Reminder implementation for safety in child care - a cluster randomized controlled trial in paediatric care
The overall objective of this project is to evaluate the effects of implementing a clinical practice guideline for peripheral venous catheters in the format of reminders, integrated in the electronic patient record. Specifically we hypothesise:
1. That a cluster randomized intervention using electronic reminders in peadiatric care will reduce complications related to peripheral venous catheters in hospitalised children
2. That the electronic reminders will improve registered nurses adherence to the clinical guidelines for peripheral venous catheters.
In addition, the study aims to describe the relationship between registered nurses perceptions of work context and the outcomes of the intervention.
Regional Ethics Review Board in Uppsala, Sweden, 06/04/2009 and 01/12/2010, refs: 2008/107 and 2008/360
A single centre cluster randomized controlled study
Primary study design
Secondary study design
Cluster randomised trial
Patient information sheet
Not available in web format, please use contact details to request a participant information sheet
The study focus is on complications related to pheripheral venous catheters that are used for adminstration of medications and fluids in patients.
1. Intervention arm: Reminders based on recommendations from clinical practice guidelines for peripheral venous catheters, integrated in the electronic patient record.
2. Control arm: Clinical practice guidelines available on the Intranet, following normal procedure for dissemination of guidelines.
Primary outcome measures
Recorded occurrence of peripheral venous catheter-related complications at removal.
Secondary outcome measures
Registered nurses self-reported adherence to the clinical practice guideline recommendations for managing peripheral venous catheters.
Overall trial start date
Overall trial end date
Participant inclusion criteria
12 paediatric hospital wards, including neonatal and paediatric patients, with the same electronic patient record system.
1. Hospitalised Children, age 0 - 18 years, with peripheral venous catheters:
1.1. Inserted and documented in a template for peripheral venous catheters at baseline and after the intervention.
1.2. Only one peripheral venous catheter per patient was included.
Registered nurses at the 12 peadiatric wards:
1.3. Who had worked at one of the 12 wards at the time for data-collection.
Target number of participants
The sample included 12 wards at a peadiatric hospital. A sample size of 1213 peripheral venous catheters (patients), about 100 per unit, was calculated, that is 2426 peripheral venous catheters per cluster, both at baseline and at follow-up.
Participant exclusion criteria
Peripheral venous catheters were excluded that:
1. Lacked complete recording of reasons for removal.
Registered nurses were excluded who during the data-collection periods:
1. Had only adminstrative duties
2. Were on parental leave
3. Sick leave,
4. Doing full time studies
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Astrid Lindgrens Children's Hospital, Karolinska University Hospital
Health Care Sciences Postgraduate School, Karolinska Institutet
Funding Body Type
Funding Body Subtype
Dalarna University, DU
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
The intention is to submit the paper to Implementation Science for publication. The paper will include the results on the effects of implementing a clinical practice guideline for peripheral venous catheters in the format of reminders integrated in the electronic patient record, on complications related to peripheral venous catheters in hospitalised children, and registered nurses adherence to the guidelines. The submission is planned during 2015.
Intention to publish date
Participant level data
Not expected to be available
Results - basic reporting