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Barriers and facilitators to more timely treatment of aneurysmal subarachnoid haemorrhage across two tertiary referral centres in Australia: A thematic analysis

Citation

Nguyen, TP and Stirling, C and Kitsos, G and Nichols, L and Chandra, RV and Rehman, Sabah and Smith, K and Mosley, I and Lai, L and Asadi, H and Dubey, AK and Froelich, JJ and Thrift, AG and Gall, SL, Barriers and facilitators to more timely treatment of aneurysmal subarachnoid haemorrhage across two tertiary referral centres in Australia: A thematic analysis, Australasian Emergency Care, 25, (3) pp. 267-272. ISSN 2588-994X (2022) [Refereed Article]

Copyright Statement

© 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

DOI: doi:10.1016/j.auec.2022.01.003

Abstract

BackgroundDelays in treatment of aSAH appear to be common but the causes are not well understood. We explored facilitators and barriers to timely treatment of aSAH.

Methods:We used a multiple case study with cases of aSAH surviving > 1 day identified prospectively. We conducted semi-structured interviews with the patient, their next-of-kin and health professionals involved in the case. Within-case analysis identified barriers and facilitators in 4 phases (pre-hospital, presentation, transfer, in-hospital) followed by thematic analysis across cases using a case-study matrix.

Results:Twenty-seven cases with 90 interviewees yielded five themes related tofacilitators or barriers of timely treatment. "Early recognition" led to urgent response. "Accessibility to health care" depended on patientís location, transport, and environmental conditions. Good "Coordination" between and within health services was a key facilitator." Complexity" of patientís condition affected time to treatment in multiple time periods. "Availability of resources" was identified most frequently during the diagnostic and treatment phases as both barrier and facilitator.

Conclusion:The identified themes may be modifiable at the patient/health professional level and health system level and may improve timely treatment of aSAH through targeted interventions, subsequently contributing to improve morbidity and mortality of patients with aSAH.

Item Details

Item Type:Refereed Article
Keywords:aneurysmal subarachnoid haemorrhage, time to treatment, qualitative method
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Health system performance (incl. effectiveness of programs)
UTAS Author:Nguyen, TP (Ms Thuy Nguyen)
UTAS Author:Stirling, C (Professor Christine Stirling)
UTAS Author:Kitsos, G ( Gemma Kitsos)
UTAS Author:Nichols, L (Mrs Linda Nichols)
UTAS Author:Rehman, Sabah (Dr Sabah Rehman)
UTAS Author:Gall, SL (Associate Professor Seana Gall)
ID Code:153771
Year Published:2022
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-10-05
Last Modified:2022-11-29
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