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Monday, November 2, 2009: 2:00 PM
Learning Objective 1: identify predictors of behavioral intention to disinfect needleless intravenous systems.
Learning Objective 2: delineate the importance of using an educational pedagogy aligning preceptor practice with established, empirally-derived guidelines for disinfection of needleless intravenous systems.
Purpose: Effective disinfection of needleless access devices is paramount. Studies demonstrate optimal disinfection time is 15 seconds. Despite scientific support for this ‘gold standard,’ there remains a paucity of reported literature regarding why nurses do not consistently adhere to this guideline. Therefore, the study purpose was to examine predictors (autonomy, self-efficacy, and beliefs) of behavioral intention to utilize best practice disinfection techniques in needleless intravenous systems. Methods: Descriptive, correlational design; Convenience sample (N=171); Scales: Dempster Practice Behaviors and General Self Efficacy (with well established validity/reliability). A third instrument, Smith/Becker Attitudes Toward Disinfection Techniques, was investigator-designed and based upon Fishbein and Ajzen’s Theories of Planned Behavior and Reasoned Action. This scale measures beliefs, values, control, social norm and motive to comply with disinfection of needleless connectors. The outcome measure was behavioral intention to disinfect needleless access devices.
Conclusions: Mean age: 35.17 years (SD 11.48; 21-71 years); the majority of participants were white, non-Hispanic (71.3%, n=122), and female (81.9%; n=140). Seventy-one percent (n=122) had a BSN or higher degree and were registered nurses an average of 9.03 (SD=11.32) years. Years of experience correlated with autonomy (r=0.31; p=0.00) and self-efficacy (r=0.24; p=0.002). Negative correlations were found on age (r=-0.17; p=0.03) and years of practice experience (r=-0.23; p=0.003) with behavioral intention to consistently use optimal disinfection techniques. There was a positive correlation between concern for preventing introduction of bacteria into the bloodstream and behavioral intention (r=0.26; p=0.001). Beliefs (social norms) of colleagues (unit leaders, physicians, PICC nurses) were significantly correlated with behavioral intention, but perceptions of staff nurses’ attitudes most influenced decisions to scrub the hub (r=0.45; p=0.00). Implications: While older, more experienced nurses were more autonomous and self-efficacious, they were less likely to utilize established best practice in disinfecting needleless intravenous systems. The findings have important implications for nursing education and preceptor training.
Conclusions: Mean age: 35.17 years (SD 11.48; 21-71 years); the majority of participants were white, non-Hispanic (71.3%, n=122), and female (81.9%; n=140). Seventy-one percent (n=122) had a BSN or higher degree and were registered nurses an average of 9.03 (SD=11.32) years. Years of experience correlated with autonomy (r=0.31; p=0.00) and self-efficacy (r=0.24; p=0.002). Negative correlations were found on age (r=-0.17; p=0.03) and years of practice experience (r=-0.23; p=0.003) with behavioral intention to consistently use optimal disinfection techniques. There was a positive correlation between concern for preventing introduction of bacteria into the bloodstream and behavioral intention (r=0.26; p=0.001). Beliefs (social norms) of colleagues (unit leaders, physicians, PICC nurses) were significantly correlated with behavioral intention, but perceptions of staff nurses’ attitudes most influenced decisions to scrub the hub (r=0.45; p=0.00). Implications: While older, more experienced nurses were more autonomous and self-efficacious, they were less likely to utilize established best practice in disinfecting needleless intravenous systems. The findings have important implications for nursing education and preceptor training.