Determinants of intention to deviate from clinical practice guidelines.

The volitional nature of procedural violations in work systems creates a challenge for human factors research and practice. In order to understand how violations are caused and what can be done to mitigate them, there is a need to determine the influence of workers' beliefs about rules and guidelines. This study demonstrates the use of a social psychological approach to investigate the beliefs of anaesthetists about clinical practice guidelines. A survey was completed by 629 consultant anaesthetists, who rated their beliefs about deviation from three guidelines (performing pre-operative visits; checking anaesthetic equipment; handling intravenous fluid bags). Regression analysis indicated that the belief ratings predicted self-rated intention to deviate from the guidelines. Implications for understanding anaesthetists' adherence to guidelines are discussed. STATEMENT OF RELEVANCE: This study builds upon previous work by the authors, presenting a more detailed insight into potential causes of procedural violations in healthcare. The study also demonstrates the use of a social psychological method to the investigation of violations. Hence, it is of interest to researchers and practitioners interested in human reliability, especially in healthcare.