• Melissa L Langhan, Jordan C Kurtz, Paula Schaeffer, Andrea G Asnes, and Antonio Riera.
• Section of Emergency Medicine, Yale University School of Medicine. Electronic address: Melissa.Langhan@yale.edu.
• J Crit Care. 2014 Dec 1; 29 (6): 1035-40.

PurposeAlthough capnography is being incorporated into clinical guidelines, it is not used to its full potential. We investigated reasons for limited implementation of capnography in acute care areas and explored facilitators and barriers to its implementation.MethodsA purposeful sample of physicians and nurses in emergency departments and intensive care units participated in semistructured interviews. Grounded theory, iterative data analysis, and the constant comparative method were used to analyze the data to inductively generate ideas and build theories.ResultsNineteen providers were interviewed from 5 hospitals. Six themes were identified: variability in use of capnography among acute care units, availability and accessibility of capnography equipment, the evidence behind capnography use, the impact of capnography on patient care, personal experiences impacting use of capnography, and variable knowledge about capnography. Barriers and facilitators to use were found within each theme.ConclusionsWe observed varied responsiveness to capnography and identified factors that work to foster or discourage its use. These data can guide future implementation strategies. A deliberate strategy to foster utilization, mitigate barriers, and broadly accelerate implementation has the potential to profoundly impact use of capnography in acute care areas with the goal of improving patient care.Copyright © 2014 Elsevier Inc. All rights reserved.

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