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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00434460
Other study ID # ABATE VAP
Secondary ID
Status Completed
Phase N/A
First received February 12, 2007
Last updated August 31, 2010
Start date April 2007
Est. completion date July 2010

Study information

Verified date August 2010
Source Canadian Critical Care Trials Group
Contact n/a
Is FDA regulated No
Health authority Canada: Canadian Institutes of Health Research
Study type Observational

Clinical Trial Summary

The purpose of this prospective, multicentre, time-series study is to develop, implement, refine, and evaluate a sustainable behaviour change strategy in the intensive care unit (ICU).


Description:

Background:

In order to improve the care of our patients, it is necessary for research evidence to be translated into clinical practice. There are gaps in our understanding of knowledge translation (KT) and this is evident in the Intensive Care Unit (ICU), specifically as it applies to the prevention, diagnosis and treatment of ventilator-associated pneumonia (VAP). VAP is associated with a high burden of illness in the critically ill and there is an extensive amount of research evidence on this disease. It has been demonstrated that best practice as defined by research evidence is not uniformly applied to VAP. In addition, recent advances in VAP knowledge need be disseminated and implemented in order to improve patient safety and outcomes from VAP. A systematic process of knowledge transfer is crucial to translate this research into evidence-based bedside practice and the development and implementation of evidence based Clinical Practice Guidelines (CPGs) may facilitate VAP knowledge uptake. In addition, there is a need to study knowledge translation (KT) in the ICU since there is little information about optimal KT and CPG implementation strategies in this environment and efforts that are effective in other clinical areas may not result in meaningful change in the ICU.

Research Question:

What is the effect of VAP CPGs implemented by a multidisciplinary behaviour change strategy (consisting of multifaceted educational strategies led by local opinion leaders and augmented with reminders) on VAP guideline concordance and on clinical VAP outcomes in the ICU?

Research Plan:

Data will only be collected on consecutive patients mechanically ventilated for at least 48 hours. The following health care professionals will be studied to assess the behaviour change strategy for the VAP CPGs: physicians (intensivists, ICU fellows, ICU rotating residents), nurses, respiratory therapists, dieticians, physiotherapists and ICU administrators.

The study will be conducted in 3 phases:

1. Development of a behaviour change strategy consisting of three components:

- Local opinion leader team

- Educational strategy

- Reminder system

2. Prospective implementation of the behaviour change strategy over a 24 month period

3. Prospective evaluation of the behaviour change strategy over a 24 month period

- Concordance with VAP guidelines over time

- Factors associated with VAP guideline concordance

- Clinical VAP outcomes pre- and post-guideline implementation


Recruitment information / eligibility

Status Completed
Enrollment 1320
Est. completion date July 2010
Est. primary completion date
Accepts healthy volunteers No
Gender Both
Age group 17 Years and older
Eligibility Inclusion Criteria:

- Age >= 17 years old

- Mechanically ventilated > 48 hours < 96 hours

Exclusion Criteria:

- Previous enrollment in the study

Study Design

Observational Model: Cohort, Time Perspective: Prospective


Intervention

Behavioral:
Education
Implementation of clinical practice guideline for ventilator associated pneumonia through education.

Locations

Country Name City State
Canada St. Joseph's Healthcare, McMaster University Hamilton Ontario
Canada Kingston General Hospital, Queen's University Kingston Ontario
Canada Royal Columbian Hospital, University of British Columbia New Westminister British Columbia
Canada The Ottawa Hospital, University of Ottawa Ottawa Ontario
Canada Thunder Bay Regional Health Sciences Centre Thunder Bay Ontario
Canada Sunnybrook Health Sciences Centre, University of Toronto Toronto Ontario
Canada William Osler Health Centre Toronto Ontario
Canada St. Paul Hospital, University of British Columbia Vancouver British Columbia
Canada Vancouver Island Health Research Centre Victoria British Columbia
Canada Hotel Dieu Grace Hospital Windsor Ontario
United States Geisinger Health Centre, Temple University Danville Pennsylvania

Sponsors (5)

Lead Sponsor Collaborator
Canadian Critical Care Trials Group AstraZeneca, Bayer, Canadian Institutes of Health Research (CIHR), Kingston General Hospital

Countries where clinical trial is conducted

United States,  Canada, 

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