Daily Checklists and Outcome in the Intensive Care Unit
Medical errors account for tens of thousands of deaths and tens of billions of dollars in healthcare costs in the United States every year. One field that has seen the strongest push toward quality improvement has been critical care medicine, likely because its particularly high degree of medical complexity makes it a practice area prone to high error rates with serious consequences. One of the most commonly used interventions used to help reduce errors in the intensive care unit (ICU) has been the implementation of checklists.
The investigators propose a clinical trial in a University critical care setting to determine whether an electronic checklist versus verbal prompting to use a written checklist improves clinical practice and patient outcomes. The investigators also plan to compare these data with a time period prior to the study to determine if the electronic checklist or verbal prompting are better than usual care. The investigators hypothesize that both the electronic checklist and verbal prompting to use a written checklist will be better for clinical practice and patient outcomes than usual care, and that verbal prompting will lead to better outcomes compared to the electronic checklist.
調査の概要
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Illinois
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Chicago、Illinois、アメリカ、60611
- Northwestern University
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Chicago、Illinois、アメリカ、60611
- Northwestern Memorial Hospital
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-
参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Admission to a medical intensive care unit (MICU) team during the study timeframe
Exclusion Criteria:
- Transfer from MICU team to a separate ICU team within 12 hours of admission
- Transfer to MICU team from a separate ICU team after more than 72 hours on the separate ICU team
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：ヘルスサービス研究
- 割り当て：非ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：Electronic checklist
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Electronic checklist for process of care issues implemented in our institution.
Training on a regular basis of the electronic checklist arm to use the electronic checklist.
Process of care issues on the electronic checklist include several that are under investigation: antibiotics and mechanical ventilation.
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実験的：Verbal prompting
Verbal prompting with written checklist
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Prompting by study investigators of physicians on the verbal prompting arm.
Prompting will include questions related to antibiotic utilization and mechanical ventilation weaning.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Empiric Antibiotic Duration
時間枠：During intensive care unit admission, an average of 5 days per patient (although individual patients may vary)
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During intensive care unit admission, an average of 5 days per patient (although individual patients may vary)
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Proportion of Empiric Antibiotics
時間枠：ICU admission
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The difference between the electronic checklist and prompted groups' proportion of all antibiotics that were administered empirically (empiric/total antibiotics).
|
ICU admission
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Hospital Mortality
時間枠：During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
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During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
|
|
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Length of Stay
時間枠：During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
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During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
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Ventilator-free Days
時間枠：During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
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Number of days within the first 28 days after ICU admission that a patient does not require mechanical ventilation.
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During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
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Proportion of Successful Prompts
時間枠：During ICU admission, an average of 5 days (although individual patients may vary)
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Prompting group: number of patient-days that prompting led to empirical antibiotics being discontinued or narrowed/number of patient-days prompting occurred Electronic checklist group: number of patient-days that electronic checklist led to empirical antibiotics being discontinued or narrowed/number of patient-days electronic checklist was completed |
During ICU admission, an average of 5 days (although individual patients may vary)
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Proportion of Patients-days on Which Empirical Antibiotics Were Used
時間枠：ICU admission
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Proportion of patients-days on which empirical antibiotics were used
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ICU admission
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Standardized Mortality Ratio
時間枠：Hospital admission
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Hospital admission
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Curtis H Weiss, MD、Northwestern University
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。