Telehealth-Enabled, Real-time Audit and Feedback for Clinician AdHerence (TEACH)
- Conditions
- Respiration, Artificial
- Interventions
- Other: Telehealth- enabled support for SAT/SBT adherenceOther: Usual audit and feedback for SAT/SBT adherence
- Registration Number
- NCT05141396
- Lead Sponsor
- Intermountain Health Care, Inc.
- Brief Summary
The purpose of this trial is to evaluate if augmenting a usual audit and feedback implementation approach with telehealth-enabled support improves coordinated spontaneous awakening/breathing trials and patient outcomes for mechanically ventilated patients.
- Detailed Description
Sedation and analgesia are utilized with invasive mechanical ventilation (IMV) to improve patient comfort and synchrony with the mechanical ventilator. Prolonged sedation, however, may result in increased time on IMV and increased risk for ventilator associated pneumonia, delirium, and poor long-term cognitive outcomes. Daily interruptions in sedation \[spontaneous awakening trials (SAT)\] coordinated with daily spontaneous breathing trials (SBT) reduce mortality, increase ventilator free days, decrease intensive care unit (ICU) length of stay, and reduces ventilator-associated events. Coordination of spontaneous awakening and breathing trials (C-SAT/SBT), however, are underutilized due to significant barriers to implementation and adherence. This cluster-randomized hybrid implementation/effectiveness trial will compare C-SAT/SBT adherence and clinical outcomes in the presence of traditional audit and feedback implementation strategies alone or augmented with a novel Telehealth-Enabled, real-time Audit and feedback for Clinician adHerence ("TEACH") implementation strategy.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 13400
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention - Telehealth- enabled support plus usual audit and feedback for SAT/SBT adherence Telehealth- enabled support for SAT/SBT adherence Usual audit and feedback + telehealth-enabled support Control - Usual audit/feedback for SAT/SBT adherence only Usual audit and feedback for SAT/SBT adherence Usual audit and feedback Intervention - Telehealth- enabled support plus usual audit and feedback for SAT/SBT adherence Usual audit and feedback for SAT/SBT adherence Usual audit and feedback + telehealth-enabled support
- Primary Outcome Measures
Name Time Method Ventilator-free days to day 28 28 days ventilator-free days to day 28
Adherence to C-SAT/SBT intubation to extubation - an average of 5 days Fraction of eligible days on which coordinated spontaneous awakening trial and spontaneous breathing trial completed.
- Secondary Outcome Measures
Name Time Method 30-day Mortality 30 days 90-day Mortality 90 Days Reintubation intubation to extubation - an average of 5 days Hospital Length of Stay Through hospital discharge, an average of 10 days New ventilator-associated pneumonia Through hospital discharge, an average of 10 days ICU Length of Stay Through hospital discharge, an average of 10 days Unintentional Extubation intubation to extubation - an average of 5 days
Trial Locations
- Locations (11)
American Fork Hospital
🇺🇸American Fork, Utah, United States
Cedar City Hospital
🇺🇸Cedar City, Utah, United States
Layton Hospital
🇺🇸Layton, Utah, United States
Intermountain Medical Center
🇺🇸Murray, Utah, United States
Utah Valley Hospital
🇺🇸Provo, Utah, United States
Logan Regional Hospital
🇺🇸Logan, Utah, United States
Mckay Dee Hospital
🇺🇸Ogden, Utah, United States
Riverton Hospital
🇺🇸Riverton, Utah, United States
St. George Regional Hospital
🇺🇸Saint George, Utah, United States
Alta View Hospital
🇺🇸Sandy, Utah, United States
LDS Hospital
🇺🇸Salt Lake City, Utah, United States