- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01269736
Implementation of Practice Standards for ECG Monitoring (PULSE)
28. august 2017 opdateret af: Yale University
The purpose of this study is to test the effect of implementing new practice standards for electrocardiographic (ECG) monitoring on nurses' knowledge and skills, quality of care, and patient outcomes.
The investigators hypothesize that increased knowledge and skills of nurses will lead to enhanced quality of care, which will result in improved outcomes for patients.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Despite advances in hospital electrocardiographic (ECG) monitoring technology, monitoring practices are inconsistent and often inadequate.
The investigators recently published practice standards for ECG monitoring.
The primary purpose of this 5-year multisite randomized clinical trial is to test the effect of implementing these standards on nurses' knowledge and skills, quality of care, and patient outcomes.
The investigators expect that increased knowledge and skills of nurses will lead to enhanced quality of care, which will result in improved outcomes for patients.
Units serving cardiac patients in 17 hospitals will participate.
Hospitals will be randomized to the experimental or control group after baseline measures of knowledge and skills, quality of care, and patient outcomes are obtained.
The intervention will include ECG monitoring education and strategies to implement and sustain change.
The online education will include 4 modules: essentials of ECG monitoring, arrhythmia monitoring, ischemia monitoring, and QT interval monitoring.
The strategies to implement and sustain change in the clinical area include reinforcement of education, incentives, and the designation of "champions" on each unit who will actively promote the implementation of the practice standards.
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
92057
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Ontario
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Ottawa, Ontario, Canada, K1Y 4W7
- University of Ottawa Heart Institute, Ottawa, Canada
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California
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Long Beach, California, Forenede Stater, 90806
- Long Beach Memorial Medical Center
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San Francisco, California, Forenede Stater, 94122
- University of California, San Francisco Medical Center
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Connecticut
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New Haven, Connecticut, Forenede Stater, 06510
- Yale-New Haven Hospital
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Maine
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Portland, Maine, Forenede Stater, 04102
- Maine Medical Center
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Massachusetts
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Springfield, Massachusetts, Forenede Stater, 01199
- Baystate Medical Center
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Minnesota
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Saint Paul, Minnesota, Forenede Stater, 55102
- United Hospital
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New York
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Buffalo, New York, Forenede Stater, 14215
- Erie County Medical Center
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North Carolina
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Chapel Hill, North Carolina, Forenede Stater, 27516
- University of North Carolina Hospitals
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Ohio
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Canton, Ohio, Forenede Stater, 44710
- Aultman Hospital
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Pennsylvania
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Philadelphia, Pennsylvania, Forenede Stater, 19104
- Hospital of the University of Pennsylvania
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Philadelphia, Pennsylvania, Forenede Stater, 19107
- Thomas Jefferson University Hospital
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Texas
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Austin, Texas, Forenede Stater, 78705
- Seton Medical Center
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Dallas, Texas, Forenede Stater, 75252
- Baylor University Medical Center
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Wisconsin
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Madison, Wisconsin, Forenede Stater, 53715
- Meriter Heart Hospital
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Hong Kong, Kina
- Hong Kong Sanatorium & Hospital
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Ja
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- Nurses (and monitor technicians): All nurses (and monitor technicians) working on participating units serving patients with cardiac disease
- Patients: All patients cared for on participating units
Exclusion Criteria:
- Nurses (and monitor technicians): No nurses (or monitor technicians) will be excluded
- Patients: No patients on the participating units will be excluded, even if their primary diagnosis is not cardiac
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Sundhedstjenesteforskning
- Tildeling: Randomiseret
- Interventionel model: Crossover opgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Eksperimentel: Education
Online ECG monitoring education program and strategies to implement and sustain change for nurses
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Online ECG monitoring education program and strategies to implement and sustain change for nurses
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Ingen indgriben: Control
Usual in-service education for nurses
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Nurses' Knowledge and Skills Related to ECG Monitoring
Tidsramme: Baseline, 15 months, 30 months
|
Participants took a 20-item online test on essentials of ECG monitoring, and arrhythmia, ischemia, and QT interval monitoring.
Scores represent the percentage of correct answers.
(Test scores range from 0 to 100 with higher scores representing more correct answers)
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Baseline, 15 months, 30 months
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Quality of Patient Care Related to ECG Monitoring
Tidsramme: Baseline, 15 months, 30 months
|
Percentage of patients with accurate electrode placement, accurate rhythm interpretation, cardiac arrest, cardiac arrest initiated by arrhythmia, appropriate monitoring, telemetry units only, ST-segment monitoring when indicated, and QTc measurement when indicated
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Baseline, 15 months, 30 months
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Patient Outcomes
Tidsramme: Baseline, 15 months, 30 months
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Mortality, in-hospital MI, and not surviving a cardiac arrest were obtained using administrative data and laboratory data (eg, troponin, CK-MB) for all patients.
Mortality was defined as death that occurred on one of the participating units.
To identify the occurrence of in-hospital MI, laboratory data, timing of procedures, and location of patient at the time of the first blood draw indicating the event were used.
Cardiac arrest was defined as an event initiated by an arrhythmia that required immediate intervention and was initiated on a PULSE participating unit.
For each qualifying cardiac arrest, it was determined whether the patient survived the event.
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Baseline, 15 months, 30 months
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Marjorie Funk, PhD, RN, Yale University School of Nursing
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Funk M, Rose L, Fennie K. Challenges of an Internet-based education intervention in a randomized clinical trial in critical care. AACN Adv Crit Care. 2010 Oct-Dec;21(4):376-9. doi: 10.1097/NCI.0b013e3181e6765d.
- Funk M, Winkler CG, May JL, Stephens K, Fennie KP, Rose LL, Turkman YE, Drew BJ. Unnecessary arrhythmia monitoring and underutilization of ischemia and QT interval monitoring in current clinical practice: baseline results of the Practical Use of the Latest Standards for Electrocardiography trial. J Electrocardiol. 2010 Nov-Dec;43(6):542-7. doi: 10.1016/j.jelectrocard.2010.07.018. Epub 2010 Sep 15.
- Funk M, Fennie KP, Stephens KE, May JL, Winkler CG, Drew BJ; PULSE Site Investigators. Association of Implementation of Practice Standards for Electrocardiographic Monitoring With Nurses' Knowledge, Quality of Care, and Patient Outcomes: Findings From the Practical Use of the Latest Standards of Electrocardiography (PULSE) Trial. Circ Cardiovasc Qual Outcomes. 2017 Feb;10(2):e003132. doi: 10.1161/CIRCOUTCOMES.116.003132. Erratum In: Circ Cardiovasc Qual Outcomes. 2017 Oct;10(10):
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. august 2008
Primær færdiggørelse (Faktiske)
1. marts 2014
Studieafslutning (Faktiske)
1. marts 2014
Datoer for studieregistrering
Først indsendt
3. januar 2011
Først indsendt, der opfyldte QC-kriterier
3. januar 2011
Først opslået (Skøn)
4. januar 2011
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
31. august 2017
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
28. august 2017
Sidst verificeret
1. juni 2017
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 0711003292
- R01HL081642 (U.S. NIH-bevilling/kontrakt)
Plan for individuelle deltagerdata (IPD)
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Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
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