Study of Knowledge Translation of Clinical Practice Guidelines for Ventilator Associated Pneumonia
- Conditions
- Ventilator Associated Pneumonia
- Interventions
- Behavioral: Education
- Registration Number
- NCT00434460
- Lead Sponsor
- Canadian Critical Care Trials Group
- Brief Summary
The purpose of this prospective, multicentre, time-series study is to develop, implement, refine, and evaluate a sustainable behaviour change strategy in the intensive care unit (ICU).
- Detailed Description
Background:
In order to improve the care of our patients, it is necessary for research evidence to be translated into clinical practice. There are gaps in our understanding of knowledge translation (KT) and this is evident in the Intensive Care Unit (ICU), specifically as it applies to the prevention, diagnosis and treatment of ventilator-associated pneumonia (VAP). VAP is associated with a high burden of illness in the critically ill and there is an extensive amount of research evidence on this disease. It has been demonstrated that best practice as defined by research evidence is not uniformly applied to VAP. In addition, recent advances in VAP knowledge need be disseminated and implemented in order to improve patient safety and outcomes from VAP. A systematic process of knowledge transfer is crucial to translate this research into evidence-based bedside practice and the development and implementation of evidence based Clinical Practice Guidelines (CPGs) may facilitate VAP knowledge uptake. In addition, there is a need to study knowledge translation (KT) in the ICU since there is little information about optimal KT and CPG implementation strategies in this environment and efforts that are effective in other clinical areas may not result in meaningful change in the ICU.
Research Question:
What is the effect of VAP CPGs implemented by a multidisciplinary behaviour change strategy (consisting of multifaceted educational strategies led by local opinion leaders and augmented with reminders) on VAP guideline concordance and on clinical VAP outcomes in the ICU?
Research Plan:
Data will only be collected on consecutive patients mechanically ventilated for at least 48 hours. The following health care professionals will be studied to assess the behaviour change strategy for the VAP CPGs: physicians (intensivists, ICU fellows, ICU rotating residents), nurses, respiratory therapists, dieticians, physiotherapists and ICU administrators.
The study will be conducted in 3 phases:
1. Development of a behaviour change strategy consisting of three components:
* Local opinion leader team
* Educational strategy
* Reminder system
2. Prospective implementation of the behaviour change strategy over a 24 month period
3. Prospective evaluation of the behaviour change strategy over a 24 month period
* Concordance with VAP guidelines over time
* Factors associated with VAP guideline concordance
* Clinical VAP outcomes pre- and post-guideline implementation
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1320
- Age >= 17 years old
- Mechanically ventilated > 48 hours < 96 hours
- Previous enrollment in the study
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description 1 Education Patients receiving invasive mechanical ventilation \> 48 hours.
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (11)
Royal Columbian Hospital, University of British Columbia
🇨🇦New Westminister, British Columbia, Canada
Geisinger Health Centre, Temple University
🇺🇸Danville, Pennsylvania, United States
Kingston General Hospital, Queen's University
🇨🇦Kingston, Ontario, Canada
St. Joseph's Healthcare, McMaster University
🇨🇦Hamilton, Ontario, Canada
The Ottawa Hospital, University of Ottawa
🇨🇦Ottawa, Ontario, Canada
Sunnybrook Health Sciences Centre, University of Toronto
🇨🇦Toronto, Ontario, Canada
William Osler Health Centre
🇨🇦Toronto, Ontario, Canada
Thunder Bay Regional Health Sciences Centre
🇨🇦Thunder Bay, Ontario, Canada
Hotel Dieu Grace Hospital
🇨🇦Windsor, Ontario, Canada
St. Paul Hospital, University of British Columbia
🇨🇦Vancouver, British Columbia, Canada
Vancouver Island Health Research Centre
🇨🇦Victoria, British Columbia, Canada