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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.