DEveloping a Complex Intervention for DEteriorating patients using theoretical modelling (DECIDE study): Study...

Area of Science:

• Healthcare Quality Improvement
• Nursing Practice Research
• Patient Safety

Background:

• Suboptimal care for deteriorating ward patients remains a persistent issue despite decades of focus.
• Current interventions often rely on education, showing limited success in changing staff behavior.
• Nursing staff behavior in patient monitoring and response to vital signs is influenced by various barriers and enablers.

Purpose of the Study:

• To develop a theory-based complex intervention for nursing staff.
• To enhance enablers and overcome barriers to expected behaviors in patient monitoring and response to deterioration.
• To improve the care of deteriorating ward patients.

Main Methods:

• A mixed-methods design incorporating structured observations and interviews.
• Semi-structured interviews guided by the Theoretical Domains Framework (TDF) to identify barriers and enablers.
• Nominal group technique to select behavior change techniques and delivery modes based on acceptability and feasibility.

Main Results:

• Identified key barriers and enablers influencing nursing staff behavior in patient monitoring and response.
• Specified intervention content and delivery modes through clinician consensus.
• Developed an intervention manual based on theoretical domains and behavior change techniques.

Conclusions:

• Systematic application of theory and evidence-based methods is crucial for developing effective interventions.
• The developed intervention is designed to be more likely to change staff behavior and improve patient outcomes.
• Future empirical testing is required to validate the intervention's effectiveness.