Effect of Emergency Department Care Reorganization on Door-to-antibiotic Times for Sepsis (LDS SWARM)
2020年6月1日 更新者：Ithan Peltan、Intermountain Health Care, Inc.
Sepsis is a common syndrome resulting from a dysregulated response to infection.
The timing of antibiotic initiation is an important determinant of outcomes for patients presenting to the emergency department with sepsis.
The potential effect of care reorganization on very early care for sepsis is unknown.
This study will investigate whether multidisciplinary coordination of the initial patient evaluation in the emergency department influences door-to-antibiotic time for septic patients.
研究概览
详细说明
This is a retrospective cohort study of emergency department sepsis care before versus after implementation of a "swarming" model for simultaneous patient evaluation by multidisciplinary care providers.
The analysis will use data from similar hospitals that did not change sepsis care organization during the study period to control for changes in sepsis care not resulting from the "swarming" intervention.
研究类型
观察性的
注册 (实际的)
3230
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
-
-
Utah
-
Murray、Utah、美国、84157
- Intermountain Medical Center
-
Riverton、Utah、美国、84065
- Riverton Hospital
-
Salt Lake City、Utah、美国、84143
- LDS Hospital
-
Sandy、Utah、美国、84094
- Alta View 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
18年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
取样方法
非概率样本
研究人群
Adult patients presenting to the ED with sepsis or septic shock
描述
Primary inclusion criteria:
- Adult patients age ≥18 years
- Presented to the ED of study hospital from May 16, 2015 to April 15, 2016 (pre-implementation cohort) or May 16 to November 15, 2016 (post-implementation cohort)
- Sepsis present in ED (Sequential Organ Failure Assessment [SOFA] score ≥2 points above baseline while in ED plus antibiotic initiation while in the ED)
- Triage acuity score 2-5
Inclusion criteria for supplemental sensitivity analyses:
- Presented to the ED of study hospital between May 16, 2015 and April 15, 2016 (pre-implementation cohort) or May 16, 2016 and February 15, 2017 (post-implementation cohort).
- Sepsis on presentation to ED, defined as initial Sequential Organ Failure Assessment (SOFA) score ≥2 points above baseline plus antibiotics initiation within 24 hours of ED arrival.
Overall exclusion criteria:
- Age <18 years
- No antibiotics within 24 hours of ED arrival
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
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
|
Pre-implementation (intervention site)
Adult patients age ≥18 years who received usual care after presenting to the ED of the intervention hospital with sepsis or septic shock between May 16, 2015 and April 15, 2016
|
|
|
Post-implementation (intervention site)
Adult patients age ≥18 years eligible to receive immediate evaluation by multidisciplinary team ("swarming") after presenting to the ED of the intervention hospital with sepsis or septic shock between May 16, 2016 and February 15, 2017
|
Simultaneous initial evaluation by the ED physician, nurse, and patient care associate
其他名称：
|
|
Pre-implementation (control site)
Adult patients age ≥18 years who received usual care after presenting to the ED of a non-intervention study hospital with sepsis or septic shock between May 16, 2015 and April 15, 2016
|
|
|
Post-implementation (control site)
Adult patients age ≥18 years who received usual care after presenting to the ED of a non-intervention study hospital with sepsis or septic shock between May 16, 2016 and February 15, 2017
|
研究衡量的是什么？
主要结果指标
结果测量 |
大体时间 |
|---|---|
|
Time From ED Arrival to Administration of First Dose of Antibiotics
大体时间：24 hours
|
24 hours
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Hospital Mortality
大体时间：Up to 1 year
|
Up to 1 year
|
|
|
ED Length of Stay
大体时间：Up to 1 week
|
Time (minutes) from ED arrival to ED departure
|
Up to 1 week
|
|
Door-to-physician Evaluation Time
大体时间：Up to 24 hours
|
Time (minutes) from subject's arrival in the ED until initial evaluation by a physician.
|
Up to 24 hours
|
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：Ithan Peltan, MD, MSc、Intermountain Health Care, Inc.
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 (实际的)
2015年5月16日
初级完成 (实际的)
2017年1月31日
研究完成 (实际的)
2020年4月11日
研究注册日期
首次提交
2017年7月19日
首先提交符合 QC 标准的
2017年7月20日
首次发布 (实际的)
2017年7月21日
研究记录更新
最后更新发布 (实际的)
2020年6月18日
上次提交的符合 QC 标准的更新
2020年6月1日
最后验证
2020年6月1日
更多信息
与本研究相关的术语
其他研究编号
- LDS SWARM
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
是的
IPD 计划说明
In order to protect patient privacy and comply with relevant regulations, identified data will be unavailable.
Requests for deidentified data from qualified researchers with appropriate ethics board approvals and relevant data use agreements will be processed by the Intermountain Office of Research, officeofresearch@imail.org.
IPD 共享支持信息类型
- 研究方案
- 分析代码
- 企业社会责任
药物和器械信息、研究文件
研究美国 FDA 监管的药品
不
研究美国 FDA 监管的设备产品
不
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.