Table 2 Facilitators to barcode medication administration (BCMA) use mapped to the COM-B (Capability, Opportunity, Motivation - Behaviour) Framework and Theoretical Domain Framework (TDF)
COM-B | THEORETICAL DOMAINS FRAMEWORK | THEMES (SUB-THEMES) |
|---|---|---|
CAPABILITY: PSYCHOLOGICAL | KNOWLEDGE | Training on BCMA Awareness of BCMA system Patient safety Knowledge of links to patient safety |
MEMORY, ATTENTION AND DECISION PROCESSES | Training on BCMA Troubleshooting guidance available | |
CAPABILITY: PHYSICAL | SKILLS | Training on BCMA Provision of good skills-based training Ongoing support from training team / refresher sessions |
OPPORTUNITY: SOCIAL | SOCIAL INFLUENCES | Culture and Accountability Culture of using BCMA on ward Encouraged to use by managers Encouragement and support from colleagues BCMA viewed as “standard practice” Perceived as mandatory Patients in support of BCMA system |
OPPORTUNITY: PHYSICAL | ENVIRONMENTAL CONTEXT AND RESOURCES | Equipment Individual control over drugs on trolley Adequate number of scanners / trolleys for each drug round Wireless scanners Time-efficiency Reduced walking to treatment room |
MOTIVATION: AUTOMATIC | REINFORCEMENT | Culture and Accountability Patients aware of BCMA system / expect use Organisational culture promoting / mandating BCMA |
MOTIVATION: REFLECTIVE | PROFESSIONAL ROLE AND IDENTITY | Culture and Accountability Viewed as part of nursing role |
BELIEFS ABOUT CAPABILITIES | Time-efficiency Streamlined process / Time-saving Training on BCMA Adequate training and confidence using system Patient safety Belief that using system will improve patient safety Confidence regarding avoidance of drug error provided by BCMA system | |
GOALS | Patient Safety Minimise drug errors Effect on patient interactions More time spent by patient’s bedside | |
BELIEFS ABOUT CONSEQUENCES | Patient Safety Confidence / reassurance from using BCMA system Culture and Accountability Organisational culture mandating BCMA | |
OPTIMISM | Patient Safety Confidence that patient safety will be improved |