Facilitators and obstacles to implementing the practical approach to the care kit/pack Brazil / Facilitadores e obstáculos para implementar a abordagem prática do kit de cuidados/ pacote Brasil

Abstract

Contextualization and objective: Clinical protocols are instruments that can be used to keep professionals up to date and to improve the quality of healthcare. In 2016, the implementation process of the Practical Approach to Care Kit/PACK Brazil began, a protocol developed in South Africa that trains primary care doctors and nurses to diagnose and deal with common adult conditions. This study aimed to explore the factors that interfered in the implementation of PACK Brazil with health professionals who had been trained in the protocol.Methodology: Semi-structured interviews were carried out with an intentional sample of doctors and nurses from primary healthcare centres in the city where the protocol was implemented. The thematic matrix technique was used to analyze the information collected.Results: 14 interviews were conducted; 6 of the interviewees were doctors and 8 were nurses; 13 were female. The thematic matrix divided the interview data into two themes: facilitators for the implementation of the PACK; and obstacles to implementing the PACK. The implementation of the PACK Brazil revealed facilitators related to the intervention process itself, such as the methodology used in training for the protocol. Although the acceptance of the PACK Brazil has been positive among health professionals, difficulties related to the individual characteristics of doctors and nurses and organizational obstacles were encountered when using the protocol.Final Considerations: The implementation of protocols in primary care can be a challenge, especially when it is intended to adapt materials from different socio-cultural environments. This study showed that the efforts made by the PACK Brazil implementation team were reflected in the high level of acceptance of the protocol by the interviewees. However, individual and organizational aspects of the studied context proved to be obstacles to the use of the PACK Brazil.