Is pediatric peripheral intravenous catheter care improved with computer reminders

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Abstract:

BACKGROUND: Clinical practical guidelines (CPGs) may enhance evidence-based practice, but require implementation. Computer reminders have previously shown various effects in supporting implementation; in a concomitant study, we found no effect on complications in peripheral venous catheters (PVCs) or registered nurses’ (RNs) adherence to a CPG in pediatric care. Yet, there is a need to determine how reminders operate in particular contexts.

AIM: To depict if, in what context, and how computer reminders regarding evidence-based management of PVC in pediatric care are applied according to RNs’ actions and experience.

METHODS: Qualitative data from nonparticipant observations and interviews with 18 RNs in four intervention units at a pediatric hospital were analyzed with content analysis.

FINDINGS: Attention given to the computer reminders varied; the RNs noticed them in units where there was an agreement about the management and recording of PVCs, but not elsewhere. Rather, computer reminders did not facilitate adherence to the PVC-CPG where the CPG was not acknowledged from the start. RNs who knew how to manage PVCs had peer support and received additional reminders, which suggested that the computer reminders added to the significance of PVCs in pediatric care.

LINKING EVIDENCE TO ACTION: While the computer reminders alone did not support CPG implementation, they further increased the attention to PVCs in contexts where there was a readiness to change along with a supportive culture. We suggest further studies tailoring implementation strategies to include electronic means if there is a beneficial context.

Reference:

Eldh, A.C., Tollne, A., Förberg, U. and Wallin, L. (2016) What Registered Nurses Do and Do Not in the Management of Pediatric Peripheral Venous Catheters and Guidelines: Unpacking the Outcomes of Computer Reminders. Worldviews on Evidence-Based Nursing. January 20th. [Epub ahead of print].

doi: 10.1111/wvn.12130.

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