Evidence map›Paper›PMID 39304301›Full record

ArticleJournal of advanced nursing2025

Emergency clinicians' use of adult and paediatric sepsis pathways: An implementation redesign using the behaviour change wheel.

Belinda Munroe, Michelle Hudoba, Mary Fullick, Tracey Couttie, Hughes Makoni, Ellie Butina, Niladri Ghosh, Ryan Kloger, Sharyn Balzer, Rebekkah Middleton

Abstract read
In one paragraph

Article in Journal of advanced nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Belinda MunroeEmergency Services, Illawarra Shoalhaven Local Health District, Warrawong, Australia.ORCID https://orcid.org/0000-0001-7874-7225
Michelle HudobaClinical Governance Unit, Illawarra Shoalhaven Local Health District, Wollongong, Australia.
Mary FullickNSW Clinical Excellence Commission, St Leonards, Australia.
Tracey CouttieDivision of Child and Families, Illawarra Shoalhaven Local Health District, Wollongong, Australia.
Hughes MakoniEmergency Services, Illawarra Shoalhaven Local Health District, Warrawong, Australia.
Ellie ButinaAntimicrobial Stewardship Pharmacist, Illawarra Shoalhaven Local Health District, Wollongong, Australia.
Niladri GhoshSenior Staff Specialist Infectious Diseases, Sepsis Clinical Lead, Illawarra Shoalhaven Local Health District, Wollongong, Australia.
Ryan KlogerEmergency Services, Illawarra Shoalhaven Local Health District, Warrawong, Australia.
Sharyn BalzerEmergency Services, Illawarra Shoalhaven Local Health District, Warrawong, Australia.
Rebekkah MiddletonFaculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, Australia.ORCID https://orcid.org/0000-0002-8440-7451

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo identify facilitators and barriers and tailor implementation strategies to optimize emergency clinician's use of adult and paediatric sepsis pathways.

designA qualitative descriptive study using focus group methodology.

methodsTwenty-two emergency nurses and ten emergency medical officers from four Australian EDs participated in eight virtual focus groups. Participants were asked about their experiences using the New South Wales Clinical Excellence Commission adult and paediatric sepsis pathways using a semi-structured interview template. Facilitators and barriers to use of the sepsis pathways were categorized using the Theoretical Domains Framework. Tailored interventions were selected to address facilitators and barriers, and a re-implementation plan was devised guided by the Behaviour Change Wheel.

resultsThirty-two facilitators and 58 barriers were identified corresponding to 11 Theoretical Domains Framework domains. Tailored strategies were selected to optimize emergency clinicians' use of the sepsis pathways including refinement of existing education and training programmes, modifications to the electronic medical record system, introduction of an audit and feedback system, staffing strategies and additional resources.

conclusionThe implementation of sepsis pathways in the Emergency Department setting is complex, impacted by a multitude of factors requiring tailored strategies to address facilitators and barriers and optimize uptake. IMPLICATIONS FOR PATIENT CARE: This study presents a theory-informed systematic approach to successfully implement and embed adult and paediatric sepsis pathways into clinical practice in the Emergency Department. IMPACT: Optimizing uptake of sepsis pathways has the potential to improve sepsis recognition and management, subsequently improving the outcome of patients with sepsis. REPORTING

methodThe Consolidated Criteria for REporting Qualitative research guided the preparation of this report. PATIENT OR PUBLIC CONTRIBUTION: Nil.

Indexed as

Critical PathwaysEmergency Service, HospitalSepsisAdultAustraliaChildFemaleFocus GroupsHumansMaleMiddle AgedNew South WalesQualitative Researchbehaviour changeclinical pathwaysemergency departmentimplementationmedicinenursingsepsis

Identifiers

PMID39304301
PMCPMC12535354

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.