Changing catheter locking solution practice in paediatric cancer care: barriers, enablers and strategies for implementation

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PURPOSE: This study aimed to determine the barriers, enablers, strategies and costs of implementing an alternative catheter locking solution for CVADs in paediatric cancer care. METHODS: This qualitative implementation evaluation and cost analysis study conducted semi-structured interviews with clinicians and key decision makers based on the Consolidated Framework for Implementation Research. Following rapid analysis, implementation barriers were matched with the Expert Recommendations for Implementing Change tool to provide optimal implementation strategies, and budgeted using the Costing Implementation Strategies instrument. RESULTS: Among interviewed participants (N = 23), the most common barriers to implementation were innovation cost, partnerships and connections, work infrastructure, communications, tension for change, and innovation deliverers. Based on these constructs, developing strong networks, identifying change champions and accessing funding to facilitate implementation were selected as the most suitable strategies for successful implementation. The estimated total cost of the strategy bundle per site would be AUD$29,752. CONCLUSION: Understanding the barriers and enablers to implementing an alternative catheter locking solution in paediatric cancer care allows optimal strategies and implementation enhancement plans to be developed and costed, streamlining the transition from research to practice, fast-tracking approvals through purchasing departments. Addressing structural, relational, and financial barriers while leveraging enablers, is essential for adoption and sustained impact of an alternative catheter locking solution.

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