Education of Providers on Prescribing Best Practices
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 369
- 试验地点
- 2
- 主要终点
- Median morphine milligram equivalents (MME) per opioid prescription
研究概览
简要总结
This study aims to evaluate the impact of spaced education, delivered via a smartphone application, on provider prescribing patterns.
详细描述
As part of a medical center educational initiative at Vanderbilt University Medical Center (VUMC), two educational modules will be sent to prescribing providers through either email or short message service (SMS) text messaging. The first educational module consists of a set of multiple choice questions concerning best practices for prescribing intravenous fluids in the inpatient and perioperative setting. This module is based upon recent literature and specifically derived from the results of the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) and Saline Against Lactated Ringer's or Plasma-Lyte in the Emergency Department (SALT-ED) trial, both published in the New England Journal of Medicine in 2018 and led by Vanderbilt investigators. Similarly, a second educational module concerning evidence-based pain management and opioid prescribing practices will be distributed via email or SMS text messaging.
Participants will receive one question per day. If the participant does not answer the question correctly, they will receive the opportunity to attempt the question again after reviewing evidence-based education. All questions have been curated and reviewed by a panel of experts and piloted within VUMC for feasibility and acceptability. Key concepts are repeated in each module and questions are strategically ordered throughout each module to accomplish spaced education.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •All inpatient prescribing providers
排除标准
- 未提供
结局指标
主要结局
Median morphine milligram equivalents (MME) per opioid prescription
时间窗: 8 months
By extracting prescribing data for opioids from the electronic health records
Percentage of orders for balanced intravenous (IV) fluid solutions (i.e. not normal saline)
时间窗: 8 months
By extracting prescribing data for intravenous fluids from the electronic health records
次要结局
- Length of stay for patients receiving an intravenous fluid order or an opioid prescription from a provider enrolled in the study.(8 months)
- Potassium levels in patients receiving intravenous fluid orders from a provider enrolled in the study(8 months)
- Major Adverse Kidney Events by 30 days (MAKE 30) in patients receiving intravenous fluid orders from a provider enrolled in the study(30 days)
- Percent of opioid prescriptions (inpatient) that also had a scheduled (not pro re nata (PRN)) non-opioid (APAP, nonsteroidal anti-inflammatory drugs (NSAIDs), gamma-Aminobutyric acid (GABA), muscle relaxant, etc.)(8 months)
- Number of Rapid Response Team calls (RRT s) indexed to the number of patients cared for per prescriber (evaluated by level of engagement of the learner with QuizTime)(8 months)
- Chloride levels in patients receiving intravenous fluid orders from a provider enrolled in the study(8 months)
- Median number of pills per prescription for patients receiving an opioid prescription from a provider enrolled in the study(8 months)
- Length of stay in the intensive care unit (ICU) for patients receiving an intravenous fluid order or an opioid prescription from a provider enrolled in the study(8 months)
- Percent of opioid prescriptions (discharge) that also had a scheduled (not PRN) non-opioid (APAP, NSAIDs, GABA, muscle relaxant, etc.)(8 months)
研究者
Matthew McEvoy
Professor of Anesthesiology
Vanderbilt University Medical Center
