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Examining implementation of the first risk stratification-based programme for evaluating penicillin allergy labels in Western Norway hospitals: a study protocol

Por: Alnaes · M. B. · Oppegaard · O. · Kittang · B. R. · Kleppe · L. K. · Storaas · T.
Introduction

Penicillin allergy is a significant barrier to optimal antibiotic stewardship, contributing to increased antimicrobial resistance, higher treatment costs, prolonged hospital stays and elevated mortality rates. However, approximately 90% of penicillin allergy labels are disproven on evaluation. Risk stratification-based penicillin allergy evaluation (PAE) has proven safe and effective outside allergology departments, yet its adoption in routine clinical practice remains limited. This study aims to examine the implementation of a risk stratification-based PAE programme across hospitals in Western Norway.

Methods and analysis

We aim to examine implementation of a risk stratification-based programme for evaluating and de-labelling declared penicillin allergy in Western Norway hospitals in a multicentre study. The study employs a combined stepped wedge- and interrupted time series design. It includes hospitals of varying service levels in both urban and rural settings. Each participating centre receives 12 months of active implementation support, followed by a 6 month postintervention evaluation. The study is guided by the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change. Implementation outcomes assessed include acceptability, fidelity, adoption, penetration, feasibility and sustainability.

Ethics and dissemination

The study was approved by the Regional Ethics Committee of Western Norway (approval number: 199210). All legal and formal research requirements are met. Results will be published open access in peer-reviewed journals and included in the first author’s publicly available PhD. Nationwide implementation of PAE is planned, informed by the study’s findings.

Trial registration number

Current Research Information System (Cristin) in Norway project identification number: 2500736.

Perceptions of quality of care in oncological outpatient settings: a qualitative study of healthcare professionals

Por: Kittang · J. · Ohlsson Nevo · E. · Schröder · A. · Arnell · S.
Objectives

To explore and describe how healthcare professionals within the oncological outpatient setting perceive quality of care.

Design

A qualitative, descriptive design with a phenomenographic approach was used, with focus group discussions as the means of data collection.

Setting

Primary care in oncological outpatient units in four hospitals in Sweden.

Participants

Through purposive sampling, 20 healthcare professionals entered and completed the study by participating in four focus groups, five participants in each group. Inclusion criteria were assistant nurses, nurses or physicians delivering treatment and care with radiation and/or anticancer drugs in oncological outpatient units. Excluded were healthcare professionals who had worked less than 3 months at the oncological outpatient unit.

Results

Two descriptive categories emerged from the data: ‘The professional’s personal ability for good care’ and ‘The structural conditions for good care’. These categories consist of descriptions of quality of care being perceived as a good meeting with patients, patient participation, continuity, accessibility and care grounded in science.

Conclusions

According to the healthcare professionals, quality of care relies on organisational structures in combination with a professional and personal interaction between the patients and the healthcare professionals. Knowledge about what healthcare professionals believe constitutes quality of care should therefore be highly valuable to policymakers and hospital management.

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