Optimized Admission to the Intensive Care Unit by Using Crisis Resource Management (CRM)
Study Details
Study Description
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
The quantitative before-data is a one-year observational period prior to the intervention measured by different perspectives; patients and staff outcomes.
After the intervention, was qualititive data collected from participants, who received simulation training.
The quantitative after-data is a one-year observational period post-intervention with same outcomes as before starting the intervention.
Data is already collected registry data from hospital quality assurance board. Data will be compared before and after with assessor blinded analysis. Missing data will not be replaced but reported as missing.
The investigators will try to compare the results with data from an approximately comparative ICU in Denmark due to the implementation of a new patient management system called the Health Portal.
The statistical analysis plan is based on descriptive and comparative analyses of the group before and after the trial. The quantitative results are explained in in-depths description from participants.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Structured Admission procedure 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
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.
Other Names:
|
| No Intervention: Standard Care Randomly admission procedure to all ICU patients based on the clinicians' evaluation prior implementation of the intervention. |
Outcome Measures
Primary Outcome Measures
- ICU length of stay (LOS) [through study completion, an average of 1 year]
Days admitted at the ICU using registre data
Secondary Outcome Measures
- Hospital length of stay (LOS) [At Hospital discharge within one-year before and after the intervention implementation]
Days admitted to the hospital using registre data
- Line Sepsis [through study completion, an average of 1 year]
Treatment package of number of the line sepsis after ICU admission covering the number of patients with line sepsis using registre data on Lactat <1 hour, bacteria samples ≤1 hour taken, time between diagnosis of sepsis and taken bacteria samples, time between diagnosis and given antibiotics measured by registre data
- Ventilated associated pneumonia (VAP) [through study completion, an average of 1 year]
Number of VAP measured by registre data
- Re-intubations [through study completion, an average of 1 year]
Number of re-intubations measured by registre data
- 30-days Mortality [30 days through study completion, an average of 1 year]
30-days mortality rates after ICU discharge measured by registre data
- 90-days Mortality [90 days through study completion, an average of 1 year]
90-days mortality rates after ICU discharge measured by registre data
- Staff turn-over [through study completion, an average of 1 year]
Staff turn-over before and after the intervention measured by registre data
- Sick Leave [through study completion, an average of 1 year]
Sick leave amongst staff members measured by registre data
Eligibility Criteria
Criteria
Inclusion Criteria:
- ICU admissions
Exclusion Criteria:
-
None
-
Drop-out are deaths
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Department of Anaestesiology | Holbæk | Denmark | 4300 |
Sponsors and Collaborators
- Hillerod Hospital, Denmark
- Holbaek Sygehus
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 113581
- 113581