Study Aim Care delivery in the ICU is complex, dynamic, stressful, and subject to time pressures. Thus, factors that affect sustainable MVWP implementation may differ from those in a less intensive environment. The purpose of this study was to explore factors, barriers and facilitators, that influence sustained MVWP implementation as perceived by healthcare providers in Thai ICUs. Naturalistic inquiry was used to achieve the study aim because the approach focuses on studying the phenomenon of interest in its natural state.26 The ICU, with competing priorities for staff effort, is the context of MVWP use. Understanding that context through qualitative methods is essential to understanding the barriers and facilitators to sustained use of practice protocols.