A shock in time saves lives: Theory of planned behaviour and nurse-initiated defibrillation

"The time from onset of a cardiac arrest to defibrillation is crucial hence access to and use of a defibrillator by all nurses essential. The purpose of this study was to use an established theoretical framework to examine and describe the defibrillation practices and beliefs of rural registered nurses in the Australian state of Queensland. The Theory of Reasoned Action (TRA) and Theory of Planned Behaviour (TPB) guided the research processes for this two phase study. In the first phase, focus group (n = 13) discussions identified the salient beliefs of the population. By eliciting nurses' beliefs, the subsequent quantitative study (n = 434) was conducted to determine the influences of these beliefs on nurses' use or non-use of defibrillators. The results showed that: (1) less than half of the cohort of participants were permitted to defibrillate; (2) the defibrillation beliefs of those nurses permitted to defibrillate were significantly more positive than those not permitted to do so; (3) the direct measures of TPB and selected variables external to the model predicted a significant portion of the variance in the measure of nurse-initiated defibrillation intention; and, (4) subjective norm emerged as the strongest predictor of intention. In conclusion, Queensland rural hospital nurses and employers still have some distance to travel down the path of nurse-initiated defibrillation. The TPB is a viable framework on which to base interventions designed to promote defibrillation by rural nurses. Understanding the role of social norms is of central importance to ensure all nurses can initiate the chain of survival expeditiously whenever the need arises."