- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03577561
Proficiency Based Training to Investigate Blood Sampling Errors Including WBIT
Technology Enhanced Learning and Proficiency Based Progression to Investigate and Mitigate Blood Sampling Errors Including 'Wrong Blood in Tube' in Our Hospitals; Can we Improve Patient Safety and Reduce Resource Wastage?
Study Overview
Status
Intervention / Treatment
Detailed Description
Objective To determine the effectiveness of a Proficiency Based Progression Training programme, together with evidence based individual feedback for any residual errors, which has been specifically developed for healthcare professionals performing phlebotomy at Cork University Hospital at reducing blood sampling errors including Wrong Blood in Tube (WBIT) .The investigators will use the research data generated to recommend an evidence based training and competency assessment approach to health care providers in Ireland,. This will allow us to internationally address the universal problem of sample mislabeling and WBIT.
METHODS Subjects All SHO (128) and intern (46) trainees working at participating sites during an 18-month timeframe will be asked to participate. For interns the investigators will expect their participation in the two weeks before they commence work in June/July 2018/9. For SHO's the investigators will ensure training is integrated as part of their normal work routine and hospital practices. Participation will be expected and the investigators have secured the backing of the hospital executive management group, clinical directors and university teachers for implementation of this study.
Proficiency based progression training The phlebotomy metric which was developed at CUH in 2017 is the provides the key tool in the development of the PBP training programme. All interns and SHOs in institutions participating in the study will receive PBP training. All trainees will be required to engage with an online didactic education package and a simulation skill training module. Both of these education and training platforms will be derived from the procedure characterisation and benchmarked on experienced practitioner's performance. Trainees will be required to engage with the education and training platforms in a process of deliberate practice learning until they demonstrate the requisite performance benchmark. Only at that point will they be allowed to take samples in a clinical setting. Proficiency demonstration will be mandatory before progressing to ward proctored skill supervision on real patients. In addition, the doctors in training will receive ongoing and proximate feedback on their sampling mislabeling (including wrong blood in tube) performance as soon as it is discovered. Furthermore, they would be responsible for taking the new sample and explain to the patient the accurate reason why the blood sample had to be re-taken, as per open disclosure policy in the HSE.
Comparison Groups The control groups will be derived from extensive baseline data from CUH hospitals from trainees
Control group A: 1 -year historical data (2016/2017) The blood sampling error rate in the interns receiving PBP training in 2018 will be compared to historical data on doctors who would have received whatever training they would normally undergo as a part of their existing training program. It will not differ from what they would normally receive at that institution.
Control group B (2017/2018) In a pilot project in July 2017, 46 interns received the phlebotomy PBP training at CUH. The error rates in the interns in 2017 will be compared to the newly trained interns in 2018 to determine the effectiveness of the training over time.
Data collection at Cork University Hospital The Medically qualified clinical researcher Dr Noirin O'Herlihy, will set up and co-ordinate training for the two medical groups. She will inform the Interns and SHO in formal and informal sessions. She will be present at session to ensure accurate simulation of real life ward environments. She will obtain written informed consent from the medics in simulation and collect baseline demographic data on all doctors in training participating in the study.
Once competency has been demonstrated in simulation, she will be responsible for setting up real life clinical, monitored competency assessment in the real ward setting. Data collection will take place using an agreed standard operating procedure which is closely adhered to by all data collection sites.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Munster
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Cork, Munster, Ireland, T12 DC4A
- Cork University Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
All blood samples performed at Cork Unversity Hospital and Kerry General Hospital by Doctors in Training
Exclusion Criteria:
If the doctor is not using his own log in to request blood samples on the clinical manager software If the doctor does not attend the training session
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Control group A
Control group A: 1 -year historical data (2016/2017) The blood sampling error rate in the interns receiving proficiency based progression training in 2018 will be compared to historical data on doctors who would have received whatever training they would normally undergo as a part of their existing training program.
It will not differ from what they would normally receive at that institution.
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|
Active Comparator: Control Group B
Control group B (2017/2018) In a pilot project in July 2017, 46 interns received the phlebotomy proficiency based progression training at CUH.
The error rates in the interns in 2017 will be compared to the newly trained interns in 2018 to determine the effectiveness of the training over time.
The intervention is the proficiency based progression training programme in phlebotomy.
|
Trainees will receive an online didactic education package and a simulation skill training module.
Both of these education and training platforms will be derived from the procedure characterisation and benchmarked on experienced practitioner's performance.
Trainees will be required to engage with the education and training platforms in a process of deliberate practice learning until they demonstrate the requisite performance benchmark.
Proficiency demonstration will be mandatory before progressing to ward proctored skill supervision on real patients.
In addition, the doctors in training will receive ongoing and proximate feedback on their sampling mislabeling.
Other Names:
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Active Comparator: Interventional Group
The blood sampling error rate of doctors in training provided with the intervention i.e. improved proficiency based progression training programme will be analysed from July 10th 2018 until the study ends. The proficiency based progression training will consist of an online eLearning module to teach the doctors the correct process to take blood in the hospital. The doctors will then have to attend a face to face training day on a simulation ward where they will be asked to take blood according to a metric of 77 steps with less than 13 errors and no critical errors. Finally, the doctors will be observed taking blood on the ward and again must take it to a proficient standard. |
Trainees will receive an online didactic education package and a simulation skill training module.
Both of these education and training platforms will be derived from the procedure characterisation and benchmarked on experienced practitioner's performance.
Trainees will be required to engage with the education and training platforms in a process of deliberate practice learning until they demonstrate the requisite performance benchmark.
Proficiency demonstration will be mandatory before progressing to ward proctored skill supervision on real patients.
In addition, the doctors in training will receive ongoing and proximate feedback on their sampling mislabeling.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total Number of Rejected Samples due to pre-analytical errors
Time Frame: 6 months
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The total number of blood samples that were not tested due to pre analytical errors by the doctors in training as a percentage of the total number of samples taken by the doctors
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6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Over and Underfilling of the specimen bottle
Time Frame: 6 months
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Any sample not tested due to over or under filling of the bottle as a percentage of the total number of samples performed
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6 months
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Clotted Samples
Time Frame: 6 months
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The number of samples not tested due to clotting of the sampleas a percentage of the total number of samples performed
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6 months
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Haemolysed Samples
Time Frame: 6 months
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The number of blood samples not tested as the blood sample was haemolysedas a percentage of the total number of samples performed
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6 months
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No Specimen Received
Time Frame: 6 months
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The number of blood requests received without a specimen bottleas a percentage of the total number of samples performed
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6 months
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Incorrect Bottle
Time Frame: 6 months
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The number of blood requests received where the blood was taken in the incorrect specimen bottle as a percentage of the total number of samples performed
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6 months
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Other Causes for Rejected Samples
Time Frame: 6 months
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Any other cause for the blood request not being processed as a percentage of the total number of samples performed
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6 months
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Wrong Blood in Tube
Time Frame: 6 months
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The number of specimens where the blood sample in the tube is not that of the patient label on the specimen bottle as a percentage of the total number of samples performed
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6 months
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Director: Anthony Gallagher, PhD, University College Cork
- Principal Investigator: Mary R Cahill, MD, University College Cork
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1820
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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