Reduction in the incidence of pressure ulcers upon implementation of a reminder system for health-care providers.

PURPOSE: To measure the clinical impact of the introduction of a reminder system for healthcare professionals to alert patients who are at risk for pressure ulcers (PU). METHODS: This was a pre- and post-test study of patients who were discharged from 6 medical-surgical units of the University Hospital of Fuenlabrada in 2009 and 2010. Beginning in January 2010, implementation of an on-screen list of reminders was automatically updated daily on the units' computers including patient arrival date, last assessment of ulceration risk and location of any PU. The cumulative incidence of PU was measured for patients discharged in 2009 (group A: healthcare professionals were not exposed to on-screen reminder) and 2010 (group B: healthcare professionals were exposed to on-screen reminder list). The relative risk (RR) was estimated. The study was completed with a stratified analysis and binary logistic regression. RESULTS: In group A, there were 84 cases of PU among 9263 patients discharged (0.9%); whereas in group B, there were 59 cases among 9220 patients discharged (0.6%). The RR of PU for group B/group A was 0.706 (p=0.038). In the logistic regression analysis, after adjusting for study variables, the odds ratio of PU B/A was 0.558. CONCLUSION: A list of on-screen reminders at the beginning of a healthcare professional's shift to inform them of patients at risk for developing a PU was effective at reducing the incidence of these clinical burdens.

[Impact of implementation of reminders to reduce adverse effects in patients with peripheral venous catheterizations]. / Impacto de la implantación de recordatorios para disminuir eventos adversos en pacientes con accesos venosos periféricos.

BACKGROUND: The main purpose of this paper is to measure the clinical impact of the implementation of a reminder system that would warn of patients who are at risk of presenting an adverse event (AE) related to the peripheral venous catheter. METHOD: On the basis of the registers used for monitoring intravenous catheters, an automated consultation was realized that elaborated a list of the patients admitted, including: date of admission, date of the insertion of the venous access device, and type of device. It was implanted in January 2010 and updated three times a day with the computers of the unit. A quasi-experimental study has measured the cumulative incidence of phlebitis, extravasation and obstructions in the patients registered in 2009 and 2010. The association between qualitative variables was evaluated with the Chi-squared test, and relative risk (RR) and Number Needed to Treat (NNT) were estimated. RESULTS: Nine thousand two hundred and sixty-three patients were registered in the studied units in the year 2009, and 9,220 patients in 2010. The results were the following: Patients with phlebitis 2010/2009: RR: 0.827 (p < 0.001). Patients with extravasations 2010/2009: RR: 0.804 (p < 0.001). Patients with obstructions 2010/2009: RR: 0.954 (p < 0.554). CONCLUSION: With the help of a reminder list (which includes the patients with vascular access and the date), there has been a decrease in the number of phlebitis and extravasations but not in the number of obstructions.