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Magnesium sulphate for fetal neuroprotection: benefits and challenges of a systematic knowledge translation project in Canada.

Teela, KC; De Silva, DA; Chapman, K; Synnes, AR; Sawchuck, D; Basso, M; Liston, RM; von Dadelszen, P; Magee, LA; MAG-CP Collaborative Group (2015) Magnesium sulphate for fetal neuroprotection: benefits and challenges of a systematic knowledge translation project in Canada. BMC Pregnancy and Childbirth, 15 (347).
SGUL Authors: von Dadelszen, Peter Magee, Laura Ann

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BACKGROUND: Administration of magnesium sulphate (MgSO4) to women with imminent preterm birth at <34 weeks is an evidence-based antenatal neuroprotective strategy to prevent cerebral palsy. Although a Society of Obstetricians and Gynaecologists of Canada (SOGC) national guideline with practice recommendations based on relevant clinical evidence exists, ongoing controversies about aspects of this treatment remain. Given this, we anticipated managed knowledge translation (KT) would be needed to facilitate uptake of the guidelines into practice. As part of the Canadian Institutes of Health Research (CIHR)-funded MAG-CP (MAGnesium sulphate to prevent Cerebral Palsy) project, we aimed to compare three KT methods designed to impact both individual health care providers and the organizational systems in which they work. METHODS: The KT methods undertaken were an interactive online e-learning module available to all SOGC members, and at MAG-CP participating sites, on-site educational rounds and focus group discussions, and circulation of an anonymous 'Barriers and Facilitators' survey for the systematic identification of facilitators and barriers for uptake of practice change. We compared these strategies according to: (i) breadth of respondents reached; (ii) rates and richness of identified barriers, facilitators, and knowledge needed; and (iii) cost. RESULTS: No individual KT method was superior to the others by all criteria, and in combination, they provided richer information than any individual method. The e-learning module reached the most diverse audience of health care providers, the site visits provided opportunity for iterative dialogue, and the survey was the least expensive. Although the site visits provided the most detailed information around individual and organizational barriers, the 'Barriers and Facilitators' survey provided more detail regarding social-level barriers. The facilitators identified varied by KT method. The type of knowledge needed was further defined by the e-learning module and surveys. CONCLUSIONS: Our findings suggest that a multifaceted approach to KT is optimal for translating national obstetric guidelines into clinical practice. As audit and feedback are essential parts of the process by which evidence to practice gaps are closed, MAG-CP is continuing the iterative KT process described in this paper concurrent with tracking of MgSO4 use for fetal neuroprotection and maternal and child outcomes until September 2015; results are anticipated in 2016.

Item Type: Article
Additional Information: © 2015 Teela et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Keywords: Canada, Cerebral Palsy, Female, Guideline Adherence, Health Personnel, Humans, Infant, Newborn, Magnesium Sulfate, Neuroprotective Agents, Pregnancy, Premature Birth, Societies, Medical, Translational Medical Research, MAG-CP Collaborative Group, Humans, Cerebral Palsy, Premature Birth, Magnesium Sulfate, Neuroprotective Agents, Pregnancy, Infant, Newborn, Health Personnel, Societies, Medical, Guideline Adherence, Canada, Female, Translational Medical Research, Knowledge translation, Magnesium sulphate, Fetal neuroprotection, Preterm birth, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine, 1117 Public Health And Health Services, 1110 Nursing
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: BMC Pregnancy and Childbirth
Language: eng
22 December 2015Published
Publisher License: Creative Commons: Attribution 4.0
Project IDFunderFunder ID
UNSPECIFIEDCanadian Institutes of Health ResearchUNSPECIFIED
PubMed ID: 26694323
Web of Science ID: WOS:000367044300006
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