Form #4 Form #4 Post-Training Semi-Structured interview Protocol

Standardizing Antibiotic Use in Long-term Care Setting

Attachment F-Post-Training Semi-Structured Interview Protocol

Post training semi-structured interview

OMB: 0935-0177

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Attachment F: Post-Training Semi-Structured Interview Protocol

Form Approved
OMB No. XXXX-XXX
Exp. Date XX/XX/XXXX





Post-Training Semi-Structured Interview Protocol

Approach

When selecting participants, individuals will be categorized (1) leadership and champion staff; (2) frontline nursing staff (e.g., RN’s and LPN/LVNs), and (3) attending in-house clinicians.

We have assumed 15-60 minutes for each interview.

Objectives

The purpose of these interviews is to obtain information on the following:

  • Obtain a description of the reactions to the Loeb criteria and use of the Loeb criteria communication and order form

  • Discuss potential organizational facilitators to using the form

  • Discuss potential organizational barriers to using the form and how to overcome them




Public reporting burden for this collection of information is estimated to average 60 minutes per response, the estimated time required to complete the interview. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (XXXX-XXXX) AHRQ, 540 Gaither Road, Room #5036, Rockville, MD 20850.















Purpose of the Interview(s)

The purpose of these set of questions is to (1) obtain initial reactions to the Loeb criteria communication and order form; (2) discuss facilitators; (3) discuss current barriers; (4) assess methods to overcome barriers; and (5) discuss reactions to training.

For Site Visits

Nursing home name:

Name

Title















Testing materials checklist

Interview guide

Interviewer clock

Audio recording equipment (2)

Batteries

Verify audio recording equipment

Pens

Informed consent forms (1 copy for participant to sign, plus 1 copy for participant to keep)



I. Introduction [use this intro for all staff]

Welcome

Hello. My name is {FIRST NAME} and I work for the American Institutes for Research, or AIR, which is a non-profit research organization in Washington, DC. I am here with {NOTE TAKER} who will be taking notes.

Background and Disclosures

  • Background. Our discussion today is part of a research project sponsored by the Agency for Healthcare Research and Quality, or AHRQ. AHRQ is the federal government agency charged with improving the quality and safety of health care for all Americans. AHRQ is funding two projects that seek to standardize antibiotic use in long term care settings.

  • Purpose. We are here today to learn about your nursing home’s your implementation of and reactions to the Loeb criteria communication and order form. We also would like to know what helped to facilitate the use of the form and what were some barriers.

  • Confidentiality. When we write our report, we will not include your name or the nursing home’s name.

  • Consent. Before we begin, here are two consent forms, one for you to sign and give back and one for you as a copy.

[GO APPROPRIATE SECTION AND BEGIN RECORDING]

I. Leadership Questions

  1. How, if at all, did staff react when they heard Loeb Criteria Communication and Order Form would be implemented in their departments? Was there a specific staff person to champion this effort? How were they told of this decision? What types of questions did they ask?

  2. In your opinion, how does the direct nursing care staff view the Loeb Criteria Communication and Order Form? To what extent do they support or not support it? Are they excited about Loeb Criteria Communication and Order Form or not? Do they feel positively or negatively? Please let me why you think this.

  3. How was Loeb Criteria Communication and Order Form implemented initially?

    1. Was it implemented in phases or not? By floor?

  4. What staff were involved? How were staff involved? [If applicable], how were staff selected to be involved? How much, if any, experience did these staff have in quality improvement activities?

    1. Who filled out whether the Loeb Criteria were met?

  5. How, if at all, was the leadership for implementing the Communication and Order Form assigned? Please describe this process.

  6. What additional training and/or resources were provided to staff after the initial training? Resources might include team meetings, IT support, consultation with the trainer, etc.

  7. Has the implementation changed from it started? Please describe the reasons for these changes.

  8. Thinking back on the initial implementation of the Loeb Criteria Communication and Order Form projects, what were the 2 or 3 greatest challenges? [FOR EACH CHALLENGE ASK:]

    1. Did you or your staff anticipate these problems? If so, please describe.

    2. Who tackled these challenges? Was a particular staff member assigned to address the challenge?

    3. How did you seek overcome these challenges? What did you do specifically? How successful were these efforts? Please describe the issue.

  9. [IF NECESSARY] Did you have any challenges at the facility level, such as lack of visibility and resources, lack of leadership, challenges of implementing in a nursing home, disruption of patient care?

  10. [IF NECESSARY] Did you have any challenges at the floor-level, such as competing demands?

  11. [IF NECESSARY] Did you have any challenges at the staff level for example, resistance to the intervention?

  12. [IF NECESSARY] Did you have any challenges at the individual clinician or for example, resistance to the intervention or resistance to the Loeb Criteria?

  13. [IF NECESSARY] Did you have any challenges at the patient level for example, lack of infections?

  14. Thinking back on the initial implementation of the Loeb Criteria Communication and Order Form, what were the 2 or 3 greatest facilitators?

  15. What helped you and/or your department implement and/or make progress with your Loeb Criteria Communication and Order Form project? POSSIBLE PROBES (for each facilitator):

    1. What resources made Loeb Criteria Communication and Order Form easier to implement on the organizational/departmental/or project level?

    2. How was it that you had access to this / these resources?

  16. [IF NECESSARY] Did you have facilitators at the project team level such as infection expertise, coaching, interest in championing?

  17. [IF NECESSARY] Did you have facilitators at the department level such as leadership, type or size of practice?

  18. [IF NECESSARY] Did you have facilitators at the individual staff level such as enthusiasm about intervention?

  19. [IF NECESSARY] Did you have facilitators at the individual clinician such as interest in the intervention?

  20. Please describe any surprises or unintended consequences (positive or negative) of the intervention and its implementation (e.g., staff morale improved or got worse, found new ways to utilize advanced practice nurses) surfaced during the implementation process? If so, please describe.

II. RN/LPN Questions

  1. How did you first react when hearing of the facility’s decision to implement Loeb Criteria Communication and Order Form in your department? Why did you feel this way? Please tell me about that.

  2. How was Loeb Criteria Communication and Order Form implemented initially?

    1. Was it implemented in phases or not? By floor?

  3. What staff were involved?

  4. What additional training and/or resources did you receive after the initial training? Resources might include team meetings, IT support, consultation with the trainer, etc.

  5. Has the implementation from when it started? How so? What happened?

  6. Thinking back on the initial implementation of the Loeb Criteria Communication and Order Form projects, what were the 2 or 3 greatest challenges? [FOR EACH CHALLENGE ASK:]

    1. How did you seek overcome these challenges? What did you do specifically? How successful were these efforts? Please describe the issue.

  7. Thinking back on the initial implementation of the Loeb Criteria Communication and Order Form, what were the 2 or 3 greatest facilitators?

  8. What helped you and/or your department implement and/or make progress with your Loeb Criteria Communication and Order Form project?

III. Clinician Questions

  1. Do you remember seeing the form?

  2. Did you use the criteria to determine whether to initiate antibiotics or not?

  3. Were there times where you did not use the criteria? For what reasons?

F-7


File Typeapplication/msword
AuthorElizabeth Frentzel
Last Modified ByElizabeth Frentzel
File Modified2011-02-02
File Created2011-02-02

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