Morphine administration by Paramedics: An application of the Theory of Planned Behaviour

Weber, Anthony; Dwyer, Trudy; Mummery, W. Kerry

doi:10.1016/j.injury.2010.12.006

Cited by 17 publications

(12 citation statements)

References 19 publications

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“…This finding is consistent with several previous studies investigating paramedic behaviour in the context of decision making. Weber et al investigated paramedic ‘behaviour’ when making decisions in relation to administration of morphine by a population of Australian paramedics [13], using Ajzen’s Theory of Planned Behaviour (TPB) model as a theoretical framework [28, 29]. TPB seeks to explain human behaviour as being the result of a person’s attitude (their self-beliefs), social norms (perceived beliefs of peers, co-workers, or social group) and their intent (their belief in their ability to be successful in the behaviour of interest).…”

Section: Discussionmentioning

confidence: 99%

“…This study also identified a lack of appreciation by participating paramedics of the complexity of the decisions they were making, evidenced by a reluctance to use, and an indifferent attitude towards an available algorithmic falls-decision tool. Other studies have investigated paramedic decision making in other contexts including high acuity care [2, 12], morphine administration [13], post-seizure management [14], activation of catheterisation labs [15], intravenous cannulation [16] and acute mental health presentations [17]. Decision making in less urgent situations has not been investigated despite the increasing volume of this category of work and the complexity that may be involved [18].…”

Section: Introductionmentioning

confidence: 99%

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‘Popping nana back into bed’ - a qualitative exploration of paramedic decision making when caring for older people who have fallen

Simpson

Thomas

Bendall

et al. 2017

BMC Health Serv Res

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Background: Older fallers constitute a large proportion of ambulance work, and as many as 25% are not transported to hospital following paramedic assessment. The objective of this study was to explore the decision making process used by paramedics when caring for older fallers. Methods: A qualitative study was conducted using constructivist grounded theory methodology. Purposive sampling was used to recruit paramedics to participate in semi-structured interviews and focus groups. Data analysis commenced with line-by-line coding, developing into formation of theoretical categories. Theoretical sampling was then used to clarify emerging theoretical concepts, with data collection and analysis continuing until theoretical saturation was achieved. Results: A total of 33 paramedics participated in 13 interviews and 4 focus groups. When caring for older fallers, paramedic decision making is profoundly affected by 'role perception', in which the individual paramedic's perception of what the role of a paramedic is determines the nature of the decision making process. Transport decisions are heavily influenced by a sense of 'personal protection', or their confidence in the ambulance service supporting their decisions. 'Education and training' impacts on decision making capacity, and the nature of that training subliminally contributes to role perception. Role perception influences the sense of legitimacy a paramedic attaches to cases involving older fallers, impacting on patient assessment routines and the quality of subsequent decisions. Conclusions: Paramedic decision making processes when caring for older people who have fallen appear to be strongly influenced by their perception of what their role should be, and the perceived legitimacy of incidents involving older fallers as constituting 'real' paramedic work.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

‘Popping nana back into bed’ - a qualitative exploration of paramedic decision making when caring for older people who have fallen

Simpson

Thomas

Bendall

et al. 2017

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Also, Edwards et al (2001) utilized the TPB and they found that around 40% of the variation in intention was accounted for by the TPB determinants. Consistently, Weber, Dwyer and Mummery (2012) revealed that the constructs of the TPB explained 26% of the variance in the intention to administer morphine.…”

mentioning

confidence: 64%

“…Recently, this theory used by Weber et al (2012) to assess the factors that affect the administration of morphine analgesic to the patient. The self-administered electronic questionnaires were sent to the paramedics participants in order to gather the required data.…”

Section: Perceived Behavioral Controlmentioning

confidence: 99%

Psychosocial Theories and Pain Management Practices: A Review of Empirical Research

Alzghoul¹,

Abdullah

2015

MJSS

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“…Inadequate or under medications have been identified as undesired outcomes when the health professional's knowledge and assessment skills are below standard [5] [6]. There are a number of possible causes for inadequate knowledge and assessment skills including organisational culture and lack of ongoing education of health professionals [5] [7]. In response, some Australian ambulance services have implemented problem-based education and practical assessments that follow an audit process [8].…”

Section: Introductionmentioning

confidence: 99%

Knowledge of Morphine Administration by Ambulance Paramedics: A Comparison of Two Clinical Levels of Paramedics

Weber¹,

Maguire²,

Dwyer³

2015

OJEM

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Objective: The purpose of this study is to identify any differences in adherence to morphine administration protocols between two clinical levels of paramedics within one emergency medical system in Australia. Methods: The participants were made up of 63 Advanced Care Paramedics (ACPs) who were trained in basic and intermediate life support and 45 Intensive Care Paramedics (ICPs) who were trained in advanced life support skills; all were operational and practicing paramedics qualified in morphine administration. Participants were required to complete a survey designed to assess their knowledge of morphine drug therapy protocol (DTP). The survey involved two sections: 1) demographics, and 2) questions related to two scenario-based cases. Scenario one was a cardiac case and scenario two was a pediatric case. Results: In scenario one, more intensive care paramedics administered the correct dose than the advanced care paramedics (25.4% vs. 4.4%; df = 101, P = 0.002); scenario two showed no statistically significant difference between the two groups (35.5% vs. 31.6%; df = 97, P = 0.3). Conclusion: The comparison of the two levels of paramedics and their adherence to drug protocols identified that ICPs had a higher rate than ACPs for adherence to morphine administration protocols for patients suffering cardiac related chest pain. The clinical differences may be based on the length of the opioid-administration training program, clinical exposure to morphine administration, work experience and length of qualifications as an ACP or ICP. Our findings suggest that there is a need for structured initial and ongoing continuing education programs in pain management to maintain knowledge and behavior in pain management strategies. Further research is also required into paramedic's behavioral intention regarding morphine administration to also identify what constructs affect their intent to administer morphine.

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Morphine administration by Paramedics: An application of the Theory of Planned Behaviour

Cited by 17 publications

References 19 publications

‘Popping nana back into bed’ - a qualitative exploration of paramedic decision making when caring for older people who have fallen

‘Popping nana back into bed’ - a qualitative exploration of paramedic decision making when caring for older people who have fallen

Psychosocial Theories and Pain Management Practices: A Review of Empirical Research

Knowledge of Morphine Administration by Ambulance Paramedics: A Comparison of Two Clinical Levels of Paramedics

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