Comparison of educational interventions to impact behavioral intent toward pressure ulcer prevention among nurses on medical surgical units

Background: Implementation of evidence-based knowledge in healthcare is challenging with success rates less than optimal at times. This is particularly true in the area of pressure ulcer prevention. Attention to use of the affective domain in educational interventions to implement best practices may be part of the solution. Purpose: The ultimate purpose of this study was to compare the use of two different educational interventions on medical-surgical nurses\u27 behavioral intent to use evidence-based practice in preventing pressure ulcers. Theoretical Framework: The theoretical framework for this study was the theory of planned behavior. Methods: This study proceeded in three phases and collected both qualitative and quantitative data for instrument development and instrument testing. The resultant instrument was used to collect data for hypothesis testing in a cluster randomized experiment. Results: The theory of planned behavior was not fully supported in this study. Attitudes toward pressure ulcers were predictive of behavioral intent. Nurses who experienced the affective domain educational intervention showed significant improvements over the control group on attitude and perceived behavioral control. Behavioral intent and subjective norm were not impacted. Conclusions: A reliable and valid theory of planned behavior derived instrument was created. The theory of planned behavior was partially supported. An affective domain intervention has the potential to favorably impact nurses in valuing pressure ulcer prevention, despite any barriers