Table 5 Classification of belief statements according to questionnaire results, presented by domain

Belief in Capabilities

There is POOR teamwork when looking after septic patients

There is GOOD teamwork when looking after septic patients

Important barrier

I am NOT confident performing the Sepsis Six

I AM confident performing the Sepsis Six

Important enabler

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

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

We provide POOR sepsis care at this hospital

We provide GOOD sepsis care at this hospital

Unimportant barrier

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

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

Overall, the RISKS of performing the Sepsis Six outweigh the benefits

Overall, the BENEFITS of performing the Sepsis Six outweigh the risks

Important enabler

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

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

Behavioral Regulation

Sepsis Six performance is NOT audited regularly in my department

Sepsis Six performance IS audited regularly in my department

Unimportant barrier

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

We get INSUFFICIENT feedback on our Sepsis Six performance

We get SUFFICIENT feedback on our Sepsis Six performance

Unimportant barrier

Sepsis Six performance is NOT discussed in meetings in my department

Sepsis Six performance IS discussed in meetings in my department

Unimportant barrier

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

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

Environment, Context and Resources

There is INSUFFICIENT staffing to perform the Sepsis Six

There is SUFFICIENT staffing to perform the Sepsis Six

Important barrier

There is INSUFFICIENT time to perform the Sepsis Six

There is SUFFICIENT time to perform the Sepsis Six

Important barrier

There is INSUFFICIENT equipment / medication to perform the Sepsis Six

There is SUFFICIENT equipment / medication to perform the Sepsis Six

Important barrier

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

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

Septic patients are RARELY managed in an appropriate location

Septic patients are ALWAYS managed in an appropriate location

Important barrier

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

I do NOT feel anxious/stressed when treating septic patients

I DO feel anxious/stressed when treating septic patients

Unimportant barrier

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

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

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

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

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

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

SOME steps in the Sepsis Six are more or less important than others

ALL steps in the Sepsis Six are equally important

Unimportant barrier

Knowledge

I am NOT aware of what the Sepsis Six involves

I AM aware of what the Sepsis Six involves

Important enabler

I am NOT aware of the evidence supporting the Sepsis Six

I AM aware of the evidence supporting the Sepsis Six

Unimportant enabler

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

I OFTEN miss sepsis

I RARELY miss sepsis

Important barrier

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

Optimism

Sepsis Six performance at this hospital will NOT improve

Sepsis Six performance this this hospital WILL improve

Important barrier

Increasing Sepsis Six performance will NOT improve patient care

Increasing Sepsis Six performance WILL improve patient care

Important enabler

Reinforcement

The hospital is NOT formally rewarded for good Sepsis Six performance

The hospital IS formally rewarded for good Sepsis Six performance

Unimportant barrier

Individuals are NOT formally rewarded for good Sepsis Six performance

Individuals ARE formally rewarded for good Sepsis Six performance

Unimportant barrier

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

There is INSUFFICIENT leadership for improving Sepsis Six performance

There is SUFFICIENT leadership for improving Sepsis Six performance

Unimportant barrier

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

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

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

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

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

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

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

Performing the Sepsis Six is NOT part of my role

Performing the Sepsis Six IS part of my role

Important enabler

It is NOT part of my role to identify septic patients

It IS part of my role to identify septic patients

Important enabler

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

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

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