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Table 3 Modified Sepsis Six intervention summary based on Template for Intervention Development and Replication (TIDier)

From: Bridging the gap between pragmatic intervention design and theory: using behavioural science tools to modify an existing quality improvement programme to implement “Sepsis Six”

Modified intervention components Rationale Mode of delivery Delivered to When/how often
Sepsis Six introductory education sessions including target setting of 95 % implementation To familiarise staff with the bundle and generate enthusiasm Face to face (group) Doctors and nurses Once when Sepsis Six is first introduced and once at each new/junior staff induction to the ward
Promotional and educational documentsa To educate staff about the pathway and promote self-monitoring Documents Doctors and nurses Ongoing
Materials provided to aid implementationb To make implementation more convenient Environment changes Resources varied between wards Ongoing
New intervention components
 Partnership agreement contract between clinical leads in area and intervention facilitator To engage senior staff members, highlight role model status and ensure collective commitment to implementation Documents Clinical lead in intervention area and nurse facilitator Once when “Sepsis Six” is first introduced to area
 Hospital at Night Co-ordinator education To stimulate action towards aiding staff with implementation on night shifts Face-to-face (individual) Hospital at Night Co-ordinators Once
Unmodified/original intervention components
 Training (septic patient simulation) To train staff on how to implement Face-to-face (group) Minority of doctors and nurses (ad hoc) Ad hoc, approximately bi-monthly
 Data measurement and group feedback- daily implementation rates displayed in staff break area and verbal feedback given To focus staff on targets and progress Rates displayed, feedback delivered face-to-face (group) All available doctors and nurses (majority nurses) on shift Rates displayed daily, weekly or bi-weekly feedback sessions
 Individual personalised feedback for staff involved in incidents when bundle was not fully implemented To target specific incidents of non-compliance Face to face (group) Staff involved in incidents where bundle was not correctly or fully implemented Ad hoc, ~2 staff per week