Knowledge, attitudes, and practices toward bundled care implementation for analgesia and sedation among emergency and outpatient healthcare providers in China

This study examines the knowledge, attitudes, and practices (KAP) among emergency and outpatient healthcare providers regarding the implementation of bundled care protocols for analgesia and sedation. A cross-sectional study was conducted between January and September 2024 across 13 primary hospitals in Zunyi City, China. KAP were assessed using a validated questionnaire. Structural equation modeling (SEM) were employed to examine both direct and indirect effects of demographic characteristics on KAP. The study included 332 valid responses. Participants had a mean age of 32.6 ± 6.8 years, with 120 (36.1%) having previously received training on bundled care protocols for analgesia and sedation. Mean scores were 9.32 ± 3.34 for knowledge (possible range: 0-17), 37.29 ± 5.01 for attitude (possible range: 9-45), and 33.40 ± 4.99 for practice (possible range: 8-40). SEM revealed that knowledge directly influenced attitude (β = 0.319, P < 0.001), and attitude directly influenced practice (β = 0.826, P < 0.001). Knowledge demonstrated a significant indirect effect on practice mediated through attitude (β = 0.264, P < 0.001), while the direct path from knowledge to practice was non-significant (β = -0.024, P = 0.572). Healthcare providers demonstrated specific knowledge gaps and important practice concerns, particularly in recognizing sedation-related complications, while many attitudes and overall self-reported practices were positive. Attitude played a mediating role between knowledge and practice, underscoring the need for targeted educational interventions.