(293) Nurses’ intention to report adverse drug events, a survey using the theory of planned behavior.

Background: Adverse drug events (ADEs) are one of the major causes of death in the world. Nurses have a considerable role in improving drug safety by reporting ADEs to national pharmacovigilance centers. However, underreporting is a major problem.

Objectives: The aim of this study is to assess the utility of theory of planned behavior (TPB) model in predicting nurses’ intention to report ADEs to Iranian Pharmacovigilance Center.

Methods: We collected data on different constructs of the TPB model, including attitude, subjective norms and perceived behavioral control, by surveying nurses working at Tehran hospitals. A questionnaire was constructed based on focus group discussions. The nurses’ demographic data, as well as their knowledge of reporting ADEs, were collected in the same questionnaire. The analysis was performed using structural equation modeling.

Results: A total number of 961 questionnaires were analyzed. Nurses indicated that reporting ADEs was beneficial (mean = 4.88 ± 0.44), pleasant (mean = 4.72 ± 0.694) and good (mean = 4.85 ± 0.52). Generally, nurses had a highly favorable attitude toward reporting ADEs based on direct measurement (mean = 4.82 ± 0.08). Nurses believed that most people who were important to them thought that they should report ADEs (mean = 4.27 ± 0.99) and it was expected of them to report ADEs (mean = 4.45 ± 0.91). They also indicated that most people who were important to them asked them to report ADEs (mean = 3.94 ± 1.16). The subjective norms scores had a mean of 12.56 (SD = 2.68, possible range: +3 to +15) and ranged from 3 to 15. Overall, nurses had a strong and positive subjective norms (mean = 4.22 ± 0.26). In addition, an assessment of nurses’ self-efficacy revealed that most respondents (71%) were highly confident that they could report ADEs if they wanted to report them (mean = 4.27 ± 0.99). Also, the majority of nurses (63.4%) stated that reporting ADEs was easy (mean = 3.57 ± 1.51). Evaluation of nurses’ beliefs about the controllability of reporting ADEs indicated that the decision to report ADEs for most nurses was beyond their control (mean = 3.61 ± 1.23). Overall, nurses had a moderately high and positive perceived behavioral control (mean = 3.97 ± 0.5). Based on structured equation analysis, attitude (r = 0.14, p = .005), subjective norms (r = 0.15, p = .005) and perceived behavioral control (r = -0.12, p = .004) significantly predicted nurses’ intention.

Conclusions: The TPB seems a useful model to predict the ADE reporting behavior of nurses. Interventions for improving ADE reporting among nurses could be well designed by targeting TPB constructs such as attitude, subjective norms toward and perceived behavioral control over ADE reporting.