Ultrasound guided nerve blocks (UGNB) for hip fractures are an alternative to escalating doses of opioids for pain control. Despite national support, we found that UGNB’s for hip fractures occur infrequently in the Emergency Department (ED). By using implementation science approach, we can identify barriers and facilitators to UGNB and develop a multifaceted bundle of evidence-based strategies to increase UGNB’s in our ED to decrease opioid exposure. We used the Consolidated Framework for Implementation Research (CFIR) to inform our focus group interviews and performed qualitative content analysis to identify major themes of barriers and facilitators of UGNB’s in the ED. Next, we mapped barriers to the Expert Recommendations for Implementing Change (ERIC) tool to select effective implementation strategies with at least 50% expert agreement of effectiveness. Selection of appropriate strategies based on context-specific barriers will be informed by the COMB behavior theory and iteratively adapted to increase adoption of UGNB and gain a deeper understanding of the mechanism by which these strategies work.
- V. Lew, A. Zanaboni, E. Blustein, D. Kane, D. Theodoro, E. Ablordeppey, 28 Are We Performing Ultrasound-Guided Nerve Blocks for Geriatric Hip Fractures in the Emergency Department? A Qualitative Survey of Perceptions, Annals of Emergency Medicine, Volume 82, Issue 4, Supplement, 2023, Pages S11-S12, ISSN 0196-0644, https://doi.org/10.1016/j.annemergmed.2023.08.047.
- Deborah Kane, Aimee James, Enyo Ablordeppey, Pain Management in Geriatric Hip Fracture Patients – Are There Barriers to Performing Ultrasound Guided Femoral Nerve Blocks?, The Journal of Pain, Volume 23, Issue 5, Supplement, 2022, Page 41, ISSN 1526-5900, https://doi.org/10.1016/j.jpain.2022.03.158.
