{
  "abstract": "Objectives This study aimed to identify determinants that hinder or facilitate implementation of the Feverkidstool, a clinical decision support tool offering a quantitative, evidence-based approach, to manage children with fever in the emergency department (ED) setting.Design Qualitative study using semistructured interviews, analysed through directed content analysis guided by the Consolidated Framework for Implementation Research (CFIR).Setting Secondary and tertiary paediatric emergency departments in three hospitals in the Netherlands.Participants Eighteen potential end users of the Feverkidstool, including paediatricians and paediatric residents working in the ED and involved in the care of febrile children, participated in the study.Primary outcome measure Determinants of Feverkidstool implementation, categorised by CFIR domains: intervention characteristics, outer setting, inner setting, characteristics of individuals and implementation process.Results Respondents (n=18) perceived the evidence-based guidance by the Feverkidstool and its potential to reduce antibiotic use as valuable. However, concerns were raised about its applicability to critically ill children and those with comorbidities. User-friendliness was seen as a facilitator, whereas the need for C reactive protein testing and lack of integration with electronic health records were mentioned as barriers. The ability to standardise care for febrile children was considered an important benefit of using the Feverkidstool.Conclusion Barriers and facilitators across all CFIR domains are identified. Addressing these will facilitate implementation. When effectively implemented, the Feverkidstool has the potential to improve care for children presenting with fever in the ED. This may potentially lead to a more standardised approach and reduce unnecessary antibiotic prescriptions.",
  "authors": [
    {
      "affiliations": [
        "Department of General Pediatrics, Erasmus MC Sophia, Rotterdam, The Netherlands"
      ],
      "name": "Sanne Vrijlandt"
    },
    {
      "affiliations": [
        "Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Childrens Hosp, Rotterdam, The Netherlands",
        "Department of Internal Medicine, Erasmus MC Universitair Medisch Centrum Rotterdam, Rotterdam, The Netherlands"
      ],
      "name": "Erwin Ista"
    },
    {
      "affiliations": [
        "Department of General Pediatrics, Sophia Children’s Hospital, Rotterdam, The Netherlands"
      ],
      "name": "Ruth Kuiper"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Juliana Children’s Hospital, The Hague, The Netherlands"
      ],
      "name": "Mirjam van Veen"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Flevoziekenhuis, Almere, The Netherlands"
      ],
      "name": "Anne-Marie van Wermeskerken"
    },
    {
      "affiliations": [
        "Pediatrics, Leiden Universitair Medisch Centrum, Leiden, The Netherlands"
      ],
      "name": "Fabienne Ropers"
    },
    {
      "affiliations": [
        "Department of General Pediatrics, Sophia Children’s Hospital, Rotterdam, The Netherlands"
      ],
      "name": "Rianne Oostenbrink"
    }
  ],
  "title": "Identifying facilitators and barriers to implementing the Feverkidstool, a clinical decision tool, in the emergency department: a qualitative study in the Netherlands",
  "uid": "45e08c12-6ad8-5b14-8205-51336c8b0388"
}