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Table 5 Selected clinical outcomes at pre and post guideline implementation ‡

From: Insights about the process and impact of implementing nursing guidelines on delivery of care in hospitals and community settings

Guideline

Selected process of care indicators and patient outcomes

Pre %

Post %

p-value

Changes† Source of Data

Asthma

N = 80 Pre

N = 48 Post

Assessment of patient use of β2 agonist

52.5

72.9

0.026

+ chart

 

Individual action plan for client discharge

3.8

23.9

0.001

+ chart

 

Teaching information provided

3.8

27.1

0.000

+ chart

Breastfeeding

Breast-feeding in hospital N = 75 Pre; N = 76 Post

   

- Interview in hospital

 

   Exclusive

80.0

67.1

  
 

   Mixed

20.0

22.4

0.012

 
 

   Formula only

0.0

10.5

  
 

Infant supplementation given N = 103 Pre; N = 89 Post

24.3

34.8

0.115

ns chart

Delirium, Dementia and Depression

N = 196 Pre

N = 186 Post

Assessment on admission for memory problems

66.3

76.9

0.024

+ chart

 

Assessment on admission for mood (i.e. depression)

29.6

45.0

0.003

+ chart

 

Assessment during stay for memory problems

62.4

72.7

0.037

+ chart

Diabetes Foot Care

N = 97 Pre

N = 119 Post

Assessment for risk factors for foot ulceration/amputation

16.5

60.7

0.000

+ chart

 

Monofilament used to assess sensation in the feet

   

+ chart

 

   Yes

0.0

57.1

0.000

 
 

   No

75.8

5.9

  
 

   No note

24.2

37.0

  

Smoking Cessation

Received advice on stopping smoking or staying quit N = 116 Pre; N = 93 Post

1.7

17.4

0.000

+ chart

 

Self-help information given N = 116 Pre; N = 93 Post

1.7

28.0

0.000

+ chart

 

Have you tried to quit smoking in the past 2 months? N = 36 Pre; N = 21 Post

66.7

33.3

0.026

- Telephone call at home

Venous Leg Ulcers

N = 87 Pre

N = 52 Post

Assessed for clinical history and features associated with venous disease

58.6

96.2

0.000

+ Chart

 

Doppler measurement of Ankle Brachial Pressure Index (ABPI)

3.7

45.7

0.000

+ Chart

  1. † According to recommendation + indicates improvement with p < 0.05, – indicates worse care with p < 0.05, ns indicates no significant difference in care
  2. Selection illustrates nursing care and patient outcomes from chart audit data as well as the only two statistically significant negative changes (-).