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dc.contributor.authorSteffen, Katherine M
dc.contributor.authorSpinella, Philip C
dc.contributor.authorHoldsworth, Laura M
dc.contributor.authorFord, Mackenzie A
dc.contributor.authorLee, Grace M
dc.contributor.authorAsch, Steven M
dc.contributor.authorProctor, Enola K
dc.contributor.authorDoctor, Allan
dc.date.accessioned2022-01-19T16:39:34Z
dc.date.available2022-01-19T16:39:34Z
dc.date.issued2021-12-17
dc.identifier.urihttp://hdl.handle.net/10713/17627
dc.description.abstractPurpose: Risks of red blood cell transfusion may outweigh benefits for many patients in Pediatric Intensive Care Units (PICUs). The Transfusion and Anemia eXpertise Initiative (TAXI) recommendations seek to limit unnecessary and potentially harmful transfusions, but use has been variable. We sought to identify barriers and facilitators to using the TAXI recommendations to inform implementation efforts. Materials and Methods: The integrated Promoting Action on Research Implementation in Health Services (iPARIHS) framework guided semi-structured interviews conducted in 8 U.S. ICUs; 50 providers in multiple ICU roles completed interviews. Adapted Framework analysis, a form of content analysis, used the iPARIHS innovation, recipient, context and facilitation constructs and subconstructs to categorize data and identify patterns as well as unique informative statements. Results: Providers perceived that the TAXI recommendations would reduce transfusion rates and practice variability, but adoption faced challenges posed by attitudes around transfusion and care in busy and complex units. Development of widespread buy-in and inclusion in implementation, integration into workflow, designating committed champions, and monitoring outcomes data were expected to enhance implementation. Conclusions: Targeted activities to create buy-in, educate, and plan for use are necessary for TAXI implementation. Recognition of contextual challenges posed by the PICU environment and an approach that adjusts for barriers may optimize adoption.en_US
dc.description.urihttps://doi.org/10.3389/fped.2021.800461en_US
dc.language.isoenen_US
dc.publisherFrontiers Media S.A.en_US
dc.relation.ispartofFrontiers in Pediatricsen_US
dc.rightsCopyright © 2021 Steffen, Spinella, Holdsworth, Ford, Lee, Asch, Proctor and Doctor.en_US
dc.subjectclinical practice guidelineen_US
dc.subjectcritical careen_US
dc.subjecterythrocyte transfusionen_US
dc.subjectimplementation scienceen_US
dc.subjectpediatric intensive care uniten_US
dc.subjectpediatricsen_US
dc.titleFactors Influencing Implementation of Blood Transfusion Recommendations in Pediatric Critical Care Units.en_US
dc.typeArticleen_US
dc.identifier.doi10.3389/fped.2021.800461
dc.identifier.pmid34976903
dc.source.journaltitleFrontiers in pediatrics
dc.source.volume9
dc.source.beginpage800461
dc.source.endpage
dc.source.countrySwitzerland


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