Identifying Barriers and Facilitators in Utilization of Tranexamic Acid for Anemia Prevention Using the Theoretical Domains Framework

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The Ohio State University

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Background: Patients who experience a hip fracture is an increasing population contributing to over 341,000 emergency department visits a year. These patients have an increased risk of anemia and blood transfusions that could increase their length of stay, readmission rate and even mortality. A literature search for best practice that affects this population's outcomes lead to a further evaluation of tranexamic acid (TXA) utilization. Methods: The aim of this study was to evaluate determinants of routine use of tranexamic (TXA) for hip fracture patients using the theoretical domains framework (TDF). An anonymous survey created in QualtricsXM was sent out via email to two network leaders in Ohio and Texas who disseminated the link to their peers for completion. Participants had to be involved in the intraoperative process within the hip fracture population. The survey was open for a 16-day window and consisted of 34 questions, 30 domain questions with a 1-5 Likert scale answer and 4 demographic questions. Results: Barriers and facilitators differed between registered nurses and physicians in the 11 domains that were evaluated. Registered nurses identified skills and social/professional role and identity to be barriers while physicians only identified the goals domain to be a barrier to utilization of TXA. Conclusion: This study was able to identify barriers and facilitators for TXA utilization within a small network of Ohio and Texas peers. If the survey were to be concentrated to one facility it would give insight into how to increase implementation success of TXA utilization within that facility.



Hip Fracture, Anemia, Tranexamic Acid, Blood Transfusion