Appendix O. Nursing Focus Group Guides

Final Nursing Focus Group 1 Protocol

Thank you for joining our group today. My name is [XXX] and this is my colleague [XXX]. We are working on an Agency for Healthcare Research and Quality project for Improving the Measurement of Surgical Site Infection (SSI) Risk Stratification and Outcome Detection. The purpose of the project has been to:

1. Develop and test an electronic detection tool for SSI surveillance;
2. Assess the personnel burden relief when implementing an e-detection tool relative to the current accepted standard for SSI Surveillance (medical record review, direct observation, data mining programs); and
3. Disseminate the e-detection tool.

Today, we'd like to learn about your experience with standard SSI Surveillance and the challenges you face. Through this information, we will develop a use case to support implementation of the e-detection tool in hospitals. We have been exempted by the Institutional Review Board, but we want you to know that we take your confidentiality and privacy very seriously. Your participation is voluntary. We will be recording our discussion as well as taking notes because this conversation is our data; however, your name will not be reported, any illustrative quotes will be anonymously referenced, and we will report any themes that emerge in aggregate together with the use case for training. There are no right or wrong answers, and I will facilitate the group so that we'll have a chance to hear from all of you. Do you have any questions before we get started?

Current SSI Surveillance Practice

Can you please describe the current practices for SSI surveillance at your facility?
(work from generic model and adapt this)

What happens when and who does what?

What resources are required for these current surveillance activities at your facility?
Probe on types/details of resources (E.g. how many people? How much time? Any special computer programs?).

E-Detection Tool for SSI Surveillance

How would you feel about adopting an e-detection tool for SSI surveillance?

How much would they value the data output (daily e-mail example)?
Would you trust this information to avoid doing double work?
Do responses vary by years in practice (we think so)?

Do you think it likely that an e-detection tool would be used at your facility?
Probe on barriers and enabling factors.

How would the role of IP nurses change or be affected by an e-detection tool?

In your opinion, what is the single best contribution of an e-detection tool for SSI surveillance?

Do any other issues or suggestions come to mind that we have not yet discussed?

Thank you for your time. Please complete the form in front of you so that we can provide a small honorarium as a token of our appreciation.

Draft Nursing Focus Group 2 Protocol

Thank you for joining our group today. My name is [XXX] and this is my colleague [XXX]. We are working on an Agency for Healthcare Research and Quality project for Improving the Measurement of Surgical Site Infection (SSI) Risk Stratification and Outcome Detection. The purpose of the project has been to:

1. Develop and test an electronic detection tool for SSI surveillance;
2. Assess the personnel burden relief when implementing an e-detection tool relative to the current accepted standard for SSI Surveillance (medical record review, direct observation, data mining programs); and
3. Disseminate the e-detection tool.

Today, we'd like to learn about your experience with standard SSI Surveillance and the challenges you face. Through this information, we will develop a use case to support implementation of the e-detection tool in hospitals. We have been exempted by the Institutional Review Board, but we want you to know that we take your confidentiality and privacy very seriously. Your participation is voluntary. We will be recording our discussion as well as taking notes because this conversation is our data; however, your name will not be reported, any illustrative quotes will be anonymously referenced, and we will report any themes that emerge in aggregate together with the use case for training. There are no right or wrong answers, and I will facilitate the group so that we'll have a chance to hear from all of you. Do you have any questions before we get started?

Current SSI Surveillance Practice

What are the biggest issues you face in doing standard SSI surveillance at your facility?

How are results of these SSI surveillance data used and reported at your facility?

Taking a look at this flow chart of a reported surveillance process, does this seem to you to generically portray how SSI surveillance works? Is there anything that you would change or add? [chart from Focus Group 1]

E-Detection Tool for SSI Surveillance

What are your initial thoughts or concerns about replacing your current SSI surveillance practice with an e-detection tool?

How would you envision using an e-detection tool for SSI surveillance at your facility?

What resources would you need to implement an e-detection tool?

How would the flow chart of the surveillance process change with an e-detection tool? [reference the chart again and notate changes]

What do you need to know about the tool or assurances about its performance in order to adopt it?

How likely would you be to adopt an e-detection tool for SSI surveillance at your facility?

Who would make the decision to adopt the e-detection tool for SSI surveillance at your facility?

Is there anything we haven't asked about that you would like to comment on or suggest to the team as we move forward?

Thank you for your time. Please complete the form in front of you so that we can provide a small honorarium as a token of our appreciation.

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