Key considerations prior to nasal high flow deployment in a Peruvian PICU from providers' perspectives.

AIM: Implementation of healthcare interventions in resource-limited settings remains challenging. This exploratory qualitative study describes social and institutional factors to consider prior to nasal high flow deployment in a middle-income country.

METHODS: Researchers conducted 8 nursing focus groups and 4 semi-structured physician interviews at Instituto Nacional de Salud del Niño in Lima, Peru. Participants were identified via purposive sampling. Data were transcribed, translated and coded using a rigorous and iterative process. Pertinent themes were identified using thematic analysis with Dedoose software.

RESULTS: Thirty-nine nurses and 4 physicians participated in focus groups and interviews, respectively. Participants identified five major factors: (a) Adequate training, (b) Clinician buy-in, (c) Resource-limited setting, (d) Local social context, and (e) Organizational change management. To create buy-in, physicians and nurses emphasized the need to recognize benefit of the intervention and agree with clinical practice standardization. Physicians and nurses described barriers specific to resource-limited settings, including unreliable supply chain, whereas nurses shared concerns about increasing workload and physician-nurse social hierarchy. Participants recognized the importance of team commitment and ongoing interdisciplinary communication for sustainability.

CONCLUSION: While some factors to consider prior to deployment of healthcare technology are universal, resource-limited settings have unique implementation barriers. This article is protected by copyright. All rights reserved.