Promoting evidence-based childhood fever management through a peer education programme based on the theory of planned behaviour

Helen Edwards, Anne Walsh, Mary Courtney, Sarah Monaghan, Jenny Wilson, Jeanine Young
Journal of Clinical Nursing 2007, 16 (10): 1966-79

AIMS AND OBJECTIVES: This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management.

BACKGROUND: Paediatric nurses' inconsistent, ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests. Determinants of antipyretic administration, identified by the theory of planned behaviour, were belief-based attitudes and subjective norms.

DESIGN: A quasi-experiment explored group effects of a peer education programme, based on the theory of planned behaviour, on factors influencing paediatric nurses' antipyretic administration. Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months postpeer education programme.

METHODS: All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited. The peer education programme consisted of four one-hour sessions targeting evidence-based knowledge, myths and misconceptions, normative, attitudinal and control influences over and rehearsal of evidence-based fever management. All nurses in experimental hospital targeted wards were eligible to attend. Peer education and support facilitated session information reaching those unable to attend sessions.

RESULTS: Two-way univariate anovas explored between subject, experimental and control group and within subject factors, pre, post and latency data. Significant interactions in normative influence (p = 0.01) and intentions (p = 0.01), a significant main group effect in control influence (p = 0.01) and a significant main effect between audit data across time points (p = 0.03) highlight peer education programme effectiveness in behaviour change. Normative, control and intention changes postpeer education programme were maintained in latency data; mean temperature was not.

CONCLUSION: The peer education programme, based on a behaviour change theory, initiated and maintained evidence-based intentions for antipyretics use in fever management.

RELEVANCE TO CLINICAL PRACTICE: The promotion of evidence-based change in organizational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes.

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