title: Determinants of intention to deviate from clinical practice guidelines.
abstract: The volitional nature of procedural violations in work systems creates a challenge for human factors research and practice. In order to understand how violations are caused and what can be done to mitigate them, there is a need to determine the influence of workers' beliefs about rules and guidelines. This study demonstrates the use of a social psychological approach to investigate the beliefs of anaesthetists about clinical practice guidelines. A survey was completed by 629 consultant anaesthetists, who rated their beliefs about deviation from three guidelines (performing pre-operative visits; checking anaesthetic equipment; handling intravenous fluid bags). Regression analysis indicated that the belief ratings predicted self-rated intention to deviate from the guidelines. Implications for understanding anaesthetists' adherence to guidelines are discussed. STATEMENT OF RELEVANCE: This study builds upon previous work by the authors, presenting a more detailed insight into potential causes of procedural violations in healthcare. The study also demonstrates the use of a social psychological method to the investigation of violations. Hence, it is of interest to researchers and practitioners interested in human reliability, especially in healthcare.
authors.affiliation: School of Medicine, University of Manchester, Manchester, UK. phippsdl@vodafone.net
authors.forename: Denham L
authors.initials: DL
authors.lastname: Phipps
authors.forename: Dianne
authors.initials: D
authors.lastname: Parker
authors.forename: George H
authors.initials: GH
authors.lastname: Meakin
authors.forename: Paul C W
authors.initials: PC
authors.lastname: Beatty
mesh_terms: D000758:Anesthesia / Q000592:standards; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D033182:Intention; D010818:Practice Patterns, Physicians'; D011593:Psychology, Social; D012449:Safety; D006113:United Kingdom