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Updated: Jun 3, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

Published on: August 1, 2019

The SAFE or SORRY? programme. part II: effect on preventive care.

Betsie G I van Gaal¹, Lisette Schoonhoven, Joke A J Mintjes

¹Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. b.vangaal@iq.umcn.nl

International Journal of Nursing Studies

|March 29, 2011

Summary

The SAFE or SORRY? programme reduced adverse events like pressure ulcers, UTIs, and falls. However, it did not increase preventive care for at-risk patients, highlighting challenges in measuring guideline compliance.

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Last Updated: Jun 3, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

Published on: August 1, 2019

Area of Science:

Healthcare Quality Improvement
Patient Safety
Evidence-Based Practice Implementation

Background:

Patients often face multiple, simultaneous adverse events, necessitating integrated care guidelines.
Current guideline implementation typically addresses single issues, leaving gaps in comprehensive patient care.

Purpose of the Study:

To evaluate the SAFE or SORRY? programme, which targeted three common adverse events: pressure ulcers, urinary tract infections, and falls.
To explore the process of change and its impact on preventive care delivery within a multifaceted implementation strategy.

Main Methods:

A cluster-randomised trial conducted in ten hospital and ten nursing home wards between September 2006 and November 2008.
Monitoring of preventive care for adult patients with an expected stay of at least five days, comparing intervention and usual care groups.
Analysis of data collected on preventive care aligned with guidelines for pressure ulcers, urinary tract infections, and falls.

Main Results:

No significant difference in preventive pressure ulcer measures was observed between intervention and usual care groups in hospitals or nursing homes.
A statistically significant decrease in preventive care for urinary tract infections was noted among at-risk hospital patients.
No increase in preventive care for falls was observed in either hospital or nursing home settings.

Conclusions:

Despite reducing adverse events, the SAFE or SORRY? programme did not demonstrate an increase in preventive care for at-risk patients.
The study highlights significant challenges in measuring compliance with multiple healthcare guidelines.
Further research is required to develop effective process indicators for implementing multiple guidelines.