Table 2 Key barriers and facilitators identified from needs assessment

Innovation Domain

 Innovation relative advantage

^aMixed perceptions regarding the advantages and disadvantages of SA compared to alternatives

 Innovation evidence base

^aMany providers unaware of evidence base for SA

 Innovation cost

Some perceptions that cost of SA is prohibitive

Inner Setting

 Access to knowledge and information

^aMany providers have insufficient education and training in SA use

 Tension for change

^aGeneral perception that ETT is the “go-to” practice when possible; lack of identified need for alternatives

 Materials and equipment

^aAvailability or lack of availability of LMA supplies at hand in the moment they would be used (including correct size, accessibility, knowing where to find them)

 Compatibility

^aHospital policies/workflows/norms that are incompatible with LMA use

 Culture – recipient-centeredness

Shared values, beliefs, and norms among units/teams about the importance of using evidence-based practices

Outer Setting

 Policies and laws

^aPolicies related to scope of practice for particular providers; liability concerns

 Local attitudes

Shared professional attitudes about following evidence base and doing what is best for recipients