Critical Illness
Conditions
Keywords
intensive care, crisis resource management, simulation training, before and after study
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.
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.
Interventions
BEHAVIORALStructured 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.
Sponsors
Holbaek Sygehus
Hillerod Hospital, Denmark
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Masking description
Data analysis
Intervention model description
Before and after interventional study
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* ICU admissions
Exclusion criteria
* None * Drop-out are deaths
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ICU length of stay (LOS) | through study completion, an average of 1 year | Days admitted at the ICU using registre data |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 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 |
| 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 |
| 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 |
| 30-days Mortality | 30 days through study completion, an average of 1 year | 30-days mortality rates after ICU discharge measured by registre data |
Countries
Denmark
Outcome results
None listed