Research Article

Applying Theory to Understand and Modify Nurse Intention to Adhere to Recommendations regarding the Use of Filter Needles: An Intervention Mapping Approach

Table 1

Details of the simulation strategy.

Step (theoretical construct targeted)DetailsParameters (examples)

(1) Presentation of scientific evidence (knowledge)Present scientific evidence on the negative effects of glass ampoules for patients, information on research, and recommendations about the use of filter needles.For modeling [28]: attention, remembrance, self-efficacy and skills, reinforcement of model, and identification with model.
(2) Preparing medication from a glass ampoule (perceived behavioral control)Two nurses prepare medication contained in a glass ampoule (e.g., furosemide or narcotic). One uses a filter needle; the other uses a standard needle.    
(3) Positive feedback (reinforcement)Do positive feedback during the simulation (ability of nurses to manipulate the equipment and to prepare medication).For reinforcement [28]: reinforced by significant other.
(4) Pointing out ease of use (perceived behavioral control)Point out the ease of use of filter needles.    
(5) Mental imagery of glass particles (attitude)Lead nurses through imagining glass particles (with pictures) injected in the patient and the microorganisms that become lodged in the capillaries, blocking them.    
(6) Comparing time between filter and standard needles (perceived behavioral control)When the medication is prepared, do a comparison between the time taken to prepare the medication with the filter needle and the standard needle.For persuasion [29]: repeated connections between behavior and positive feelings.
(7) Verbalization of the situationAllow time for verbalization of the situation for the nurses who prepared the medication.    
(8) Inversing the roles (perceived behavioral control)Do the simulation again by inversing the roles of the two nurses.    
(9) Feedback and evaluation (perceived behavioral control)Following the simulation, evaluate the potential barriers to the use of filter needles on the unit. Find solutions, if possible. Offer follow-up if there is an impasse or obstacle that was not resolved.    
(10) Verbalization of the interventionAllow time for a verbalization of the overall experience with the intervention.