Patient Safety and Continuity with an Evidence-Based Decision Support Tool for Nursing Practice and Documentation Case Study

The Norwegian health legislation, in collaboration with the health and quality reform of 2000/2001, imposed heightened requirements for the coordination and quality assurance of health services. At the same time, the health authorities in Norway initiated requirements for increased use of information and communication technology to streamline, coordinate and improve communication between the various organisations and institutions. VAR Healthcare was developed to support the requirements of these new initiatives.

The name VAR has its origin from the old Norse “vǫr,” which, among other things, means “take care of, watch over, guard, be aware of.” In old Norse mythology, Var is a goddess related to wisdom. She is so wise that no secret can be hidden from her. This meaning fits well the intention with our evidence-based tool: to contribute to wise and visible nurses who practice quality, efficient and safe patient care.

VAR Healthcare started as a public research and development project within the Norwegian Industrial and Regional Development Fund (now called Innovation Norway) in 2001. The project involved various hospitals, nursing home and education institutions. The Norwegian Nurses Organisation assumed ownership of the project in 2002 to ensure the further development and practical implementation of VAR, as well as to process the results of the project. Cappelen Damm AS purchased VAR Healthcare in the spring of 2012 as a separate division and digital initiative within its publishing house. The organisation now consists of 15 employees, 13 of which are highly educated, skilled and experienced nurses.

Good competence in nursing has direct benefits for patient safety and quality of care. This has been an important political health initiative in Norway since the health and quality reforms of 2000-01. These requirements are also present in several countries globally, including Denmark, Scotland, the U.S., Wales and others. Healthcare procedures have traditionally been developed locally and with little or no coordination for each hospital unit or health institutions, nor with educational texts. For example, one hospital with whom we collaborated had up to 60 variations of the same procedure. Clinical practice experience shows that developing and maintaining healthcare procedures according to the latest research/best practices is a challenging and time consuming process.

Considerable resources are required to keep up with the latest research and to formulate the findings in a precise and easily understandable manner. This requires time, knowledge and continuity, resources that are often scarce in clinical practice. Because of the new demands from the health authorities, there was a clear need for utilizing available technology and developing a system for healthcare procedures. This system needed to be based on best evidence in order to improve efficiency, save money, improve communication and treatment throughout units and institutions and bridge education and practice.