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

Duncan Smith1,2, Jill J Francis1, Leanne M Aitken1,3

  • 1School of Health Sciences, City, University of London, London, UK.

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Summary
This summary is machine-generated.

This study developed a theory-based intervention to improve nursing staff behavior in monitoring deteriorating patients and responding to abnormal vital signs. The intervention aims to enhance enablers and overcome barriers to critical care practices.

Keywords:
afferent limb failurebehaviourdeteriorating patientfocused observationnational early warning score (news)nursingrapid response systemtheoretical domains framework (TDF)

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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.