Intermountain Stewardship in Community Outpatient Settings-Resources & Engagement-Pediatrics
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 259,000
- 主要终点
- Guideline-adherent Broad vs. Narrow Spectrum Antibiotic Prescribing
研究概览
简要总结
The goal of this implementation project is to detail the process of implementing the best practice of antibiotic stewardship in the pediatric population across the Intermountain Health medical system. The main questions it aims to answer are:
- How can a large healthcare system drive high adherence to antibiotic stewardship across a large and diverse number of sites?
- How do determinants of implementation and needed strategies vary by context?
- What is the utility of a higher-resource implementation effort (named "Boost) focusing on outlier sites?
Data will be collected on number of children reached, adherence changes over time, types of implementation strategies employed, and characteristics of sites, prescribers, and patients.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 6 Months 至 17 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 6 months through 17 years
- •ARTI diagnosis (acute otitis media (AOM), Group A Streptococcal (GAS) pharyngitis, acute sinusitis, and community-acquired pneumonia (CAP))
排除标准
- •Age <6months or >18 years
- •No ARTI diagnosis
研究组 & 干预措施
Children with ARTIs, Wave 1
Children under 18 treated in Wave 1 of antibiotic stewardship for the following conditions: acute otitis media (AOM), Group A Streptococcal (GAS) pharyngitis, acute sinusitis, and community-acquired pneumonia (CAP)
干预措施: Implementation strategies including training & education, EMR tools, audit & feedback reports, and facilitation (Other)
Children with ARTIs, Wave 2
Children under 18 treated in Wave 2 of antibiotic stewardship for the following conditions: acute otitis media (AOM), Group A Streptococcal (GAS) pharyngitis, acute sinusitis, and community-acquired pneumonia (CAP)
干预措施: Implementation strategies including training & education, EMR tools, audit & feedback reports, and facilitation (Other)
结局指标
主要结局
Guideline-adherent Broad vs. Narrow Spectrum Antibiotic Prescribing
时间窗: Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation.
Rates of narrow-spectrum antibiotic (AB) prescriptions as a proportion of all antibiotics prescribed in aggregate and within each of these diagnoses: Acute otitis media, Group A streptococcal pharyngitis, Acute sinusitis, and Pneumonia.
Guideline-adherent Duration of Antimicrobial Therapy
时间窗: Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation.
Rate of AB prescriptions with guideline-adherent number of days prescribed as proportion of all AB prescriptions in aggregate and for each of the target ARTI diagnoses.
次要结局
- Rate of Treatment Failure(Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation)
- Adoption (Staff): Adherence to Protocols(Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation)
- Adoption (Organization): Adherence to Protocols(Baseline month adherence and post implementation (12 months). Maintenance period is 6 months post implementation.)