Deimplementing CXR After CVC (DRAUP) in the ICU

NCT06146348 | Completed DMC

• 2 other identifiers: 2023121135K01HL161026-02
• Study Type: interventional
• Target: 101
• Locations: 1 country
• Sites: 1

Brief Summary

This study proposes adapting and testing an innovative, behavioral theory-driven deimplementation program called DRAUP in two intensive care units for proof of concept and support that the program can help providers and hospital organizations address context determinants of deimplementation. Study data will be used to optimize the intervention for a subsequent larger trials.

Conditions

Behavior and Behavior Mechanisms; Implementation Science

Outcome Measures

Primary Outcomes (1)

• DRAUP in

  Deadoption of CXR after US guided CVC confirmation

  24 months

Secondary Outcomes (1)

• Fidelity

  24 months

Study Arms (2)

CVC confirmed by DRAUP

EXPERIMENTAL

new mode of CVC confirmation for correct location and excluding pneumothorax

Behavioral: adapted DRAUP strategy bundle

CVC confirmed by CXR

EXPERIMENTAL

traditional mode of CVC confirmation for correct location and excluding pneumothorax

Behavioral: adapted DRAUP strategy bundle

Interventions

adapted DRAUP strategy bundle BEHAVIORAL

DRAUP deimplementation strategy bundle includes: 1) education and training, 2) supervision and in-person decision support, and 3) audit and feedback to target capability. Opportunity is addressed by 4) algorithm development and 5) organizational support. Finally, 6) facilitators and 7) planned adaptation after interval program assessment address the motivations needed to change behavior.

CVC confirmed by CXR; CVC confirmed by DRAUP

Eligibility Criteria

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

You may qualify if:

• (1) ICU faculty, fellows, senior residents (post graduate year 3) and advanced practice practitioners
• Availability of ultrasound machines with archiving capability (DICOM)
• A minimum of 100 supradiaphragmatic CVC insertions annually in adult patients (age \>18)
• Capacity to access digital archiving (PICOM)
• supradiaphragmatic CVC placed
• severe instability (cardiac arrest, severe shock) where CVC would be used without CXR,
• level 1 trauma;
• burn patients with no viable skin surface for imaging

Sponsors & Collaborators

• Washington University School of Medicine: lead
• National Heart, Lung, and Blood Institute (NHLBI): collaborator

Study Sites (1)

Washington University School of Medicine

St Louis, Missouri, 63108, United States

Location

MeSH Terms

Conditions

Behavior

Study Officials

• Enyo Ablordeppey, MD MPH

  Washington University School of Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assoc Prof of Anesthesiology

Study Record Dates

• First Submitted: November 17, 2023
• First Posted: November 24, 2023
• Study Start: January 1, 2024
• Primary Completion: December 31, 2025
• Study Completion: December 31, 2025
• Last Updated: April 21, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

US (1)