Trauma Patient Transitional Work: A Multidisciplinary Feasibility Survey of Planned Behavior Elements.

Abstract

Background: Patient transitions in critical care require coordination across provider roles and rely on the quality of providers' actions to ensure safety. Studying the behavior of providers who transition patients in critical care may guide future interventions that ultimately improve patient safety in this setting.

Objective: To establish the feasibility of using the Theory of Planned Behavior in a trauma environment and to describe provider behavior elements during trauma patient transfers (de-escalations) to non-critical care units.

Methods: This cross-sectional study surveyed a convenience sample of 103 multidisciplinary providers who do the cognitive and physical work of transitioning trauma patients from critical care to another non-critical care unit at a U.S. Level I trauma center. Descriptive methods for survey development, analysis, and administration were evaluated.

Results: A total of 72 respondents completed the survey; they included registered nurses, nurse practitioners, and medical doctors, demonstrating a 70% response rate. Statistically significant differences among ICU roles were observed in perceived control (Eta-squared = 0.09, p = .001) and in several anchors in the attitude, subjective norms, and behavioral intent theoretical domains (Cohen's d ranging from 0.36 to 2.03, p < .05).

Conclusions: This study demonstrated variability in theory domains, signaling an opportunity to study a representative sample. It can serve as a blueprint for future behavioral studies designed to examine the Theory of Planned Behavior elements in trauma critical care providers.