Table 5 Behaviour change taxonomies (BCTs) with their relating intervention functions and planned implementation strategy specific to the care bundle
BCTs | Intervention Functions | Proposed implementation strategy | Barrier(s)/Facilitator(s) addressed (TDF domain) |
|---|---|---|---|
Information about health consequences | Education, persuasion | Staff will be informed about the improvement in pneumonia rates reduction with the protocol from previous study | Belief of consequences of care bundle (Belief about consequences) Understanding of evidence-informed interventions for patient with blunt chest injury (Knowledge) |
Feedback on behaviour | Education, persuasion, incentivisation | Staff compliance will be monitored through audits and by clinical champions Staff will be informed of the results informally via clinical champions and formally through email and newsletter correspondence | Belief of consequences of care bundle (Belief about consequences) Understanding of evidence-informed interventions for patient with blunt chest injury (Knowledge) |
Feedback on outcome(s) of behaviour | Education, incentivisation, training | Feedback will be given to staff on patients treated with the care bundle | Understanding of evidence-informed interventions for patient with blunt chest injury (Knowledge) Belief of consequences of care bundle (Belief about consequences) Emotions relating to commencing new protocol (Emotion) Remembering to use protocol (Memory, attention, and decision processes) Confidence in patient assessment skills (Physical skills) |
Information about others’ approval | Education, persuasion | Local staff will appear in the care bundle video showing support | Identify with professional role associated with care of blunt chest injury patients (Professional/ social role and identity) |
Credible source | Persuasion | Senior local staff will appear in a video informing staff about the care bundle | Identify with professional role associated with care of blunt chest injury patients (Professional/ social role and identity) |
Prompts/cues | Education, environmental restructuring | A visual prompt (screen icon) will be developed for the electronic medical record to flag to staff that patient is eligible for care bundle Flyers will be put up around the workplace to remind staff of the care bundle | Remembering to use protocol (Memory, attention, and decision processes) |
Verbal persuasion about capability | Persuasion, enablement | Staff will be encouraged during educational sessions and by change champions that they are capable of following the care bundle | Emotions relating to commencing new protocol (Emotion) |
Identification of self as role model | Persuasion, enablement | Staff will be asked to volunteer for the roles of change champions and to be in the video | Emotions relating to commencing new protocol (Emotion) Identify with professional role associated with care of blunt chest injury patients (Professional/ social role and identity) |
Commitment | Incentivisation, enablement | Staff will appear in a video committing to the care bundle | Remembering to use protocol (Memory, attention, and decision processes) |
Demonstration of behaviour | Training, modelling | Staff will receive demonstrations of behaviour in a video, in education sessions and at the bedside with the change champions | Confidence in patient assessment skills, Confidence in skills needed for evidence-informed management of blunt chest injury, Adequate skill in regional analgesia prescription and management (Physical skills) Remembering to use protocol (Memory, attention, and decision processes) Identify with professional role associated with care of blunt chest injury patients (Professional/ social role and identity) Emotions relating to commencing new protocol (Emotion) |
Instruction on how to perform behaviour | Training | Staff will receive instructions of behaviour in a video, in education sessions and at the bedside with the change champions | Confidence in patient assessment skills, Confidence in skills needed for evidence-informed management of blunt chest injury, Adequate skill in regional analgesia prescription and management (Physical skills) Remembering to use protocol (Memory, attention, and decision processes) |
Habit formation | Training | Staff will be encouraged to assess all potentially eligible patients systematically | Confidence in patient assessment skills, Confidence in skills needed for evidence-informed management of blunt chest injury, Adequate skill in regional analgesia prescription and management (Physical skills) Remembering to use protocol (Memory, attention, and decision processes) |
Adding objects to the environment | Environmental restructuring, enablement | An icon will be added for the electronic medical record to flag to staff that patient is eligible for care bundle A pager will be setup to be able to contact staff responding to the care bundle | Remembering to use protocol (Memory, attention, and decision processes) Access to protocol (Environmental context and resources) Emotions relating to commencing new protocol (Emotion) |
Restructuring the physical environment | Environmental restructuring, enablement | Equipment necessary for the care bundle will be placed in a location that ensures ease of access Equipment will be adequately labelled with instructions Additional equipment will be supplied to ensure adequate supply The protocol will be tested by staff to ensure ease of use | Remembering to use protocol (Memory, attention, and decision processes) Access to protocol, the protocol design, Access to equipment (Environmental context and resources) Emotions relating to commencing new protocol (Emotion) |
Social Support | Enablement | Change champions will be chosen from each area who will receive extra training to be able to provide extra support | Social supports (Social influences) |