Barriers and enablers of recognition and response to deteriorating patients in the acute hospital setting: A theory‐driven interview study using the Theoretical Domains Framework

Smith, Duncan and Cartwright, Martin and Dyson, Judith and Hartin, Jillian and Aitken, Leanne M. (2021) Barriers and enablers of recognition and response to deteriorating patients in the acute hospital setting: A theory‐driven interview study using the Theoretical Domains Framework. Journal of Advanced Nursing. ISSN 1365-2648

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Abstract

Aim
To explore barriers and enablers of recognition and response to signs of patient deterioration by nursing staff in an acute hospital.

Design
A theory‐driven interview study underpinned by the Theoretical Domains Framework of behaviour change.

Methods
Between 07/01/2019 and 18/12/2019 a purposive sample of registered nurses and healthcare assistants was recruited to participate in a semi‐structured (audio‐recorded) interview, to explore the determinants of seven specified behaviours of the afferent limb. Anonymised transcripts were deductively coded (using the 14 Theoretical Domains Framework domains as coding categories) and then extracts within each domain were inductively analysed to synthesise belief statements and themes. Prioritisation criteria from published literature were applied.

Results
Thirty‐two semi‐structured interviews were conducted. From 1,888 quotes, 184 belief statements and 66 themes were synthesised. One hundred and forty‐six belief statements, represented by 58 themes, met prioritisation criteria. Nine domains of the Theoretical Domains Framework were of high importance: Knowledge; Social, Professional Role and Identity; Beliefs about Consequences; Reinforcement; Intentions; Goals; Memory, Attention and Decision Processes; Environment, Context and Resources and Social Influences.

Conclusions
Barriers and enablers most likely to impact on nursing staff afferent limb behaviour were identified in nine domains of the Theoretical Domains Framework.

Item Type:	Article
Additional Information:	Article version: VoR From Crossref journal articles via Jisc Publications Router History: epub 19-03-2021; issued 19-03-2021. Licence for VoR version of this article starting on 19-03-2021: http://creativecommons.org/licenses/by/4.0/
Identification Number:	10.1111/jan.14830
Dates:	Date Event 5 March 2021 Accepted 19 March 2021 Published
Uncontrolled Keywords:	critical care, nurse roles, nursing observations, qualitative approaches, research implementation
Subjects:	CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-01 - nursing (non-specific)
Divisions:	Faculty of Health, Education and Life Sciences > College of Health and Care Professions
SWORD Depositor:	JISC PubRouter
Depositing User:	JISC PubRouter
Date Deposited:	29 Mar 2021 08:34
Last Modified:	12 Jan 2022 11:25
URI:	https://www.open-access.bcu.ac.uk/id/eprint/11459