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Emergency response teams are implemented throughout hospitals to support direct\u2010care clinicians in managing patient deterioration, but patient clinical deterioration is often not identified or acted upon by clinicians in ward settings. To date, no studies have used an integrative theoretical framework in multiple sites to examine why clinicians\u2019 delay identification and action on patients\u2019 clinical deterioration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To identify barriers and facilitators that influence clinicians\u2019 absent or delayed response to patient clinical deterioration using the Theoretical Domains Framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Theoretical Domains Framework guided: (a) semi\u2010structured interviews with clinicians, health consumers and family members undertaken at two sites; (b) deductive analyses of inductive themes to identify barriers and facilitators to optimal care. This study complied with the COREQ research guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Seven themes identified: (a) information transfer; (b) ownership of patient care; (c) confidence to respond; (d) knowledge and skills; (e) culture; (f) emotion; and (g) environmental context and resources.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The Theoretical Domains Framework identified traditional social and professional hierarchies and limitations due to environmental contexts and resources as contributors to diminished interprofessional recognition and impediments to the development of effective relationships between professional groups. Communication processes were impacted by these restraints and further confounded by inadequate policy development and limited access to regular effective team\u2010based training. As a result, patient safety was compromised, and clinicians frustrated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results inform the development, implementation and evaluation of a behaviour change intervention and increase knowledge about barriers and facilitators to timely response to patient clinical deterioration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>Results contribute to understanding of why clinicians delay responding to patient clinical deterioration and suggest key recommendations to identify and challenge traditional hierarchies and practices that prevent interdisciplinary collaboration and decision\u2010making.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.15620","type":"journal-article","created":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T09:28:49Z","timestamp":1608715729000},"page":"803-818","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Identifying barriers and facilitators to recognition and response to patient clinical deterioration by clinicians using a behaviour change approach: A qualitative study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6089-8225","authenticated-orcid":false,"given":"Rachel M.","family":"Walker","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery Griffith University Brisbane Qld Australia"},{"name":"Menzies Health Institute Queensland Griffith University Brisbane Qld Australia"},{"name":"Division of Surgery Princess Alexandra Hospital Brisbane Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4025-9741","authenticated-orcid":false,"given":"Rhonda J.","family":"Boorman","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Griffith University Brisbane Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Vaux","sequence":"additional","affiliation":[{"name":"Metro South Patient Flow Program Princess Alexandra Hospital Brisbane Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Cooke","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Griffith University Brisbane Qld Australia"},{"name":"Menzies Health Institute Queensland Griffith University Brisbane Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne M.","family":"Aitken","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Griffith University Brisbane Qld Australia"},{"name":"Menzies Health Institute Queensland Griffith University Brisbane Qld Australia"},{"name":"School of Health Sciences City University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea P.","family":"Marshall","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Griffith University Brisbane Qld Australia"},{"name":"Menzies Health Institute Queensland Griffith University Brisbane Qld Australia"},{"name":"Gold Coast Health Gold Coast Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969733016643863"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2014.10.044"},{"issue":"1","key":"e_1_2_12_4_1","first-page":"43","article-title":"Barriers to non\u2010critical care nurses identifying and responding to early signs of clinical deterioration in acute care facilities","volume":"29","author":"Allen G.","year":"2020","journal-title":"MEDSURG Nursing"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2018.06.004"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0605-9"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/13561820.2015.1049339"},{"key":"e_1_2_12_8_1","unstructured":"Australian Commission on Safety and Quality in Health Care. 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