An evidence-based research approach to improving outcomes and reducing hospital-acquired complications in patients with rib fractures: Chest Injury bundle of care Protocol (ChIP)

Not Applicable

Completed

• Conditions: Rib fractures; Blunt chest injury; Injuries and Accidents - Other injuries and accidents; Injuries and Accidents - Fractures; Public Health - Health service research

• Registration Number: ACTRN12618001548224
• Lead Sponsor: niversity of Sydney

Brief Summary

This research project helped us determine the impact of implementing an evidence-informed blunt chest injury early activation protocol (ChIP) on patient and hospital outcomes. This study demonstrated how the behaviour change wheel could be used to revise and improve a clinical protocol in the ED context. There were significant and sustained improvements in care practices known to result in better patient outcomes. The incidence of pneumonia following the introduction of ChIP was reduced significantly. In the after-ChIP cohort, more patients received a pain team review, physiotherapy and trauma team review. Findings from this study showed that ChIP reduced the incidence of pneumonia and improved the delivery of healthcare services. There were 1790 patients included. ChIP was associated with 90% decreased odds of unplanned ICU admissions at the intervention sites compared to the control groups in the post-implementation period. The intervention sites had a 58% decrease in non-invasive ventilation use in the post-implementation period compared to the pre-implementation period. There was no significant change in mortality. There were higher odds of care practices known to result in better outcomes and there was improvement in the delivery of health care services.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-09-17
• Study Completion: 2020-02-07
• Last Update Posted: 22 April 2024

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 1798

Inclusion Criteria

Blunt thoracic trauma mechanism
Adult greater or equal to 18 years
Admitted to hospital
Rib/sternum fracture (clinical or radiological diagnosis)

Exclusion Criteria

Injury occurred while in hospital for other reason (activation system not possible)
Major cognitive impairment (patients are unable to participate in the care bundle)
Intubated Prehospital or in the emergency department

Study & Design

• Study Type: Observational
• Study Design: Not specified