Trial reportImplementation science : IS2016
Effects of computer reminders on complications of peripheral venous catheters and nurses' adherence to a guideline in paediatric care--a cluster randomised study.
Trial report in Implementation science : IS, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 5 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Reported use of implementation science theories, models, and frameworks in 151 implementation trials: secondary analysis of a systematic review targeting nursing practice.Translational behavioral medicine · 2025Pooled it
- Extrinsic and intrinsic factors acting as barriers or facilitators in nurses' implementation of clinical practice guidelines: a mixed-method systematic review.Acta bio-medica : Atenei Parmensis · 2022Pooled it
- Pooled it
- Defining and assessing context in healthcare implementation studies: a systematic review.BMC health services research · 2020Pooled it
- Patient-mediated interventions to improve professional practice.The Cochrane database of systematic reviews · 2018Pooled it
- Results of the CHlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections Study (CHanGing BathS): a stepped wedge cluster randomized trial.Implementation science : IS · 2021Trial
- Implementation science promotes clinical practice of guidelines: a scoping review.BMC health services research · 2025Article
- Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review.Journal of medical Internet research · 2023Article
- Examining clinician choice to follow-up (or not) on automated notifications of medication non-adherence by clinical decision support systems.BMC medical informatics and decision making · 2023Article
- Implementation of clinical practice changes in the PICU: a qualitative study using and refining the iPARIHS framework.Implementation science : IS · 2021Article
- The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature.Implementation science : IS · 2020Review
- Hospital organizational context and delivery of evidence-based stroke care: a cross-sectional study.Implementation science : IS · 2019Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReminder systems in electronic patient records (EPR) have proven to affect both health care professionals' behaviour and patient outcomes. The aim of this cluster randomised trial was to investigate the effects of implementing a clinical practice guideline (CPG) for peripheral venous catheters (PVCs) in paediatric care in the format of reminders integrated in the EPRs, on PVC-related complications, and on registered nurses' (RNs') self-reported adherence to the guideline. An additional aim was to study the relationship between contextual factors and the outcomes of the intervention.
methodsThe study involved 12 inpatient units at a paediatric university hospital. The reminders included choice of PVC, hygiene, maintenance, and daily inspection of PVC site. Primary outcome was documented signs and symptoms of PVC-related complications at removal, retrieved from the EPR. Secondary outcome was RNs' adherence to a PVC guideline, collected through a questionnaire that also included RNs' perceived work context, as measured by the Alberta Context Tool. Units were allocated into two strata, based on occurrence of PVCs. A blinded simple draw of lots from each stratum randomised six units to the control and intervention groups, respectively. Units were not blinded. The intervention group included 626 PVCs at baseline and 618 post-intervention and the control group 724 PVCs at baseline and 674 post-intervention. RNs included at baseline were 212 (65.4 %) and 208 (71.5 %) post-intervention.
resultsNo significant effect was found for the computer reminders on PVC-related complications nor on RNs' adherence to the guideline recommendations. The complication rate at baseline and post-intervention was 40.6 % (95 % confidence interval (CI) 36.7-44.5) and 41.9 % (95 % CI 38.0-45.8), for the intervention group and 40.3 % (95 % CI 36.8-44.0) and 46.9 % (95 % CI 43.1-50.7) for the control. In general, RNs' self-rated work context varied from moderately low to moderately high, indicating that conditions for a successful implementation to occur were less optimal.
conclusionsThe reminders might have benefitted from being accompanied by a tailored intervention that targeted specific barriers, such as the low frequency of recorded reasons for removal, the low adherence to daily inspection of PVC sites, and the lack of regular feedback to the RNs.
trial registrationCurrent Controlled Trials ISRCTN44819426.
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