Psychometric Properties of the Barriers to and Facilitators of Implementing the Sepsis Six Care Bundle (BLISS-1) Questionnaire

Dania Bani Hamad,1 Mohammad Rababa,2 Raeda Abu Ali,1 Hala ALeasa3 1Department of Nursing, Al-Balqa Applied University, Al-Salt, Jordan; 2Department of Adult Health Nursing, Jordan University of Science and Technology, Irbid, Jordan; 3Internship Doctor at Specialty Hospital, Amman, JordanCorrespondence: Mohammad Rababa, Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, 22110, Jordan, Email [email protected]: Sepsis, a severe medical condition caused by a dysregulated host response to infection, accounts for 20% of global fatalities. While simplifying early sepsis treatment with the Sepsis Six care bundle has been shown to reduce mortality by 46.6%, multiple barriers often prevent clinical nurses from adhering to sepsis care recommendations. Identifying these barriers is essential to eliminating them, and thus the Sepsis Six Care bundle (BLISS-1) questionnaire was developed to identify the barriers to and facilitators of nurses’ implementation of the Sepsis Six care bundle while caring for sepsis patients. The current study assessed the psychometric properties of the BLISS-1 questionnaire to evaluate its validity and reliability.Purpose: This study assessed the psychometric properties of the BLISS-1 questionnaire.Methods: A total of 180 clinical nurses working in different critical care units at a selected University Hospital participated in a cross-sectional, descriptive study. Data were collected using the BLISS-1 Questionnaire, used to assess the perceived barriers to and facilitators of Sepsis Six performance. Descriptive statistics, Cronbach’s alpha reliability analysis, and Promax rotation EFA were performed to assess the validity and reliability of the questionnaire.Results: The BLISS-1 questionnaire has strong internal consistency, with Cronbach’s alpha values of 0.978 for perceived barriers and 0.976 for perceived importance. Factor analysis revealed that key barriers included skepticism about the protocol’s clinical efficacy and operational challenges such as limited training and insufficient resources.Conclusion: This study revealed the BLISS-1 questionnaire to be highly reliable. Focused education, appropriate resource allocation, and supporting policies are needed to increase nurses’ adherence to the Sepsis Six protocol and, hence, improve patient outcomes.Keywords: sepsis, sepsis six, clinical nurses, barriers, BLISS-1 questionnaire, patient outcomes