Evidence Based QUality Improvement for Prescribing Stewardship in ICU: Can a Structured Antimicrobial Review be Implemented in LMIC ICUs?
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 6,300
- 主要终点
- Fidelity
研究概览
简要总结
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).
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
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 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
排除标准
- •ICU's which demonstrate adoption and reach of 80% or greater (median over 2 months) of a pre-existing structured antimicrobial review
结局指标
主要结局
Fidelity
时间窗: 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
时间窗: 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
时间窗: Evaluated over the calendar month period of month 7
Proportion of prescriptions reviewed as intended once implementation support has been withdrawn
次要结局
- Antimicrobial Density (AD)(Evaluated over calendar month periods during months 1-7 of the study.)
- Duration of Therapy(Evaluated over calendar month periods during months 1-7 of the study)
- Antimicrobial Redundancy Rate(Evaluated over calendar month periods during months 1-7 of the study)
- Antimicrobial resistance rate(Evaluated over calendar month periods during months 1-7 of the study)
- Antimicrobial prescribing rate(Evaluated over calendar month periods during months 1-7 of the study)