Participants were recruited from fo

Participants were recruited from four tertiary
care hospitals in Bangkok, Thailand with ICUs that had sustained MVWP implementation for at least two years. Hospital bed capacity varied from 500 to 1,000 beds, the number of ICUs varied from four to six per hospitals, with ICU bed capacity of eight to ten beds. Participants were recruited through purposive and snowball sampling.20 Forty-three registered nurses who had at least one year of work experience at the bedside with MVWP implementation were recruited for focus group discussion. To supplement data obtained from the focus groups and obtain multidisciplinary and administrative perspectives, twenty participants were purposively recruited for in-depth interviews: eight bedside nurses from the focus groups, four head nurses, four nurse supervisors, and four physicians. Inclusion criteria for the head nurses were: have responsibility for staff continuing education, resources, and supervision. Inclusion criteria for nurse supervisors were: responsible for facilitating communication and collaboration among staff and with other units, monitoring MVWP use, and staff continuing education on MVWP use. The inclusion criterion for physicians was having work experience with MVWP implementation for at least one year in one of the four study hospitals.