DEveloping a Complex Intervention for DEteriorating Patients (DECIDE)
Research type
Research Study
Full title
DEveloping a Complex Intervention for DEteriorating Patients using Theoretical Modelling (DECIDE study)
IRAS ID
247047
Contact name
Duncan J Smith
Contact email
Sponsor organisation
City, University of London
Clinicaltrials.gov Identifier
ICA-CDRF-2017-03-020, HEE/NIHR reference number
Duration of Study in the UK
3 years, 4 months, 27 days
Research summary
To support nurses in recognising deteriorating patients, tools have been developed and are used in UK hospitals. These tools provide a record of clinical observations (blood pressure, heart rate, breathing rate, temperature and oxygen level) whilst also generating an ‘early warning score’ (EWS) every time observations are performed. The higher the score the greater the risk that deterioration will continue. The charts also instruct staff on what action to take. If a patient has a medium or high EWS, nurses should contact a doctor for help. Unfortunately, there is evidence that these instructions are not always followed, leaving unwell patients at risk. The aim of this research is to develop an intervention to change the behaviour of nurses when they are reacting to the EWS. \n\nFirst, the researcher will spend time observing nurses on hospital wards. The behaviours observed on the wards will be compared to the ideal behaviours set out in published information. \n\nNurses will then be interviewed to explore their beliefs about the causes of the observed behaviour. Interview data will be analysed using a framework called the Theoretical Domains Framework (TDF). This analysis will allow the likely causes of behaviour to be identified and grouped by TDF domains. Structured methods will then be used to decide which domains are most important and should be targeted by the intervention. Each of these important domains will be matched to a behaviour change technique (BCT). \n\nA group of clinical staff will then be asked to participate in a structured group process designed for problem solving. Group members will discuss how the BCTs could be delivered on the wards and rank the BCTs according to acceptability. The BCTs ranked the highest during this process, will be considered first by the research team when they are agreeing the content of the intervention.\n\n
REC name
North of Scotland Research Ethics Committee 1
REC reference
18/NS/0118
Date of REC Opinion
29 Oct 2018
REC opinion
Favourable Opinion