The SAFE or SORRY? programme. Part II: effect on preventive care
The SAFE or SORRY? programme. Part II: effect on preventive care
Background: patient care guidelines are usually implemented one at a time, yet patients are at risk for multiple, often preventable, adverse events simultaneously.
Objective: the SAFE or SORRY? programme targeted three adverse events (pressure ulcers, urinary tract infections and falls) and was successful in reducing the incidence of these events. This article explores the process of change and describes the effect on the preventive care given.
Design: separate data on preventive care were collected along the cluster randomised trial, which was conducted between September 2006 and November 2008.
Settings: ten hospital wards and ten nursing home wards.
Participants: we monitored nursing care given to adult patients with an expected length of stay of at least five days.
Methods: the SAFE or SORRY? programme consisted of the essential recommendations of guidelines for pressure ulcers, urinary tract infections and falls. A multifaceted implementation strategy was used to implement this multiple guidelines programme. Data on preventive care given to patients were collected in line with these guidelines and the difference between the intervention and the usual care group at follow-up was analysed.
Results: the study showed no overall difference in preventive pressure ulcer measures between the intervention and the usual care group in hospitals (estimate = 6%, CI: ?7–19) and nursing homes (estimate = 4%, CI: ?5–13). For urinary tract infections, even statistically significantly fewer hospital patients at risk received preventive care (estimate = 19%, CI: 17–21). For falls in hospitals and nursing homes, no more patients at risk received preventive care.
Conclusion: though the SAFE OR SORRY? programme effectively reduced the number of adverse events, an increase in preventive care given to patients at risk was not demonstrated. These results seem to emphasise the difficulties in measuring the compliance to guidelines. More research is needed to explore the possibilities for measuring the implementation of multiple guidelines using process indicators
1049-1057
Van Gaal, Betsie G.I.
1638dc4b-976d-4351-a790-efd1e7809965
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Mintjes, Joke A.J.
f6eee935-6903-4245-9e47-69afdc5864a0
Borm, George F.
ba8fb1f5-c7d1-4131-a8c6-c89254f5efc8
Koopmans, Raymond T.C.M.
3df55d8d-a5cb-4353-80ff-87fdfbba5ab5
van Achterberg, Theo
eb49404e-62c6-427d-bb94-580254177a30
September 2011
Van Gaal, Betsie G.I.
1638dc4b-976d-4351-a790-efd1e7809965
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Mintjes, Joke A.J.
f6eee935-6903-4245-9e47-69afdc5864a0
Borm, George F.
ba8fb1f5-c7d1-4131-a8c6-c89254f5efc8
Koopmans, Raymond T.C.M.
3df55d8d-a5cb-4353-80ff-87fdfbba5ab5
van Achterberg, Theo
eb49404e-62c6-427d-bb94-580254177a30
Van Gaal, Betsie G.I., Schoonhoven, Lisette, Mintjes, Joke A.J., Borm, George F., Koopmans, Raymond T.C.M. and van Achterberg, Theo
(2011)
The SAFE or SORRY? programme. Part II: effect on preventive care.
International Journal of Nursing Studies, 48 (9), .
(doi:10.1016/j.ijnurstu.2011.02.018).
(PMID:21440891)
Abstract
Background: patient care guidelines are usually implemented one at a time, yet patients are at risk for multiple, often preventable, adverse events simultaneously.
Objective: the SAFE or SORRY? programme targeted three adverse events (pressure ulcers, urinary tract infections and falls) and was successful in reducing the incidence of these events. This article explores the process of change and describes the effect on the preventive care given.
Design: separate data on preventive care were collected along the cluster randomised trial, which was conducted between September 2006 and November 2008.
Settings: ten hospital wards and ten nursing home wards.
Participants: we monitored nursing care given to adult patients with an expected length of stay of at least five days.
Methods: the SAFE or SORRY? programme consisted of the essential recommendations of guidelines for pressure ulcers, urinary tract infections and falls. A multifaceted implementation strategy was used to implement this multiple guidelines programme. Data on preventive care given to patients were collected in line with these guidelines and the difference between the intervention and the usual care group at follow-up was analysed.
Results: the study showed no overall difference in preventive pressure ulcer measures between the intervention and the usual care group in hospitals (estimate = 6%, CI: ?7–19) and nursing homes (estimate = 4%, CI: ?5–13). For urinary tract infections, even statistically significantly fewer hospital patients at risk received preventive care (estimate = 19%, CI: 17–21). For falls in hospitals and nursing homes, no more patients at risk received preventive care.
Conclusion: though the SAFE OR SORRY? programme effectively reduced the number of adverse events, an increase in preventive care given to patients at risk was not demonstrated. These results seem to emphasise the difficulties in measuring the compliance to guidelines. More research is needed to explore the possibilities for measuring the implementation of multiple guidelines using process indicators
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e-pub ahead of print date: 26 March 2011
Published date: September 2011
Organisations:
Faculty of Health Sciences
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Local EPrints ID: 339203
URI: http://eprints.soton.ac.uk/id/eprint/339203
ISSN: 0020-7489
PURE UUID: 9b73e20e-d508-489d-843d-52f6c10c094a
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Date deposited: 25 May 2012 08:41
Last modified: 15 Mar 2024 03:41
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Contributors
Author:
Betsie G.I. Van Gaal
Author:
Joke A.J. Mintjes
Author:
George F. Borm
Author:
Raymond T.C.M. Koopmans
Author:
Theo van Achterberg
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