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Daily Checklists and Outcome in the Intensive Care Unit

2012年11月5日 更新者:Curtis Weiss、Northwestern University

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.

研究概览

研究类型

介入性

注册 (实际的)

451

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Illinois
      • Chicago、Illinois、美国、60611
        • Northwestern University
      • Chicago、Illinois、美国、60611
        • Northwestern Memorial Hospital

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 孩子
  • 成人
  • 年长者

接受健康志愿者

不

有资格学习的性别

全部

描述

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

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:卫生服务研究
  • 分配:非随机化
  • 介入模型:并行分配
  • 屏蔽:单身的

武器和干预

参与者组/臂
干预/治疗
实验性的:Electronic checklist
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.
实验性的:Verbal prompting
Verbal prompting with written checklist
Prompting by study investigators of physicians on the verbal prompting arm. Prompting will include questions related to antibiotic utilization and mechanical ventilation weaning.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Empiric Antibiotic Duration
大体时间:During intensive care unit admission, an average of 5 days per patient (although individual patients may vary)
During intensive care unit admission, an average of 5 days per patient (although individual patients may vary)
Proportion of Empiric Antibiotics
大体时间:ICU admission
The difference between the electronic checklist and prompted groups' proportion of all antibiotics that were administered empirically (empiric/total antibiotics).
ICU admission

次要结果测量

结果测量
措施说明
大体时间
Hospital Mortality
大体时间:During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
Length of Stay
大体时间:During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
Ventilator-free Days
大体时间:During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
Number of days within the first 28 days after ICU admission that a patient does not require mechanical ventilation.
During hospitalization, an average of 2 weeks per patient (although individual patients may vary)
Proportion of Successful Prompts
大体时间:During ICU admission, an average of 5 days (although individual patients may vary)

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)
Proportion of Patients-days on Which Empirical Antibiotics Were Used
大体时间:ICU admission
Proportion of patients-days on which empirical antibiotics were used
ICU admission
Standardized Mortality Ratio
大体时间:Hospital admission
Hospital admission

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:Curtis H Weiss, MD、Northwestern University

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2011年7月1日

初级完成 (实际的)

2012年4月1日

研究完成 (实际的)

2012年4月1日

研究注册日期

首次提交

2011年7月13日

首先提交符合 QC 标准的

2011年7月14日

首次发布 (估计)

2011年7月18日

研究记录更新

最后更新发布 (估计)

2012年12月4日

上次提交的符合 QC 标准的更新

2012年11月5日

最后验证

2012年11月1日

更多信息

与本研究相关的术语

其他相关的 MeSH 术语

其他研究编号

  • NUIRBSTU00013313

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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