Online training improves paramedics’ knowledge of autonomic dysreflexia management guidelines

Abstract

Study Design: Single-group pre-test/post-test with 3- and 6-month follow-ups. Objective: To test the effects of the “ABCs of AD” educational module on immediate and longer-term changes in paramedics’ knowledge and beliefs about using the autonomic dysreflexia (AD) clinical practice guidelines (CPGs). Setting: Canada Methods: 119 paramedics completed an AD knowledge test and measures of attitudes, perceived control, self-efficacy, social pressure from patients and health care professionals, and intentions to use the AD-CPGs before and 1-week, 3-months and 6-months after viewing “ABCs of AD”. Results: There were significant improvements in AD knowledge, attitudes, and social pressure from patients to use the AD-CPGs from baseline to 1-week, 3-months and 6-months post-viewing (all p<0.001). Self-efficacy and intentions increased 1-week post-viewing (p<.001) but returned to baseline levels at 3- and 6-months (p>0.05). There was no change in perceived control or social pressure from health care professionals. AD knowledge and beliefs explained 50-61% of the variance in intentions to use the AD-CPGs. Attitudes, social pressure from patients, and perceived behavioural control were significant unique predictors of intentions at all time-points (p<0.05); AD knowledge was a significant predictor at 6-months only (p=0.048). No other predictors were significant. Conclusions: “ABCs of AD” has immediate and sustained effects on paramedics’ knowledge of, attitudes toward, and perceived pressure from patients to use the AD-CPGs. Updates to paramedic patient care guidelines and standards are needed to increase ABCs OF AD 3 paramedics’ perceived control and self-efficacy to implement the guidelines, and their intentions to use the AD-CPGs.