Table 3 Determinants related to identifying risk factors or screening for GBS colonization, mentioned by care providers (n = 25)

Identifying risk factors

Procedural clarity (guideline)

3

3

3

3

Unclear definition previous child with EOGBS

N

N

N

N

No standard cut-off point urinary tract infection despite guideline

N

N

N

N

No standard procedure PROM (referral after 18, 24, > 24 hours)

N

N

N

N

Correctness (guideline)

1

1

1

1

Symptoms of urinary tract infection are often missed

N

N

N

N

Social support by other care providers (user)

2

2

2

2

No adequate history taking of previous child with EOGBS

N

N

N

N

Not standard GBS detection in urine culture by general practitioner, therefore AB treatment not directed at GBS because status unknown

N

N

N

N

Legislation and regulations (socio-political context)

1

1

1

1

Data exchange between care providers of previous pregnancy

N

N

N

N

Screening for GBS colonization (swab taking)

Procedural clarity (guideline)

1

0

1

1

Local differences in swab taking (vaginal /vs vaginal rectal /vs urine)

N

N

N

Correctness (guideline)

0

0

0

1

Test result swab taken during birth not available in time

N

Compatibility with current guideline (guideline)

1

0

1

0

Collaboration with laboratory already in place

P

P

Personal benefits / drawbacks (user)

1

0

1

0

Extra work for primary care midwives

N

N

Outcome expectations (user)

4

0

4

0

Sensitivity/specificity swab not 100% because of intermittent carrier status

N

N

Women can adequately take swab themselves (validity culture)

N/P

N/P

Swab result not available for every woman at time of birth

N

N

Client/patient satisfaction (user)

3

0

3

0

Women do not like swab taking

N

N

Women prefer swab taking for reassurance

P

P

Increases anxiety in women and partners

N

N

Social support by other care provider (user)

2

0

2

0

Data exchange culture results

N/P

N/P

Self-efficacy (user)

1

0

1

0

Confidence in discussing test results with women

P

P

Knowledge (user)

1

0

1

0

Care providers know how to take a swab

P

P

Time available (organisational context)

1

0

1

0

Time consuming because of providing information and swab taking

N

N

Staff capacity (organisational context)

1

0

1

0

Sufficient capacity laboratory personnel

P

P

Material resources and facilities (organisational context)

3

0

3

0

Easy to administer in primary care

P

P

Swabs not available

N

N

Often delay if culture taken in primary care

N

N

Financial resources (organisational context)

2

0

2

0

Increased costs in primary care (swab taking)

N

N

Increased costs in laboratory personnel

N

N

Total numbers of determinants, related to

28

7

28

9

the guideline itself

6

4

6

6

the user (care provider)

14

2

14

2

the organisational context

7

0

7

0

the socio-political context

1

1

1

1