Insights into clinician utilisation and perceptions of the Paediatric Improvement Collaborative Clinical Practice Guidelines: a mixed-methods study

一项混合方法研究:深入了解临床医生对儿科改进协作临床实践指南的使用情况和看法

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Abstract

OBJECTIVES: This study aimed to explore perceptions of the Paediatric Improvement Collaborative's (PIC's) Clinical Practice Guidelines (CPGs) among clinicians, with a focus on awareness, frequency of use, applicability and areas for improvement. DESIGN, SETTING: Cross-sectional online survey and semi-structured interviews. PARTICIPANTS: Clinicians working in all Australian states and territories. Recruitment was via non-probability convenience sampling. Invitations to participate in the online survey were posted on national- and state-level paediatric organisations, networks and groups. Survey participants could express interest in taking part in a follow-up online interview. RESULTS: A total of 466 clinicians, including consultants/specialists (46.1%), specialists in training (residents/registrars: 20.4%), nurses (17.8%), allied health professionals (4.7%) and general practitioners (3.6%) participated in the survey. Findings indicated a high level of usage, with two-thirds of participants (63.9%) using the guidelines weekly. Most participants (91.8%) deemed the CPGs highly applicable to their practice settings, and over half (57.9%) had referred to more than 10 different PIC CPGs in the past month. Patterns of use reflected experience, seniority and scope of practice, with utilisation significantly higher among specialists in training, those working in emergency settings and those with less practising experience. Ten clinicians were interviewed to gain deeper insights, reinforcing that PIC CPGs serve multiple purposes, such as to check practice and for self-learning, for teaching more junior staff, and to reinforce treatment decisions with parents and patients. The guidelines were noted as being useful for all members of the multidisciplinary team in providing consistent language and uniform care. Key areas for improvement included enhancing accessibility in time-pressured environments, such as incorporating human factors-based navigation features and standardised layouts, and integrating additional tools and localised referral information. CONCLUSIONS: PIC CPGs are viewed as a source of credible, evidence-based information that was valued across medical, nursing and allied health professionals.

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