Marjon Borgert

162 Chapter 7 interaction was not found, the model was examined for confounding. Confounding was de ned as ≥ 10% change in the coe cient of the central determinant (transfusion bundle compliance) as a consequence of adding a covariate. Because each nurse can be responsible for the performance of one or more transfusions for the same or di erent patients we accounted for dependence of transfusion bundle compliance data within nurses by including the nurses as a random e ect in the model. Statistical signi cance is considered to be at P < 0.05. When appropriate statistical uncertainty will be expressed by the 95% con dence levels. All data were entered into a Microsoft Access database. Analyses were performed using R (version: 3.1.3; R Foundation for Statistical Computing, Vienna, Austria). We used Stata software (version 14) for the multilevel logistic regression analysis. Ethical considerations The study was approved by the Medical Ethics Committee of the Academic Medical Center of Amsterdam, the Netherlands and the need for informed consent was waived. RESULTS Nurses demographics In total, 120 of the 125 nurses participated in this study, 59 in Team A and 61 in Team B. Five nurses were excluded. There were no signi cant di erences in age between the nursing teams, neither in gender or years of work experience (Table 1). In team A, 61% (36/59) of the nurses followed the web-based educational program, compared to 100% (61/61) in Team B (di erence 39% (95% CI: -51 to -27, P < 0.001). Individual A&F In Team B, feedback was given in 32% (40/124) via face-to-face contact. In 68% (84/124), a personal feedback report was sent by email. Emails were sent when face-to-face contact was not possible due to the following reasons: change of shifts in 35% (29/84), too busy in 2% (2/84), days o /holiday in 63% (53/84). Patient demographics During the implementation period 101 patients received at least one unit of RBCs and 116 post-implementation. Table 2 shows that the cohorts were similar in both groups with respect to age, gender, severity of illness (Apache IV), ICU LOS and ICU mortality.