Focus groups
®
MAY
Two focus groups and 7 interviews (20 to 60 min in duration) were conducted with a total of 15 participants (1 to 6 participants per group). Of the 15 participants, 4 were registered nurses, 1 was a clinical nurse educator, 3 were physicians, and 7 were pharmacists. One focus group and 3 interviews took place at the SHC from May to August 2017, 3 interviews were conducted at the RGH between March and April 2018, 1 interview was conducted at the PLC in June 2019, and 1 focus group was conducted at the FMC in July 2019.Themes and subthemes were identified across the CFIR and TDF behaviour change domains. Themes identified relating to the domain of environmental context and resources included process implementation and intervention characteristics. Identified barriers to process implementation were the alert system, medication time, and workload. Regarding the alert system, one participant stated: Subthemes of intervention characteristics that were identified as barriers included price, pill size, and post-discharge compliance. While Bio-K + ® was provided to patients in hospital, patients would have to purchase Bio-K + ® once they were discharged from hospital (to complete their five day post-antibiotic course), and staff were concerned that patients would be disinclined to purchase or unable to afford it, reducing post-discharge compliance. One participant noted: Knowledge barriers that were identified included health care provider education, literature, and evidence. Attending physicians were unsure if the medical residents had the same level of training and education on Prevent CDI-55 + , such as the inclusion criteria for patients. In addition, some participants were concerned about the evidence for probiotics: Barriers related to social and professional role and identity included the physician’s role, the nurse’s role, and the pharmacist’s role. Nurse and pharmacist participants noted that they could suggest to the physician to prescribe Bio-K + ®, however, they could not start a patient on Bio-K + ® independently. However, nurse and pharmacist participants also noted this as a facilitator to Bio-K + ® prescribing: Table Reported barriers, facilitators, and implemented changes