title: What influences pre-hospital cannulation intentions in paramedics? An application of the theory of reasoned action.
abstract: BACKGROUND
  Intravenous cannulation is a common and important intervention undertaken by paramedics for administration of fluids and drugs in the pre-hospital setting. This study was a partial application of the theory of reasoned action to the prediction of pre-hospital cannulation intentions as part of an evaluation of an educational intervention to change cannulation behaviour in paramedics in line with national guidance.
  
  
  METHODS
  In 2008 a self-completion questionnaire was sent to paramedics from Nottinghamshire and Lincolnshire divisions of East Midlands Ambulance Service NHS Trust, UK. This included measures of prior behaviour related to cannulation, attitude towards cannulation, normative influence related to cannulation and intention to cannulate as well as demographic information.
  
  
  RESULTS
  Of the 323 paramedics sent questionnaires 137 (42.2%) responded. Attitude towards cannulation (but not normative or peer influence) was a necessary factor for prediction of intention to cannulate in respondents. Past cannulation behaviour was indirectly related to intention to cannulate through the mediation of attitude towards cannulation.
  
  
  CONCLUSIONS
  The theory of reasoned action provides a parsimonious way to predict intentions to cannulate. This study suggests that design and evaluation of interventions to reduce inappropriate cannulation should be targeted towards changing attitudes of paramedics, rather than towards addressing behavioural norms. Future research could utilize social-psychological theories to better understand clinical behaviour prior to implementation of complex educational or organizational interventions.
authors.affiliation: Rutgers University, New Brunswick, NJ, USA. smitach@rutgers.edu
authors.forename: Smita C
authors.initials: SC
authors.lastname: Banerjee
authors.forename: A Niroshan
authors.initials: AN
authors.lastname: Siriwardena
authors.forename: Mohammad
authors.initials: M
authors.lastname: Iqbal
mesh_terms: D000328:Adult; D000488:Allied Health Personnel / Q000523:psychology*; D001291:Attitude of Health Personnel; D002404:Catheterization; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D011582:Psychological Theory; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom