Survey results. All percentages are for number of respondents answering that question, all Likert scales are reported as mean scores out of 5 with 1 being the most negative response and 5 being the most positive, with standard deviation in parentheses afterwards.
| Variable | Doctors | Nurses |
|---|---|---|
| Demographics: | ||
| Responses - Complete (partial) | 21 (41) | 24 (72) |
| Rank/Grade (self professed respiratory interest): F1 •F2 •CT1 •CT2 •ST3+ •HCA •Band 5 •Band 6 •Band 7 •Band 8 | 9 (1) 9 (1) 10 1 8 N/A N/A N/A N/A N/A | N/A N/A N/A N/A N/A 1 24(10) 24(16) 8(8) 1(1) |
| Ward/Work environment: •Respiratory Ward •Acute/Coronary Care Unit (includes NIV) •A&E •ITU •Medical Wards •Surgical Wards •Other | N/A N/A N/A N/A N/A N/A N/A | 2 24 6 14 4 4 4 |
| Awareness of Guidelines: | ||
| BTS Guideline awareness | 64.9% | 46.2% |
| Trust Policy awareness | 78.4% | 88.5% |
| Able to locate Trust Policy on intranet | 34.3% | 17.1% |
| Read guidelines: •BTS •Trust •Both | 34.3% 8.6% 8.6% | 7.3% 36.6% 19.5% |
| Received training within last 5 years | 62.9% | 43.9% |
| Usefulness of training (1=Not at all–5=Very) | 3.41 (0.67) | 3.82 (0.73) |
| How much did the training change your practice (1=Not at all–5=Significantly) | 3.09 (1.06) | 3.71 (0.92) |
| Awareness of Content: | ||
| Awareness of concept of target saturations | 100% | 100% |
| Confidence: · Prescribing · Administering to target saturations (1=Not at all confident–5 = Very confident) | 4.23(0.65) 3.97(0.92) | N/A 3.97(0.68) |
| Prescription Scenarios (mean mark out of 5 by two assessors (five way κ=0.274)–Doctors expected to diagnose and prescribe, nurses asked to comment what they thought prescription should be for given diagnosis) •Critically Ill Patient •Acute Coronary Syndrome •COPD at risk of Type II Respiratory Failure •Carbon Monoxide Poisoning •Obesity Hypoventilation with home nocturnal NIV | 3.65 2.93 3.56 3.35 3.35 | 2.89 2.17 3.22 2.78 2.26 |
| Agreement: | ||
| Understanding of why the approach to oxygen administration has changed | 66.7% | 85.2% |
| Belief changes are beneficial to patients (1=Outcomes are a lot worse–5=Outcomes definitely better) | 4.44 (0.75) | 4.74 (0.59) |
| Change in ease of: •Prescribing •Administering | 3.33(1.24) 3.26(0.9) | N/A 4.26(0.86) |
| Since new guideline (1=Much harder–5=Much easier) | ||
| Desired improvement in drug chart | 44.4% | 40.7% |
| Desire for merged drug and observation chart | 85.2% | 59.3% |
| Adoption: | ||
| Believe they apply guidelines in their daily practice (1=Never–5=Always) | 3.93 (0.62) | 4.44 (0.64) |
| Adherence: | ||
| Most frequently cited barriers to guideline adherence: •Habit •Too many policies •Used to treat breathlessness •Not my responsibility •Lack of familiarity with guidelines •Guidelines are unclear •Guidelines not enforced •Drug chart confusing •Oxygen is not interesting •Lack of understanding of rationale behind guidelines •Lack of training •Practical/Logistical difficulties | 33.3% 20.8% 16.7% 8.3% 4.2% 4.2% 4.2% 4.2% 4.2% 0% 0% 0% | 16% 8% 4% 0% 40% 0% 0% 0% 0% 8% 12% 12% |
| Suggested measures to improve adherence: •Teaching behind rationale •General teaching •Reminders •Increased monitoring •Individual penalties •Trust penalties •Other | 23.4% 21.3% 17% 14.9% 10.7% 4.3% 8.5% | 33.8% 22.5% 16.9% 16.9% 5.6% 2.8% 1.4% |