Optimized Admission to the Intensive Care Unit by Using Crisis Resource Management (CRM)

NCT03268967 | Unknown DMC

• 1 other identifier: 113581
• Study Type: interventional
• Target: 1,800
• Locations: 1 country
• Sites: 1

Brief Summary

Admission to the intensive care unit (ICU) is vital for surviving critical illness. An admission to ICU without having a consistent structure, structured review of the patient and a solid team organization lead to unclear communication and responsibility. Factors that correlate with patient acceptance and safety, morbidity and mortality. The hypothesize was that a structured admission can improve patients safety, reduce delays in treatment, reduce ICU length of stay, and improve mortality rate. The overall objective was to optimize patient safety, and effectively use available resources to reduce admission time, delays in treatment and procedures and mortality by using both quantitative and qualitative methods.

Conditions

Critical Illness

Keywords

intensive care; crisis resource management; simulation training; before and after study

Outcome Measures

Primary Outcomes (1)

• ICU length of stay (LOS)

  Days admitted at the ICU using registre data

  through study completion, an average of 1 year

Secondary Outcomes (8)

• Hospital length of stay (LOS)

  At Hospital discharge within one-year before and after the intervention implementation

• Line Sepsis

  through study completion, an average of 1 year

• Ventilated associated pneumonia (VAP)

  through study completion, an average of 1 year

• Re-intubations

  through study completion, an average of 1 year

• 30-days Mortality

  30 days through study completion, an average of 1 year

Study Arms (2)

Structured Admission procedure

ACTIVE COMPARATOR

After implementation of a structured admission procedure to all ICU patients inspired by principles of Crisis Resource Management, Closed loop communication, action cards, and staff simulation training

Behavioral: Structured admission procedure

Standard Care

NO INTERVENTION

Randomly admission procedure to all ICU patients based on the clinicians' evaluation prior implementation of the intervention.

Interventions

Structured admission procedure BEHAVIORAL

A structured ICU admission was inspired by principles of Crisis Resource Management and simulation training of ICU staff members. The Principles of Crisis Resource Management consisted of a treatment manual, a learning video, clear precise communication tool based on Identification-Situation-Background-Analysis-Recommendations (ISBAR) and Closed loop, actions cards, and ABCDE-evaluation of the patient including debriefing, and training in the simulation environment.

Also known as: Standard Care

Structured Admission procedure

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• ICU admissions

You may not qualify if:

• None
• Drop-out are deaths

Sponsors & Collaborators

• Hillerod Hospital, Denmark: lead
• Holbaek Sygehus: collaborator

Study Sites (1)

Department of Anaestesiology

Holbæk, 4300, Denmark

Location

MeSH Terms

Conditions

Critical Illness

Interventions

Standard of Care

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Quality Indicators, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Data analysis
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PHD, Principal Investigator

Model Details: Before and after interventional study

Study Record Dates

• First Submitted: August 28, 2017
• First Posted: August 31, 2017
• Study Start: April 1, 2014
• Primary Completion: October 1, 2017
• Study Completion: December 31, 2018
• Last Updated: March 9, 2018

Record last verified: 2018-03

Locations

DK (1)