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Case Studies Revisited

We will now summarise each of the case studies we asked you to explore and discuss the questions posed.

Case study I:

If you recall, case study I introduced a practitioner wanting to implement a behaviour change regarding the inappropriate use of medicines in a hospital. Here are the details again below.

Patients in hospital may require short-term prescriptions for antibiotics. There are a few patients that have been on long–term antibiotics in hospital. As a healthcare professional, you notice that the doctors are requesting medicines that should only be used in the short-term, without review. You are aware that this may not be in the best interest of the patient and would require a change in practice. This potential change in practice can be addressed behaviourally.

In this situation, the practitioner would have to change the factors influencing this behaviour such as capability, opportunity, and motivation, for example:

These influencing factors also act as barriers to changing behaviour. Capability relies on prescribers wanting to learn and change, which they may be resistant to. Opportunity relies on the resources of the hospital which may not be substantial and also on the social culture at the hospital, which may prevent people from speaking up. Motivation relies on changing innate reactions and habits, which is often difficult and time consuming.

Case study II:

Case study II introduced a healthcare professional wanting to change prescribing practice in a low resource area. The details of the case study are below.

You are a healthcare professional in a clinic in a low resource rural area, where stock deliveries for medical supplies are infrequent. Internet connectivity is intermittent, and there is a general lack of access to resources. Many of the doctors working in your setting have been trained overseas. These doctors often practice out of date practices, and this has continued for many years. In addition, the pharmacist is often very busy due to the lack of other staff.

Some of the factors influencing the prescribing practice in this situation are:

As in the first case study, the influences also act as barriers, insufficient resources in the clinic and area makes it difficult to introduce new processes as they require time and money. Motivations and opportunity are hard to change as they are ingrained and therefore take time to change, which the clinic may not have capacity for.

How did our summaries of the case studies compare to your original thoughts?
Did you think of any extra influences?