Primary Intensivists and Primary Nurses to Decrease Pediatric ICU Length of Stay

NCT03364933 | Completed

• 1 other identifier: AAAR5445
• Study Type: interventional
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

This is a randomized control trial of PICU patients admitted for 7 days and expected to remain for at least another 3 days and who have a complex chronic condition. Patients will be randomized to usual care or usual care plus a primary intensivist and group of primary nurses (to facilitate passing of important patient information and informed, expedited decision-making). The primary research question is whether having a primary intensivist and nurses decreases PICU length of stay.

Conditions

ICU Length of Stay

Keywords

Child; Critical Illness; Length of Stay; Satisfaction

Outcome Measures

Primary Outcomes (1)

• PICU length of stay

  Total number of days in which an individual stays in the PICU

  Up to 2 years

Secondary Outcomes (12)

• Family satisfaction

  Up to 2 years

• Provider satisfaction

  Up to 2 years

• Percentage of family meetings attended by a primary nurse

  Up to 2 years

• Duration of invasive mechanical ventilation in those patients without chronic respiratory failure and who are on invasive mechanical ventilation from the time of enrollment

  Up to 2 years

• Time to tracheotomy in those who undergo a tracheotomy

  Up to 2 years

Study Arms (2)

Primary intensivist and nurses

EXPERIMENTAL

Patients randomized to the experimental arm will have a primary intensivist and a team of primary nurses assigned to them.

Behavioral: Primary intensivist and nurses

Control

NO INTERVENTION

Patients who are randomized to the control group will receive usual care and not be assigned a primary intensivist or nurses.

Interventions

Primary intensivist and nurses BEHAVIORAL

Primary intensivist will have no active role in the daily management of patients. The primary intensivist should facilitate decision-making, be a liaison between the patient/family and PICU team, and be a resource of information for all. Responsibilities of primary intensivist: * Weekly check-in with and availability to patient/family * Attendance at family meetings * Availability to PICU team Primary nurses will be a team of up to 7 ICU nurses who will provide as much of the bedside care as possible. Responsibilities of primary nurses: * Maintain a primary nurse binder (paper format) for on-going communication about the patient among the team members; it will be their discretion what is information is communicated. * The Primary Nurse or delegate will be involved in all team/family meetings and will be expected/given an opportunity to speak during these meetings.

Primary intensivist and nurses

Eligibility Criteria

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

You may qualify if:

• PICU patients of any age who
• have a complex chronic condition
• have been admitted to the PICU for one week and are predicted by the PICU attending to continue to be admitted for at least another 3 days.

Sponsors & Collaborators

• Columbia University: lead

Study Sites (1)

Columbia University Medical Center

New York, New York, 10032, United States

Location

MeSH Terms

Conditions

Critical Illness; Personal Satisfaction

Interventions

Nurses

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Health Personnel; Health Care Facilities Workforce and Services

Study Officials

• Jeffrey Edwards, MD

  Columbia University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Pediatrics

Study Record Dates

• First Submitted: November 28, 2017
• First Posted: December 7, 2017
• Study Start: February 1, 2018
• Primary Completion: February 3, 2020
• Study Completion: February 3, 2020
• Last Updated: July 27, 2020

Record last verified: 2020-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)