Application Of The Transtheoretical Model Of Behavior To The Nurse Training Of Standard Precautions Behavior In Emergency Department

Objective: In our study,according to the Transtheoretical Model of behavior theory nurse’s behavior is divided into different stage.Investigate the distribution stage of standard precautions behavior and factors which influence the compliance of standard precautions behavior in emergency department nurses.Different training was applied according to Transtheoretical Model of behavior theory.Effect of TTM intervention on standard precautions behavior establishment and maintain in emergency department nurses was explored in the study.Methods:1 Study population1.1 48 nurses who worked in emergency department in Hebei province x hospital in June 2016 were enrolled,including 19 male and 29 female.The age of study population from 21 to 39.1.2 23 emergency department nurses in the stage of action and maintaining were selected as intervention object from June 2016 to January 2017,including 12 male and 11 female.The age of study population from 21 to 39.2 The research methods: quasi-experimental study2.1 Baseline surveyGeneral information,compliance of standard precautions behavior,influencing factors and stage of standard precautions behavior were collected from 48 emergency department nurses in June 2016.Distribution stage of standard precautions behavior and influencing factors were analysis according the survey.2.2 Intervention studyAccording to the results of the baseline survey,self controlled methodwas applied.23 nurses were selected as the study object who is in the stage of action and maintenance.Different training was applied according to Transtheoretical Model of behavior theory.The compliance of standard precautions,self-efficacy,hand disinfection after bacterial culture,the comparison of observed frequency standard precautions measures were observed before and four months intervention.The value of Transtheoretical Model of behavior theory guided turning in standard precautions behavior establishment was evaluated.By this mean to help the emergency nurses increase self-efficacy and establish a good effect of standard precautions behavior.3 Statistical processingAll data were input by Epidata3.1 and analyzed by SPSS21.0 Statistical Software Package.After the measurement data was normalized,the results of the normal distribution were expressed as mean ± standard deviation,that is,x ± s,paired t test;Does not meet the normal distribution with the result of the median(P25,P75),paired rank and inspection of the Mann-Whitney Z test method;The level data using rank and inspection;All inspection method adopts double side,inspection level α= 0.05.Results:1 The stage of standard precautions behavior stage in emergency department nurses of Hebei province X hospital as followed,8.3% of nurses in the stage of contemplation,39.6% of nurses in the preparation stage,27.1% of nurses in the action stage,25.0% of nurses in the maintenance stage.2 The main factors that influence the standard precautions behavior compliance as follows: first and foremost is that the job is so busy that emergency nurses do not have enough time.The second is the use of protective equipment affect the accuracy of my operation.The third is the required protective equipment is not easy to obtain.3 Status of standard precautions behavior stage before and after intervention.Before the intervention 10(43.5%)subjects at the stage of action and 13(56.6%)object of study at the stage of maintain.After the intervention22(95.6%)object reach the standard precautions maintenance stage,only 1(4.4%)object still at the stage of action stage.4 The standard precautions behavior compliance total score was much higher after intervention with statistically significant(P < 0.05).The general self-efficacy scale scores was much higher after intervention with statistically significant(P<0.05).The colony number of after wash hands was significantly reduced(P < 0.05).5 In the study population,hand washing,hand disinfection,wearing masks,gloves and wear gowns become more frequently after intervention with statistically significant(P<0.05).Times of wear goggles did not change before and after the intervention with no statistical difference(P > 0.05).Conclusion:1 The phenomenon of distribution stage of standard precautions behavior in emergency department nurses showed that the majority(39.6%)in the preparation stage need to be further improved.2 The compliance of standard precautions behavior main influencing factors as follows:(1)the job is busy,emergencies don’t have the time;(2)the use of protective equipment affect the accuracy of my operation;(3)the required protective equipment is not easy to obtain.3 Guided by the Transtheoretical Model of Behavior training intervention can promote the research object of standard precautions behavior along the rule of behavior change.4 Guided by the Transtheoretical Model of Behavior training intervention can improve the general self-efficacy of emergency nurses,raise the standard precautions behavior compliance of the object of study,help them establish rules of good standard precautions behavior,thus reducing the nurses’ occupational exposure and occupational infection.