Clinical guidelines, as products of research, are increasingly used to raise the quality of care delivery in acute hospital NHS Trusts. However, their use is impeded by many organizational and individual barriers and understanding of psychological barriers is underexplored. This study aimed to explore ‘intention’ as a psychological explanation of health professionals’ research utilisation behaviour using an extended Theory of Planned Behaviour (TPB) social cognitive model.
The ‘care round checklist’ was identified, in collaboration with practice partners, as a suitable guideline behaviour to evaluate. A theory-driven questionnaire was developed and utilized to measure nurses’ and Health Care Assistants’ (HCAs’) intentions. Inferential statistical tests were used to establish differences in nurses’ and HCAs’ intentional behaviour and the predictive value of the TPB model.
270 questionnaires were returned from 24 wards. The TPB model explained a modest level of intention; 20% of nurses’ and 24% of HCAs’ care round intentions. Nurses’ attitudes and perceived control best predicted intentions, whilst HCAs’ intentions were predicted by attitude and practice habit.
Conclusion and Recommendations:
The TPB model lacked sophistication to sufficiently explain intentional guideline behaviour, within a complex guideline behaviour, though role differences were significant. Further variables could add to the predictive value of intention. Future work should acknowledge limitations in the TPB model in explaining intention, and also test the model in different clinical environments and healthcare organisations. Clinically, role differences should be recognized in the future design and implementation of care rounds.