Study of Knowledge Translation of Clinical Practice Guidelines for Ventilator Associated Pneumonia

Ventilator Associated Pneumonia Clinical Trial

— ABATEVAP  

Official title:

Active Observational Study of the Adoption and Transfer of Clinical Practice Guidelines Through Education, for Ventilator Associated Pneumonia (ABATE VAP Study)

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00434460
• Other study ID #: ABATE VAP
• 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
• 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

Related Conditions & MeSH terms

• Pneumonia
• Pneumonia, Ventilator-Associated
• Ventilator Associated Pneumonia

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, 

External Links

•   Link