Barriers and enablers to penicillin allergy assessment and testing in the intensive care unit: A mixed-methods study
Authors' conclusion
Variation in ICU-led PenA assessment appears to reflect organisational and behavioural influences rather than intrinsic clinical barriers. Differences between settings were associated with governance structures, leadership, education, and social reinforcement.
Study context
- Population
- ICU healthcare staff working in ICUs with and without penicillin allergy assessment programmes13 interviewed
- Participants
- 113 participants
- Outcome
- Barriers and enablers to ICU-led penicillin allergy assessment
Methodological detailsconvergent, electronic survey with follow-up interviews, thematic analysis guided by the Theoretical Domains Framework
- Convergent
- Electronic survey with follow-up interviews
- Thematic analysis guided by the Theoretical Domains Framework
Main finding
As reported in the abstract
- Barriers: limited training, poor guideline awareness, low confidence in risk stratification and drug challenge procedures, perceived medico-legal risk, unclear ownership, workload pressures
- Enablers: clear governance structures, robust protocols, decision support tools, access to specialist advice, local champions, audit and feedback mechanisms
- Staff in ICUs with established programmes described greater confidence and integration of assessment into routine practice
Observational data: associations, not effects.
Original publication
Barriers and enablers to penicillin allergy assessment and testing in the intensive care unit: A mixed-methods study. J Crit Care. Published 23 March 2026. doi:10.
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