Marijke Noome1,2, Boukje M Dijkstra1,3, Evert van Leeuwen4, Lilian C M Vloet1,4. 1. Research Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, the Netherlands. 2. The Hague University of Applied Sciences, the Netherlands. 3. Intensive Care Unit, Radboud University Medical Centre Nijmegen, the Netherlands. 4. Scientific Institute for Quality of Healthcare, Radboud University Medical Centre Nijmegen, the Netherlands.
Abstract
AIM: The aim of this study was to examine the effectiveness of supporting intensive care units on implementing the guidelines. BACKGROUND: Quality of care can be achieved through evidence-based practice. Guidelines can facilitate evidence-based practice, such as the guidelines 'End-of-life care in the intensive care unit, nursing care'. Before intensive care nurses are able to use these guidelines, they needs to be implemented in clinical practice. Implementation is a complex process and may need support. DESIGN: Cluster randomized controlled trial. METHODS:Intensive care nurses of eight intensive care units in the intervention group followed a supportive programme that educated them on implementation, strategies, goals, project management and leadership. The intervention group focused on a stepwise approach to implement the guidelines. The control group (n = 5) implemented the guidelines independently or used the standard implementation plan supplementary to the guideline. The effectiveness of the programme was measured using questionnaires for nurses, interviews with nurses and a questionnaire for family of deceased patients, in the period from December 2014-December 2015. RESULTS: Overall, an increase in adherence to the guidelines was found in both groups. Overall, use of the guidelines in the intervention group was higher, but on some aspects the control group showed a higher score. Care for the patient and the overall nursing care scored significantly higher according to family in the intervention group. CONCLUSION: The increase in adherence to the guidelines and the significantly higher satisfaction of family in the intervention group indicate that the supportive programme had a more positive effect.
RCT Entities:
AIM: The aim of this study was to examine the effectiveness of supporting intensive care units on implementing the guidelines. BACKGROUND: Quality of care can be achieved through evidence-based practice. Guidelines can facilitate evidence-based practice, such as the guidelines 'End-of-life care in the intensive care unit, nursing care'. Before intensive care nurses are able to use these guidelines, they needs to be implemented in clinical practice. Implementation is a complex process and may need support. DESIGN: Cluster randomized controlled trial. METHODS: Intensive care nurses of eight intensive care units in the intervention group followed a supportive programme that educated them on implementation, strategies, goals, project management and leadership. The intervention group focused on a stepwise approach to implement the guidelines. The control group (n = 5) implemented the guidelines independently or used the standard implementation plan supplementary to the guideline. The effectiveness of the programme was measured using questionnaires for nurses, interviews with nurses and a questionnaire for family of deceased patients, in the period from December 2014-December 2015. RESULTS: Overall, an increase in adherence to the guidelines was found in both groups. Overall, use of the guidelines in the intervention group was higher, but on some aspects the control group showed a higher score. Care for the patient and the overall nursing care scored significantly higher according to family in the intervention group. CONCLUSION: The increase in adherence to the guidelines and the significantly higher satisfaction of family in the intervention group indicate that the supportive programme had a more positive effect.
Authors: Christine E Cassidy; Margaret B Harrison; Christina Godfrey; Vera Nincic; Paul A Khan; Patricia Oakley; Amanda Ross-White; Hilary Grantmyre; Ian D Graham Journal: Implement Sci Date: 2021-12-04 Impact factor: 7.327
Authors: Margo M C van Mol; Sebastian Wagener; Jos M Latour; Paul A Boelen; Peter E Spronk; Corstiaan A den Uil; Judith A C Rietjens Journal: BMC Palliat Care Date: 2020-08-18 Impact factor: 3.234