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. 2020 Sep 16;15(9):e0239181. doi: 10.1371/journal.pone.0239181

Table 2. NPT constructs relevant to the AMBER care bundle.

Normalisation Process Theory (NPT) Constructs NPT framework questions relevant to AMBER care bundle
NPT construct 1- ‘Coherence’
The work people engage individually and collectively when they are faced with the problem of operationalising a set of practices
  • Is the AMBER care bundle easy to describe?

  • Is it distinct from other ward-based interventions?

  • (i.e., meaning and sense-making by participants)

    Does the AMBER care bundle have a clear purpose for all relevant participants i.e. ward staff?

  • Do ward staff have a shared sense of its purpose?

  • What benefits will the AMBER care bundle bring, and to whom?

  • It is AMBER care bundle expected to improve the performance and the clinical outcomes of patients and their families.

  • Are these benefits likely to be valued by potential participants?

  • Does the AMBER care bundle fit with the overall goals and activity of the organisation?

NPT construct 2-‘Cognitive participation’
‘Buy-in’ or relational work people do to build and sustain a community of practice around a complex intervention.
  • Do ward staff consider the AMBER care bundle to be a good idea?

  • Will they see the point of the AMBER care bundle easily?

  • Will ward staff be prepared to invest time, energy and work in it?

NPT construct 3-‘Collective action’
The operational work that people do to enact a set of practices around a complex intervention.
  • How will the AMBER care bundle affect the work of ward staff?

  • Will it promote or impede their work

  • Will ward staff require extensive training before they can use it?

NPT construct 4-‘Reflexive monitoring’
The monitoring work that people do to understand and appraise the ways that a new set of practices affect them and others around them.
  • How are ward staff likely to perceive the AMBER care bundle once it has been in use for a while?

  • Will the AMBER care bundle to be perceived as advantageous for patients or ward staff?

  • Will it be clear to them what the effects of the AMBER care bundle intervention have been?

  • Can users/staff contribute feedback about the AMBER care bundle once it is in use?

  • Can the AMBER care bundle intervention be adapted/improved based on experience?