Table 3 Barriers to the implementation of the New Zealand and Australian Antenatal Corticosteroid Clinical Practice Guidelines

Belief about consequences

There is uncertainty around the use of antenatal corticosteroids at term and practice doesn’t necessarily reflect the evidence

25

Use of antenatal corticosteroids improves outcomes of diabetic babies but their use in diabetic women can be difficult

16

The use of repeat antenatal corticosteroids is known to be beneficial but concern exists around potential adverse effects.

41

Knowledge

My knowledge on the evidence related to antenatal corticosteroids is limited

50

The evidence that supports the use of repeat antenatal corticosteroids is conflicting

37

I need more clarification on the evidence regarding antenatal corticosteroid administration in specific populations

29

There is confusion in antenatal corticosteroid practice in the understanding of a course, dose and duration between doses and courses.

14

My understanding of antenatal corticosteroids comes from what I witness in clinical practice

6

Social influences

Lack of consistency and difference of opinion make it difficult to know what is correct antenatal corticosteroid practice

48

Environmental context and resources

Competing tasks and time constraints impact on antenatal corticosteroid administration

12

Ease of access, readability and implementation tools/education discourages/encourages use of guidelines

60

Social professional role and identity

My use of the guideline would be dependent on it being based on good evidence

8

Clinical practice guidelines assist in decision making but often clinical judgement supersedes this

22