Premium
Effectiveness of supporting intensive care units on implementing the guideline ‘End‐of‐life care in the intensive care unit, nursing care’: a cluster randomized controlled trial
Author(s) -
Noome Marijke,
Dijkstra Boukje M.,
Leeuwen Evert,
Vloet Lilian C.M.
Publication year - 2017
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.13219
Subject(s) - guideline , medicine , nursing , cluster randomised controlled trial , intervention (counseling) , intensive care , intensive care unit , randomized controlled trial , critical care nursing , cluster (spacecraft) , family medicine , health care , intensive care medicine , surgery , pathology , economic growth , computer science , economics , programming language
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.