Theme | Sub-theme (# mentions) | Examples |
---|---|---|
Barriers identified related to SBIRT implementation were: | Sustainment (10) | Process complacency; difficult to coordinate with multiple clinicians |
Data collection (9) | Difficult to navigate health record; data absent from record | |
Staff adoption (9) | Nurse adherence to SBIRT; negative attitudes | |
Unit operational challenges (8) | Leader turnover; new nurses on the unit | |
SC execution (7) | SC felt alone in implementation efforts; SC role unclear | |
Study rollout (7) | Trial originally set up on different unit; site coordinator changed | |
Training coordination (6) | Finding a training schedule that worked for staff | |
Brief Intervention (BI) (5) | Lack of understanding of intent; discomfort with BI process | |
Patient-specific (4) | Patients did not see relevance or did not want help | |
Patient referral (2) | Insurance challenges; lack of available referral sites | |
Effort duplication (2) | SBIRT activities/documentation duplicated (nursing and social work) | |
Facilitators identified related to SBIRT implementation were: | Leveraging support (9) | Involvement of interprofessional stakeholders; use of early adopters |
Adapting intervention (8) | Ability to tailor/create resources; dedicated location for resources | |
SC development (8) | Learning and peer support from other SC; research team mentorship | |
Feedback loop (8) | Auditing/follow-up; reminders; rounding with staff for questions | |
Leader impact (7) | Leader engagement/support; SBIRT considered mandatory | |
Sustainment (3) | Problems anticipated ahead of time; new hire assimilation | |
Implementation efficiency (3) | Implementation planning phase; designated role (SC) | |
Outcomes identified related to SBIRT implementation were: | Awareness (13) | Clinician and patient awareness of risky substance use |
Action-oriented process (11) | Ability to act on positive screen; more referral options accessible | |
Enhanced care transitions (8) | Streamline continuum of care; support collaborative communication | |
Therapeutic relationships (6) | Show clinician care; determine patient readiness in the process | |
Connection to disease process (6) | Applicability of BI to other conditions; prevention of alcohol withdrawal | |
SC development (4) | Implementation skills; organizational resource navigation | |
Comfort (4) | Clinician and patient comfort discussing substance use |