None listed
Conditions
Brief summary
A pragmatic before and after study across NSW spinal services (RNSH, POWH, RR) to identify key evidence to practice gaps and evaluate adherence to one guideline recommendation. The study has 4 distinct phases; 1. Retrospective notes audit of current clinical practice to confirm evidence to practice gap and determine adherence to key recommendations from the ‘Clinical practice guidelines for the physiotherapy management of people with SCI’ (Audit Phase). 2. Interview physiotherapists to identify barriers and facilitators of practice for key guideline recommendations from the ‘Clinical practice guidelines for the physiotherapy management of people with SCI’ (Development of Implementation Intervention Phase). 3. Implementation of tailored intervention(s) using the COM-B model for behaviour change (Implementation Phase). 4. Evaluation of change in adherence to key recommendations from the Guidelines for the physiotherapy management of people with SCI (Evaluation Phase).
Interventions
Physiotherapist adherence to one of the guideline recommendations made in the 'Clinical practice guidelines for the physiotherapy management of people with spinal cord injury' will be assessed by a clinical notes audit before and after an implementation phase. The guideline recommendation chosen will address an evidence to practice gap identified by a retrospective clinical notes audit.
The implementation phase will involve the implementation of targeted strategies (the intervention) that will a
Physiotherapist adherence to one of the guideline recommendations made in the 'Clinical practice guidelines for the physiotherapy management of people with spinal cord injury' will be assessed by a clinical notes audit before and after an implementation phase. The guideline recommendation chosen will address an evidence to practice gap identified by a retrospective clinical notes audit. The implementation phase will involve the implementation of targeted strategies (the intervention) that will address the key barriers and facilitators of practice (Implementation phase will be up to 4 months in duration). These implementation strategies will be informed by interviews and surveys of physiotherapists and interviews of people with SCI. It is anticipated that these interviews and surveys will be completed within 3 months of the completion of the initial audit phase and the strategies to be implemented will be confirmed at this time. These may include; audit feedback systems, clinical champions; education sessions etc. The resources and materials used will reflect the chosen implementation strategy(s). Physiotherapists adherence to the guideline recommendation will be assessed by clinical notes audit conducted pre and post the implementation phase. Fidelity of the guideline recommendation will also be assessed but during the implementation phase via spot clinical notes audit. Implementation strategies will be designed to promote sustainability of adherence and fidelity of the guideline recommendation.
Sponsors
Northern Sydney Local Health District
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Physiotherapists working within a NSW spinal service, or 2. Patient receiving the intervention as recommended by the clinical practice guidelines.
Exclusion criteria
1. are unable to provide informed consent. 2. do not speak sufficient English to participate in interviews / focus groups 3. inability to participate in interviews / focus groups due to impaired cognitive function
Outcome results
None listed