Exploring Behaviour Change of Healthcare Professionals While Implementing a Complex Nursing Intervention: A Survey Study

In this study we explore the change in behaviour in terms of capability, opportunity and motivation of all healthcare professionals involved in the implementation of the complex nursing intervention PREDOCS in twelve cardiac surgery centres in the Netherlands. A multicentre survey in twelve Dutch cardiac surgery centres, implementing a complex nursing intervention: the PREDOCS consultation. Convenience samples of involved healthcare professionals completed the questionnaire, in 2018 (n = 92) and 2019 (n = 73). The COM-B-QP questionnaire based on COM-B items, MIDI items and open fields was developed and adapted to context-specific factors of every participating hospital. Depending on their role, participants rated their level of agreement with 14–26 predefined statements. The median and interquartile range and the difference/delta in medians at two-time points were calculated. At both moments in time, high scores were identified with no significant difference in five COM-B items: psychological capability, physical and social opportunity and reflective and automatic motivation. Professionals were generally well informed about the PREDOCS consultation and the PREDOCS consultation fits within their current work and profession. Staff shortages, staff turnover and insufficient insight into the effect were reported as reasons that hindered further implementation. We measured no significant change in the behaviour of healthcare professionals over time. It is unclear to what extent staff shortages, staff turnover and insufficient insight into effect influenced behaviour. Given the complexity of implementation, repeated monitoring of behaviour seems useful, so that continuous adjustment of the implementation strategy can take place.