Barriers and supports to implementation of MDI/spacer use in nine Canadian pediatric emergency departments: a qualitative study

Scott, Shannon D; Osmond, Martin H; O'Leary, Kathy A; Graham, Ian D; Grimshaw, Jeremy; Klassen, Terry

Sites that had successfully adopted the MDI/spacers had some common strategies such as participation of all professional groups and having a well-planned and executed educational component. Furthermore, having continuity of practice within the facility (i.e., same protocol in ED and in-patient units), between facilities or between the facility and community physicians made the process easier because patients received consistent information that was reinforced. As well, including MDI/spacer use as part of a guideline or protocol also facilitated successful adoption in these sites. Essentially, the sites that had successful adopted the MDI/spacer were able to recognize the unique characteristics of the innovation, adopters, and practice environment at their particular ED and successfully use these attributes to facilitate adoption.