Date of Award

2013

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

College of Graduate Studies

First Advisor

Teresa J. Kelechi

Second Advisor

Brian T. Conner

Third Advisor

Martina Mueller

Fourth Advisor

Lynne S. Nemeth

Fifth Advisor

Rose O. Sherman

Abstract

Emergency departments are a major source of hospital admissions with patients at risk for pressure ulcer development. Yet, there is a paucity of literature in two key areas: emergency RNs' role in PU prevention and their knowledge, skills, attitudes and intentions toward implementation of PU prevention guidelines. Manuscript 1 was an integrative review that found multiple factors--knowledge, attitudes, and environmental--that affect nurses' use of PU prevention. Manuscript 2 was an integrative review that found the readiness for change construct as a precursor to implementing an organizational or individual change. Some nurse researchers suggest a readiness assessment as the first step in the evidence-based practice implementation process. However, research is needed to develop a valid and reliable instrument to measure nurses' readiness for change. Manuscript 3 was a cross-sectional study that found factors from the readiness for change framework and Theory of Planned Behavior significantly influenced emergency RNs’ intention to implement pressure ulcer prevention guidelines. Readiness variables of appropriateness and personal valence combined with TPB variables of subjective norm and perceived behavioral control to affect significantly the emergency RNs' intention to implement PU prevention guidelines. In conclusion, this study demonstrated the usefulness of combining the Theory of Planned Behavior and readiness for change construct in order to assess individual intention and readiness for change.

Rights

All rights reserved. Copyright is held by the author.

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