Evidence Based QUality Improvement for Prescribing Stewardship in ICU (EQUIPS-ICU)
- Conditions
- Antimicrobial Stewardship
- Registration Number
- NCT06666738
- Lead Sponsor
- University of Oxford
- Brief Summary
The goal of this observational study is to learn about the implementation of a process to review antimicrobial prescriptions for adult patients in Intensive Care Unit (ICU).
The main question it aims to answer is: can a structured antimicrobial review can be implemented in ICUs?
Implementation will be supported by the use of local protocols, audit and feedback, and education. It will be evaluated by daily data collection of clinical processes and interviews with local champions.
Resources to conduct the study are provided by the Wellcome Flagship Innovations award. ("Collaboration for Research, Implementation and Training in Critical Care in Asia and Africa", reference 224048/Z/21/Z).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 6300
- All adult ICUs within CCAA-affiliated Care Quality Registries
- ICUs must appoint a named Champion to facilitate implementation
- All antimicrobial prescriptions for adult patients within the ICUs described above
• ICU's which demonstrate adoption and reach of 80% or greater (median over 2 months) of a pre-existing structured antimicrobial review
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Fidelity Evaluated over calendar month periods during months 4-6 (i.e. the three months immediately following implementation) The proportion of prescriptions reviewed as intended (reviewed within 48hours with documentation of all 4 review components: indication, route, duration, stop date). Reported as a proportion of the number of possible reviews.
Reach Evaluated over calendar month periods during months 4-6 (i.e. the three months immediately following implementation) Proportion of eligible patients who receive a review
Adoption Evaluated over the calendar month period of month 7 Proportion of prescriptions reviewed as intended once implementation support has been withdrawn
- Secondary Outcome Measures
Name Time Method Antimicrobial Density (AD) Evaluated over calendar month periods during months 1-7 of the study. Defined Daily Dose / 1000 patient-days. This measure of antimicrobial consumption will compare prescribed daily doses of antimicrobials to those specified by the World Health Organization (WHO) (Anatomical Therapeutic Classification (ATC) J01 Defined Daily Doses). To correct for ICU unit size the investigators will standardise by number of admitted patient-days during that month in that ICU.
Duration of Therapy Evaluated over calendar month periods during months 1-7 of the study Number of Days of antimicrobial Therapy / 1000 patient-days Analysed at the ICU level
Antimicrobial Redundancy Rate Evaluated over calendar month periods during months 1-7 of the study Days of Therapy of prespecified redundant combinations of antimicrobials. Analysed at the ICU level.
Antimicrobial resistance rate Evaluated over calendar month periods during months 1-7 of the study Number of multidrug-resistant pathogens (as specified by WHO priority list) / number of patients
Antimicrobial prescribing rate Evaluated over calendar month periods during months 1-7 of the study Number of patients receiving at least 1 antimicrobial / number of patients admitted to ICU in the same period