Acceptability of the Venting Wisely pathway for use in critically ill adults with hypoxaemic respiratory failure and acute respiratory distress syndrome (ARDS): a qualitative study protocol

• Published in: BMJ open 2024-05, Vol.14 (5), p.e075086
• Main Authors: Krewulak, Karla D, Knight, Gwen, Irwin, Andrea, Morrissey, Jeanna, Stelfox, Henry Thomas, Bagshaw, Sean M, Zuege, Danny, Roze des Ordons, Amanda, Fiest, Kirsten, Parhar, Ken Kuljit Singh
• Format: Article
• Language: English
• Subjects: Adult; Alberta; Attitude of Health Personnel; Clinical Trial; Critical Care - methods; Critical Illness - therapy; Critical Pathways; Focus Groups; Humans; INTENSIVE & CRITICAL CARE; Intensive care; Intensive Care Units; Nurses; Protocols & guidelines; Qualitative Research; Quality in health care; Respiratory Distress Syndrome - therapy; Respiratory Insufficiency - therapy; Therapists
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-075086

IntroductionHypoxaemic respiratory failure (HRF) affects nearly 15% of critically ill adults admitted to an intensive care unit (ICU). An evidence-based, stakeholder-informed multidisciplinary care pathway (Venting Wisely) was created to standardise the diagnosis and management of patients with HRF and acute respiratory distress syndrome. Successful adherence to the pathway requires a coordinated team-based approach by the clinician team. The overall aim of this study is to describe the acceptability of the Venting Wisely pathway among critical care clinicians. Specifically, this will allow us to (1) better understand the user’s experience with the intervention and (2) determine if the intervention was delivered as intended.Methods and analysisThis qualitative study will conduct focus groups with nurse practitioners, physicians, registered nurses and registered respiratory therapists from 17 Alberta ICUs. We will use template analysis to describe the acceptability of a multicomponent care pathway according to seven constructs of acceptability: (1) affective attitude;,(2) burden, (3) ethicality, (4) intervention coherence, (5) opportunity costs, (6) perceived effectiveness and (7) self-efficacy. This study will contribute to a better understanding of the acceptability of the Venting Wisely pathway. Identification of areas of poor acceptability will be used to refine the pathway and implementation strategies as ways to improve adherence to the pathway and promote its sustainability.Ethics and disseminationThe study was approved by the University of Calgary Conjoint Health Research Ethics Board. The results will be submitted for publication in a peer-reviewed journal and presented at a scientific conference.Trial registration numberClinicalTrials.gov NCT04744298.