Capnography At the Bedside: Leading Educational Efforts (CapABLE)

Capnography At the Bedside: Leading Educational Efforts (CapABLE Trial)

The purpose of this dual-site quasi-experimental pilot study is to evaluate if the implementation of an educational intervention paired with an environmental assessment to address accessibility barriers is associated with improvement in staff knowledge and skills, and adherence to national guidelines for use (evaluation in the knowledge transfer framework) in an emergency department (ED) setting.

Study Overview

• Status: Completed
• Conditions: Emergency
• Intervention / Treatment: Behavioral: Education and Reminder Posters; Other: Policy Change

Detailed Description

The objective of this study is to develop a multi-faceted implementation program (referred to as the Capnography At the Bedside: Leading Emergency Education (CapABLE Trial)) to increase the use of capnography during two critical events in the emergency department, intubation and CPR, for better detection of endotracheal intubation, endotracheal tube dislodgement, and quality CPR.

The specific aims of the proposed study are to examine:

1. the effect of a comprehensive theory-based educational intervention on staff knowledge and skills related to capnography (outcome measure).
2. the effect of a multi-faceted implementation program on the adherence to national guidelines regarding the use of capnography during critical events in the emergency department (process measure).
3. the sustainability of effects of the implementation program on adherence, knowledge and skills (outcome and process measure).

The design and methods of this study are based on the knowledge transfer framework, which dictates identification of the message, target audience, messenger, process and communication, and evaluation.

• Study Type: Interventional
• Enrollment (Actual): 902
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Emergency department (ED) staff
• Staff will include registered nurses, respiratory therapists, technical associates, physicians, physician's assistants and advanced practice nurse practitioners who fulfill the majority of their clinical duties in the ED.

Exclusion Criteria:

• Staff who are assigned to work on other units, but who work in the ED on a casual or per diem status will be excluded.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Education and Reminder; This arm will consist of participants in a location that receive with web based training and exposure to reminder posters in the workplace.	Behavioral: Education and Reminder Posters; See arm description
Active Comparator: Policy Change; This arm's participants will not receive an active intervention (education and reminders), however, policy change will take place in this location.	Other: Policy Change; See arm description

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average Monitoring Frequency	This outcome will reflect the number of patients the staff applied the monitoring to pre and post intervention.	Pre intervention 3 months and Post intervention about 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knowledge	A tool will be developed as part of the study to assess knowledge and how that might change over time (from pre to post)	Pre intervention
Knowledge	A tool will be developed as part of the study to assess knowledge and how that might change over time (from pre to post)	Post intervention (within 1 month of intervention)

Collaborators and Investigators

• Sponsor: Yale University
• Collaborators: Medtronic - MITG
• Investigators: Principal Investigator: Melissa Langhan, MD, Yale University Dept of Pediatrics, Section of Emergency Medicine

Publications and helpful links

General Publications

• Shah R, Streat DA, Auerbach M, Shabanova V, Langhan ML. Improving Capnography Use for Critically Ill Emergency Patients: An Implementation Study. J Patient Saf. 2022 Jan 1;18(1):e26-e32. doi: 10.1097/PTS.0000000000000683.

Study record dates

Study Major Dates

• Study Start (Actual): September 15, 2016
• Primary Completion (Actual): September 15, 2017
• Study Completion (Actual): October 17, 2017

Study Registration Dates

• First Submitted: September 9, 2016
• First Submitted That Met QC Criteria: September 9, 2016
• First Posted (Estimate): September 15, 2016

Study Record Updates

• Last Update Posted (Actual): August 22, 2018
• Last Update Submitted That Met QC Criteria: August 20, 2018
• Last Verified: August 1, 2018

More Information

Terms related to this study

• Keywords: capnography
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: 1503015415

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED