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Just-in-time evidence-based e-mail " reminders " in home health care : impact on nurse practices . OBJECTIVE To test the effectiveness of two interventions designed to improve the adoption of evidence-based practices by home health nurses caring for heart failure ( HF ) patients . DATA SOURCES/STUDY SETTING Information on nurse practices was abstracted from the clinical records of patients admitted between June 2000 and November 2001 to the care of 354 study nurses at a large , urban , nonprofit home care agency . STUDY DESIGN The study employed a randomized design with nurses assigned to usual care or one of two intervention groups upon identification of an eligible patient . The basic intervention was a one-time e-mail reminder highlighting six HF-specific clinical recommendations . The augmented intervention consisted of the initial e-mail reminder supplemented by provider prompts , patient education material , and clinical nurse specialist outreach . DATA COLLECTION At each home health visit provided by a study nurse to an eligible HF patient during the 45-day follow-up period , a structured chart abstraction tool was used to collect information on whether the nurse provided the care practices highlighted in the e-mail reminder . PRINCIPAL FINDINGS Both the basic and the augmented interventions greatly increased the practice of evidence-based care , according to patient records , in the areas of patient assessment and instructions about HF disease management . While not all results were statistically significant at conventional levels , intervention effects were positive in virtually all cases and effect magnitudes frequently were large . CONCLUSIONS The results of this randomized trial strongly support the efficacy of just-in-time evidence-based reminders as a means of changing clinical practice among home health nurses who are geographically dispersed and spend much of their time in the field .
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Intervention_Educational
one-time e-mail reminder highlighting six HF-specific clinical recommendations
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Intervention_Educational
initial e-mail reminder supplemented by provider prompts , patient education material , and clinical nurse specialist outreach
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Outcome_Other
practice of evidence-based care
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Outcome_Other
intervention effects
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Outcome_Other
effect magnitudes frequently
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Outcome_Other
efficacy
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Outcome_Other
just-in-time evidence-based reminders
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Participant_Condition
impact on nurse practices .
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Participant_Condition
home health nurses