A qualitative study investigating the barriers to the implementation of the 'Sepsis Six Care Bundle' in maternity wards

Nouf Abutheraa, Alexander B. Mullen, June Grant, Gazala Akram

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Background: In 2014, the Sepsis Six Care Bundle (SSCB) was introduced into a Scottish health region to improve patient outcomes. Poor compliance was demonstrated with the SSCB across different specialities. This study explored determinants of non-compliance with the SSCB in maternity wards. Methods: In-depth interviews were conducted with midwives in a single Scottish health region. Convenience sampling was used to recruit interviewees. The interviews were digitally recorded, transcribed verbatim, entered into NVivo software, and analysed using thematic analysis. Results: Thirteen face-to-face interviews were completed and lasted an average of 33 min. Three main barriers were identified to SSCB implementation; the difficulty of diagnosing sepsis, the suitability of the SSCB in a maternity setting as part of the pre-conditions phase, and the lack of staff training as part of the pre-implementation phase. Conclusion: The findings emphasize the importance of adapting improvement initiatives with sufficient preparation of staff in the rationale use to the context of care bundles.
Original languageEnglish
Article number374
Number of pages11
Issue number4
Publication statusPublished - 1 Oct 2020


  • sepsis
  • care bundle
  • behaviour
  • implementation science
  • midwives
  • sepsis six care bundle

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