Effect of Electronic Alerts on Nurses' Intentions to Perform Medication Education: An Application of the Theory of Planned Behavior

PURPOSE: Inadequate education about medications can increase the risk of medication-related errors. The national average of patients who reported that staff “Always” explained about medicines before giving it to them” was 65% for measurement period from 10/01/2015 to 09/30/2016. A multi-disciplinary team consisting of pharmacists, nurses, and informaticists developed an innovative solution utilizing electronic alerts to facilitate medication education. The authors of this study aim to understand the motivational factors that may influence nurses’ behavioral intentions to perform medication education to patients at the bedside and determine the effect of the electronic alerts on nurses’ intentions to perform medication education. METHODS: This pre-post questionnaire study was conducted at a 907-bed academic medical center. The survey was developed based upon a framework called, the theory of planned behavior, to examine motivational factors that may influence nurses’ intention to perform medication education. The study sample composed of 150 nurses working on the six pre-designated pilot units for medication education alerts. The medication education alerts were built in the form of BestPractice Advisories (BPA) available within the electronic health system. An elicitation study was arranged in focus groups to develop the questionnaire that was given to nurses before and after the implementation of the medication education alerts. Descriptive statistics, logistic and multivariate regression analyses were used to achieve the objectives of this study. RESULTS: 95 questionnaires were collected in the pre-BPA group and 98 questionnaires were collected in the post-BPA group. Attitude and subjective norm were significantly correlated with nurses’ intentions to perform medication education. After the implementation of medication education BPAs, there was a significant increase on the control beliefs and perceived power to perform medication education. CONCLUSION: The theory of planned behavioral was useful in understanding the motivational factors that may influence nurses to perform medication education. Interventions that address key influential factors may be helpful in driving medication education initiatives.