Background
Within the first hour of recognition of sepsis: | |
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- Measured lactate/hemoglobin - Urine output - Blood cultures - Antibiotics - Oxygen - Intravenous fluids |
Methods
Design and setting
Setting
Ethical approval
Semi-structured interviews
Participants
Materials
Domain | Content | Sample question as applied to this study |
---|---|---|
Knowledge | An awareness of something | What do you understand by the Sepsis Six? |
Skills | Ability or proficiency acquired through practice | Can you think of any ways in which your own skills for performing the steps in the Sepsis Six could be improved? |
Social/professional role and identity | Set of behaviors and qualities of an individual in social or work setting | To what extent do you consider performing the steps in the Sepsis Six a part of your role? |
Beliefs about capabilities | Views about one’s ability/talent/capability to perform the target behavior(s) | Are there any particular steps that you are more or less confident about performing? |
Optimism | Confidence that things will happen for the best or that desired goals will be attained | How optimistic or pessimistic are you that improving performance of the Sepsis Six holds the potential to improve patient care in the future? |
Beliefs about consequences | Acceptance of the truth, reality or validity about outcomes of a behavior in a given situation | To what extent do you believe that performing the steps in the Sepsis Six can affect patient outcomes? |
Reinforcement | Increasing the likelihood of a behavior being performed by establishing an association between performing a behavior and a given stimulus or cue | Are you aware of any ways in which performing the Sepsis Six is rewarded? |
Intentions | Conscious decision to perform a behavior or resolve to act in a certain way | To what extent do you intend to (continue to) perform the Sepsis Six in daily clinical practice? |
Motivation and Goals | Mental representation of outcomes or states that an individual wants to achieve | Do you have any specific goals for performing the Sepsis Six?
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Memory, attention and decision processes | The ability to retain information, focus selectively on aspects of the environment and choose between two or more alternatives | How easy or difficult is it to remember the steps involved in the Sepsis Six when you are performing it in daily clinical practice? |
Environmental context and resources | Circumstances of a person’s situation/environment that affect behavior | To what extent does your working environment have sufficient levels of resources needed to allow performance of the Sepsis Six within one hour of recognition? |
Social influences | Interpersonal processes that can cause individuals to change thoughts/feelings/behaviors | Are there any conflicting beliefs amongst your colleagues about the Sepsis Six? |
Emotions | Complex reaction pattern by which individual attempts to deal with a personally significant matter or event | To what extent do you feel that your emotional state affects your performance of the Sepsis Six? |
Behavioral regulation | Anything aimed at managing or changing objectively observed or measured actions | Do you ever receive feedback on your performance of the Sepsis Six on septic patients? |
Procedure
Analysis
Questionnaire
Participants
Materials
Procedure
Analysis
Selection of important belief statements
Results
Semi-structured interviews
Participant characteristics
Coding of responses into TDF domains
Domain | Belief Statement | Example Utterance | Frequency (number of interviews) |
---|---|---|---|
Knowledge | I know/do not know what the Sepsis Six involves | [The Sepsis Six is] a package of care which has been shown to improve mortality in patients with sepsis. (Consultant 1) | 10 |
My colleagues do/do not know what the Sepsis Six involves | the more senior sort of colleagues weren’t familiar with systemic inflammatory response syndrome, recognise all the sort of markers. (Nurse 4) | 10 | |
I am aware/not aware of the evidence behind the Sepsis Six | There have been obviously clinical trials which I can’t remember the names of. (Junior doctor 2) | 10 | |
My colleagues are aware/not aware of the evidence behind the Sepsis Six | If I’m honest then no. [My colleagues and I are not aware of the evidence behind the Sepsis Six] (Nurse 3) | 2 | |
People would give better Sepsis Six performance if they were more aware of the later complications of poorly managed sepsis | I think if they had perhaps more awareness about how, like, poor sepsis management could affect a patient long term, they might be, they might have more urgency in carrying it all, sort of out. About what would happen in the long term. (Nurse 4) | 1 | |
Having knowledge and understanding of the Sepsis Six does/does not influence the likelihood of it being performed | And it’s always, [giving antibiotics] tends to get done I think, because I think everyone understands the urgency. (Junior doctor 1) | 9 | |
Skills | I do/do not have the skills to perform the Sepsis Six | I mean I haven’t given antibiotics myself. (Junior doctor 1) | 9 |
My colleagues do/do not have the skills to perform the Sepsis Six | maybe if [nurses are] newly qualified, not being able to give the IV antibiotics because they would then have, because they haven’t done their IV pack (Nurse 1) | 9 | |
There is/is insufficient provision of training and assessment in the skills required to perform the Sepsis Six | I think we’ve recognised that, and we’ve trained our nurses to deliver antibiotics, fluids, take blood cultures and lactates, put in urinary catheters, so we know our nurses can do all of this, we train them to do all of this. (Consultant 1) | 9 | |
Memory, Attention and Decisions | It’s easy/difficult to remember the 6 steps in clinical practice | Give 3, take 3 away. And that we have it written down on our proformas. (Consultant 1) | 10 |
The decision to start the Sepsis Six is not made because sepsis is not recognised | So I think I’ve got a reasonable understanding of recognising sepsis. (Junior doctor 3) | 8 | |
Regular use of the Sepsis Six makes it easier to remember the steps | I mean when doing on a daily basis pretty easy to remember. But I guess if you’re not doing it on a daily basis you might forget (Junior doctor 2) | 7 | |
Behavioral Regulation | Sepsis Six performance is (not) monitored or audited regularly in my department | [Sepsis 6 is audited on a] weekly basis and the results are published weekly. (Junior doctor 3) | 10 |
I/we get insufficient feedback on our Sepsis Six performance | Yes it would be helpful to have more monitoring systems in place. And individual feedback to clinicians. (Consultant 2) | 9 | |
There are sufficient tools in place to help guide and track Sepsis Six performance in individual patients | Yes, we’ve got [a Sepsis 6 tool], it’s at the back of the pro forma and the BUFALO stickers. So there’s a lot of guidance. (Consultant 3) | 10 | |
Improving sepsis care and Sepsis Six performance is (not) discussed in regular meetings in my department | What we’re doing in surgery is auditing this sort of thing on a monthly basis, and that’s going to be presented at governance meetings. (Consultant 2) | 5 | |
Sepsis Six performance improves if we are involved in the quality improvement process | Yeah, I think so, because I think people would own things more if they felt it was, they were included in it (Nurse 2) | 3 | |
There are (no) action plans to improve Sepsis Six performance | there are other things that we’re doing such as implementing junior doctor training, nurse training on sepsis, through educational sessions, through induction. (Consultant 1) | 4 | |
Social Influences | My colleagues opinions do/do not affect my performance of the Sepsis Six | I don’t think the opinions of my colleagues does affect whether I do the Sepsis Six actually. (Junior doctor 3) | 10 |
My Colleagues do/do not believe that the Sepsis Six is beneficial to patient care | Yeah I think it’s generally believed that these steps benefit patient outcomes, so I think everyone’s kind of in favour of them. (Junior doctor 2) | 9 | |
Departmental culture facilitates/hinders performance of the Sepsis Six | I think that’s because there isn’t a culture of doing fluid charts on every patient that comes through us (Consultant 1) | 4 | |
There is insufficient leadership to improve Sepsis Six performance | But if there was a clear strategy, a clearer kind of team role, leadership role for the patients, the benefits of it, can’t see why it wouldn’t be used and why it couldn’t improve. (Consultant 3) | 7 | |
Healthcare workers do/do not feel able to escalate up the hierarchy | if you have it on a care pathway, that gives them allowance, permission almost to phone the consultant and escalate it, so they’re allowed to do that, rather than feeling I shouldn’t do this. (Consultant 2) | 4 | |
Having a Sepsis “Champion” would/would not improve performance of the Sepsis Six | it might be beneficial if, other wards as well to have a designated sepsis champion or link nurse as such, so that we can perhaps hold regular meetings every couple of months, to see how we can make changes to sepsis care. (Nurse 4) | 3 | |
Social and Professional Role | Performing the steps in the Sepsis Six is (not) my role | I think they’re all part of it. (Consultant 2) | 10 |
Performing all steps in the Sepsis Six is (not) my colleagues’ role | I think it should be everyone’s responsibility and role to do it. (Consultant 3) | 3 | |
It is my/my colleagues’ role (doctor/nurse/HCA) to identify septic patients | our nurses are very good at identifying sick patients. (Junior doctor 3) | 5 | |
It is my role to decide when to perform the Sepsis Six | we usually don’t give oxygen to somebody unless their sats are low, but in this instance, occasionally I’ve been told by a surgeon, I want them to have 2 l of oxygen. (Nurse 2) | 4 | |
There is high turnover of medical/nursing staff in areas looking after septic patients | Our medical staff, so half of them are transient, half of them are permanent. (Consultant 1) | 3 | |
My role is to improve Sepsis Six performance through non-clinical factors (leadership, support, supervision) | My role is that even if the patient is stable to ensure all the steps had been followed, and to reinforce and educate. (Consultant 3) | 4 | |
There are some steps in the Sepsis Six which I/my colleagues do not/are not allowed to perform | I don’t know, as a trust I don’t think the nurses usually take blood cultures, it seems to be a doctor role. (Nurse 2) | 6 | |
Non-clinical staff (eg bed management) put pressure on clinical staff to prioritise tasks other than Sepsis Six | And there’s such a drive for discharging them, and getting patients out, and often the bed manager puts so much pressure on the nursing staff on the wards. (Consultant 2) | 1 | |
Staff should be empowered to improve their role in Sepsis Six performance | So I think being involved in the audit kind of made us kind of aware of what needs to be done. (Junior doctor 3) | 2 | |
Environment, Context and Resources | I do (not) have sufficient resources (staff; time; equipment; medicines; bed) to perform the Sepsis Six in one hour. | Not enough beds (Consultant 2) | 10 |
The equipment I have does/doesn’t work | our gas machine is down a lot of the time (Junior doctor 3) | 8 | |
The layout of the hospital hinders/helps my performance of the Sepsis six in one hour (patient location, equipment, medicine). | trying to get a patient seen and then treated within that time, and then if they’re coming up to 4 h of being in the department are they moved to another ward before their treatment sort of is delivered, (Nurse 4) | 8 | |
Belief in Consequences | Performing the steps in the Sepsis Six improves patient outcomes | Yeah, I believe it’s vital. There’s evidence out there which supports, supports it, so, yeah (Consultant 2) | 10 |
The benefits of performing the Sepsis Six outweigh the risks | I think generally the advantages should outweigh the risks. (Junior doctor 2) | 8 | |
The benefits vs risks of performing the Sepsis Six (or some parts of it) are (not) different in certain patient groups | I think any patient with known heart problems, I’d be a little bit more careful. (Nurse 3) | 10 | |
The quicker the steps can be delivered, the more impact they have | Well, I believe if it’s carried out promptly within the 1 h then it can definitely improve the patient’s outcome. (Nurse 3) | 5 | |
Early and regular reassessment of patients requiring the Sepsis Six gives the best outcomes | I think if you keep doing them without reassessment then that would lead to problems, but in the first hour I don’t think it’s an issue. (Consultant 2) | 1 | |
Belief in Capabilties | I am (not) confident performing the steps in the Sepsis Six | I think, you know, I’ve got the skill to perform these 6 steps, there’s no doubt about it. The training has been there, I have the skill to do it (Consultant 1) | 9 |
My colleagues are (not) confident performing the steps in the Sepsis Six | I mean I would hope most people were... but yeah, I think most people are confident that I’ve seen (Junior doctor 2) | 7 | |
Some of the Sepsis Six steps are more difficult than others to achieve (urine output, cultures, antibiotics) | it’s just the urine output measurement which causes ongoing difficulties, (Consultant 1) | 9 | |
There is good/poor communication and teamwork between members of the team looking after septic patients | It’s definitely a team priority to be able to carry it all out, so if we can sort of work together, I believe that it can be done a lot quicker, rather than doing it single-handedly. (Nurse 4) | 10 | |
We provide good sepsis care at this hospital | I think for the most part our septic patients is reasonably well recognised via the acute care bundle, because they come in, they have the acute care pathway, filled out for every patient (Consultant 2) | 1 | |
I am confident looking after sick septic patients | I’m very good at dealing with a crisis and just getting on with it (Nurse 2) | 1 | |
Intentions | I (don’t) prioritise performing the Sepsis Six on a septic patient over other tasks | I think unless somebody was having a cardiac arrest I would prioritise this probably above most other things. (Nurse 2) | 10 |
I intend to improve my knowledge of the Sepsis Six | I think I do need to know a bit more about it, so I might try and educate myself before I go back to work (Nurse 2) | 2 | |
I intend to continue to perform the Sepsis Six on septic patients | I guess, well I’ll carry on carrying it out until it’s, unless there’s anything else new that comes up that improves sepsis care (Nurse 4) | 8 | |
I am more likely to complete all steps of the Sepsis Six if I think the patient is sick/less likely if they are well | if we are concerned someone really is poorly, then they often will become catheterised (Nurse 2) | 5 | |
Sometimes I choose (not) to complete the full Sepsis Six because the risks and benefits are different for that patient/situation. | your octogenarian who’s got sepsis, you might not go chucking in 2 l immediately. (Consultant 2) | 7 | |
My colleagues (don’t) prioritise performing the Sepsis Six on a septic patients over other tasks | but it’s usually the other pressures that we have on, like prioritising other patients for example, and how big our caseload is at that time (Nurse 4) | 2 | |
Some steps in the Sepsis Six are more/less important than others | I like having the fluids here quickly. That’s one of the better ones, I think (Nurse 3) | 6 | |
I (don’t) perform the Sepsis Six despite not having a confirmed diagnosis because I (don’t) believe the risks of undertreating sepsis outweigh the risks of performing the Sepsis Six | they’re not septic, but they just got a big SIRS response and they looked septic when they came in, so having antibiotics in that situation is not the wrong thing to do, as a one off, but a patient’s presenting with peritonitis or what’s not, they need to have early sepsis source control. (Consultant 2) | 3 | |
Goals | I work towards a goal that the Sepsis Six should be completed and documented within an hour on all septic patients. | We should do it on all, it should be done within an hour. (Consultant 3) | 10 |
The hospital has/does not have a goal of improving Sepsis Six compliance | I know that the Trust is starting a BUFALO[sic] to help people remember how to deliver the Sepsis Six (Nurse 4) | 10 | |
Optimism | Sepsis Six compliance at this hospital will (not) improve | Knowing how well in general all the care bundles are used, unless there’s a clear strategy on how to improve it, my worry would be that it might not improve significantly (Consultant 3) | 4 |
Increasing Sepsis Six compliance will improve patient care | I’m very optimistic that if we can push this forward that it will hugely improve patient care, and their outcome. (Nurse 2) | 9 | |
Reinforcement | Individuals are not formally rewarded or punished for (failing to) complete the Sepsis Six | Not punished, obviously it’s audited, and the departments are fed back (Junior doctor 2) | 10 |
The department or hospital is (not) formally rewarded or punished for (failing to) complete the Sepsis Six | No, I’m not aware of any ways in which we as, do you mean as a trust are punished? (Nurse 4) | 6 | |
Emotions | I get emotionally affected negatively/positively by managing septic patients | I mean obviously you do [get affected emotionally by looking after septic patients], if they’re unwell (Junior doctor 2) | 9 |
If we are affected emotionally (eg stressed, excited, fatigued) it leads to better/worse clinical performance when looking after septic patients | Well if anything it makes me go, try and make, do it faster because I recognise that they’re quite sick. (Junior doctor 1) | 9 | |
I feel good if I deliver the Sepsis Six/bad if I don’t deliver the Sepsis Six to a septic patient | I try to carry it out within the 1 h, and when it hasn’t happened I kind of feel, like frustrated (Nurse 4) | 4 |
Questionnaire
Participant characteristics
Area and Role | Number invited | Number completed | Response rate |
---|---|---|---|
MAU Consultants | 36 | 15 | 41.7% |
MAU Junior Doctors | 32 | 15 | 46.9% |
MAU Nurses | 38 | 14 | 36.8% |
SAU Consultants | 10 | 7 | 70.0% |
SAU Junior Doctors | 27 | 12 | 44.4% |
SAU Nurses | 18 | 12 | 66.7% |
ED Consultants | 9 | 7 | 77.8% |
ED Junior Doctors | 22 | 7 | 31.8% |
ED Nurses | 63 | 24 | 38.1% |
Total | 255 | 113 | 44.3% |
Belief statements
Domain | Barrier belief | Facilitator belief | Overall sample group | Important barrier (number of analysis groups) | Unimportant barrier (number of analysis groups) | Unimportant facilitator (number of analysis groups) | Important facilitator(number of analysis groups) |
---|---|---|---|---|---|---|---|
Belief in Capabilities | There is POOR teamwork when looking after septic patients | There is GOOD teamwork when looking after septic patients | Important barrier | 10 | 0 | 0 | 6 |
I am NOT confident performing the Sepsis Six | I AM confident performing the Sepsis Six | Important enabler | 0 | 0 | 0 | 16 | |
Some of the steps in the Sepsis Six are MORE DIFFICULT to perform than others | The steps in the Sepsis Six are EQUALLY EASY OR DIFFICULT to perform | Unimportant barrier | 9 | 4 | 0 | 3 | |
There is POOR communication between members of the team looking after septic patients | There is GOOD communication between members of the team looking after septic patients | Important barrier | 11 | 0 | 0 | 5 | |
We provide POOR sepsis care at this hospital | We provide GOOD sepsis care at this hospital | Unimportant barrier | 8 | 3 | 0 | 5 | |
Belief in Consequences | Delivering the Sepsis Six quickly does NOT increase how much benefit it has | Delivering the Sepsis Six quickly DOES increase the benefit it has | Important enabler | 0 | 0 | 0 | 16 |
Performing the steps in the Sepsis Six does NOT improve patient outcomes | Performing the steps in the Sepsis Six DOES improve patient outcomes | Important enabler | 0 | 0 | 0 | 16 | |
Overall, the RISKS of performing the Sepsis Six outweigh the benefits | Overall, the BENEFITS of performing the Sepsis Six outweigh the risks | Important enabler | 1 | 0 | 0 | 15 | |
The RISKS of performing the Sepsis Six outweigh the benefits in CERTAIN patient groups | The BENEFITS of performing the Sepsis Six outweigh the risks in ALL patient groups | Unimportant barrier | 6 | 3 | 1 | 6 | |
Early and regular reassessment of patients requiring the Sepsis Six has NO effect on outcomes | Early and regular reassessment of patients requiring the Sepsis Six gives the BEST outcomes | Important enabler | 0 | 0 | 0 | 16 | |
Behavioral Regulation | Sepsis Six performance is NOT audited regularly in my department | Sepsis Six performance IS audited regularly in my department | Unimportant barrier | 2 | 5 | 4 | 5 |
There are INSUFFICIENT tools in use to guide & track Sepsis Six performance in individual patients | There are SUFFICIENT tools in use to guide & track Sepsis Six performance in individual patients | Unimportant barrier | 5 | 4 | 2 | 5 | |
We get INSUFFICIENT feedback on our Sepsis Six performance | We get SUFFICIENT feedback on our Sepsis Six performance | Unimportant barrier | 8 | 7 | 0 | 1 | |
Sepsis Six performance is NOT discussed in meetings in my department | Sepsis Six performance IS discussed in meetings in my department | Unimportant barrier | 4 | 2 | 4 | 6 | |
Involving clinical staff in Sepsis Six performance improvement will NOT lead to greater improvement | Involving clinical staff in Sepsis Six performance improvement WILL lead to greater improvements | Important enabler | 0 | 0 | 1 | 15 | |
There are NO plans in place to improve Sepsis Six performance at my hospital | There ARE plans in place to improve Sepsis Six performance at my hospital | Important barrier | 2 | 1 | 2 | 11 | |
Environment, Context and Resources | There is INSUFFICIENT staffing to perform the Sepsis Six | There is SUFFICIENT staffing to perform the Sepsis Six | Important barrier | 13 | 0 | 0 | 3 |
There is INSUFFICIENT time to perform the Sepsis Six | There is SUFFICIENT time to perform the Sepsis Six | Important barrier | 11 | 0 | 0 | 5 | |
There is INSUFFICIENT equipment / medication to perform the Sepsis Six | There is SUFFICIENT equipment / medication to perform the Sepsis Six | Important barrier | 5 | 0 | 0 | 11 | |
There are INSUFFICIENT beds available in my department to look after septic patients | There are SUFFICIENT beds available in my department to look after septic patients | Important barrier | 15 | 0 | 0 | 1 | |
The equipment I need to perform the Sepsis Six does NOT work or works poorly | The equipment I need to perform the Sepsis Six DOES work well | Important enabler | 3 | 0 | 0 | 13 | |
Septic patients are RARELY managed in an appropriate location | Septic patients are ALWAYS managed in an appropriate location | Important barrier | 15 | 0 | 0 | 1 | |
Emotions | I do NOT feel bad if I do not deliver the Sepsis Six to a septic patient | I DO feel bad if I do not deliver the Sepsis Six to a septic patient | Important enabler | 0 | 0 | 1 | 15 |
I do NOT feel anxious/stressed when treating septic patients | I DO feel anxious/stressed when treating septic patients | Unimportant barrier | 3 | 13 | 0 | 0 | |
Goals | I do NOT have a time-based goal for completing the Sepsis Six on septic patients | My goal is to complete the Sepsis Six within an HOUR on all septic patients | Important enabler | 0 | 0 | 0 | 16 |
Intentions | I do NOT intend to improve my knowledge of the Sepsis Six | I INTEND to improve my knowledge of the Sepsis Six | Unimportant barrier | 1 | 6 | 2 | 7 |
When uncertain about diagnosis I WAIT FOR CONFIRMATION of sepsis before performing the Sepsis Six | When uncertain about diagnosis I PERFORM the Sepsis Six rather than miss treating potential sepsis | Important enabler | 2 | 1 | 0 | 13 | |
I do NOT intend to continue to perform the Sepsis Six on septic patients | I DO intend to continue to perform the Sepsis Six on septic patients | Important enabler | 0 | 0 | 0 | 16 | |
I am UNLIKELY to complete all steps of the Sepsis Six if I think the patient is well | I am LIKELY to complete all steps of the Sepsis Six even if I think the patient is well | Unimportant barrier | 7 | 8 | 1 | 0 | |
I do NOT prioritise performing the Sepsis Six on a septic patient over other tasks | I DO prioritise performing the Sepsis Six on a septic patient over other tasks | Important enabler | 2 | 0 | 1 | 13 | |
SOME steps in the Sepsis Six are more or less important than others | ALL steps in the Sepsis Six are equally important | Unimportant barrier | 6 | 4 | 1 | 5 | |
Knowledge | I am NOT aware of what the Sepsis Six involves | I AM aware of what the Sepsis Six involves | Important enabler | 0 | 0 | 0 | 16 |
I am NOT aware of the evidence supporting the Sepsis Six | I AM aware of the evidence supporting the Sepsis Six | Unimportant enabler | 0 | 1 | 2 | 13 | |
Memory, Attention and Decisions | It’s DIFFICULT to remember all the steps of the Sepsis Six in day-to-day clinical practice | It’s EASY to remember all the steps of the Sepsis Six in day-to-day clinical practice | Important enabler | 0 | 0 | 0 | 16 |
I OFTEN miss sepsis | I RARELY miss sepsis | Important barrier | 7 | 0 | 0 | 9 | |
Regular use of the Sepsis Six does NOT make it easier to remember the steps involved | Regular use of the Sepsis Six DOES make it easier to remember the steps involved | Important enabler | 0 | 0 | 3 | 13 | |
Optimism | Sepsis Six performance at this hospital will NOT improve | Sepsis Six performance this this hospital WILL improve | Important barrier | 3 | 1 | 0 | 12 |
Increasing Sepsis Six performance will NOT improve patient care | Increasing Sepsis Six performance WILL improve patient care | Important enabler | 0 | 0 | 0 | 16 | |
Reinforcement | The hospital is NOT formally rewarded for good Sepsis Six performance | The hospital IS formally rewarded for good Sepsis Six performance | Unimportant barrier | 0 | 15 | 1 | 0 |
Individuals are NOT formally rewarded for good Sepsis Six performance | Individuals ARE formally rewarded for good Sepsis Six performance | Unimportant barrier | 2 | 14 | 0 | 0 | |
Social Influences | The culture within my department HINDERS performance of the Sepsis Six | The culture within my department HELPS performance of the Sepsis Six | Important barrier | 6 | 0 | 0 | 10 |
There is INSUFFICIENT leadership for improving Sepsis Six performance | There is SUFFICIENT leadership for improving Sepsis Six performance | Unimportant barrier | 6 | 1 | 1 | 8 | |
My colleagues’ opinions about the Sepsis Six do NOT affect whether I perform it | My colleagues’ opinions about the Sepsis Six DO affect whether I perform it | Unimportant barrier | 5 | 10 | 0 | 1 | |
My colleagues do NOT believe that the Sepsis Six is beneficial to patients | My colleagues DO believe that the Sepsis Six is beneficial to patients | Unimportant enabler | 0 | 0 | 3 | 13 | |
I do NOT feel able to escalate when I am concerned about a patient who may need the Sepsis Six | I DO feel able to escalate when I am concerned about a patient who may need the Sepsis Six | Important enabler | 0 | 0 | 0 | 16 | |
Having a local sepsis ‘champion’ would NOT improve performance of the Sepsis Six | Having a local sepsis ‘champion’ WOULD improve performance of the Sepsis Six | Unimportant barrier | 0 | 12 | 2 | 2 | |
Skills | I do NOT have the necessary skills to perform the Sepsis Six | I HAVE the necessary skills to perform the Sepsis Six | Important enabler | 0 | 0 | 1 | 15 |
There is INSUFFICIENT provision of training required to perform the Sepsis Six | There is SUFFICIENT provision of training required to perform the Sepsis Six | Important barrier | 9 | 0 | 0 | 7 | |
Social and Professional Role | It is NOT part of my role to decide when to perform the Sepsis Six | It IS part of my role to decide when to perform the Sepsis Six | Important enabler | 0 | 0 | 0 | 16 |
Performing the Sepsis Six is NOT part of my role | Performing the Sepsis Six IS part of my role | Important enabler | 0 | 0 | 0 | 16 | |
It is NOT part of my role to identify septic patients | It IS part of my role to identify septic patients | Important enabler | 0 | 0 | 0 | 16 | |
There is RAPID turnover of medical/nursing staff in areas looking after septic patients | There is SLOW turnover of medical/nursing staff in areas looking after septic patients | Unimportant barrier | 10 | 6 | 0 | 0 | |
It is NOT part of my role to improve Sepsis Six performance through leadership & support | It IS part of my role to improve Sepsis Six performance through leadership & support | Unimportant enabler | 0 | 0 | 2 | 14 | |
There are some steps in the Sepsis Six which I am NOT ALLOWED to perform | I am ALLOWED to perform all steps in the Sepsis Six | Important enabler | 2 | 1 | 2 | 11 |