A Qualitative Study Investigating the Barriers to the Implementation of the ‘Sepsis Six Care Bundle’ in Maternity Wards

Nouf Abutheraa* (Corresponding Author), Alexander B. Mullen, June Grant, Gazala Akram

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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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

Bibliographical note

Funding: This research received no external funding.
Acknowledgments: We thank the healthcare staff who provided general support throughout the study. We are grateful to the research team in the Strathclyde Institute of Pharmacy and Biomedical Science for their contribution in the validation and review of this manuscript.

Data Availability Statement

The following are available online at http://www.mdpi.com/2227-9032/8/4/374/s1, Document S1: the COREQ checklist; Document S2: Consent Form; Document S3: Participants’ Information Sheet; Document S4: Participants’ Invitation Letter.


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


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