Adolescent, Critical Care, Intensive Care Units, Pediatric, Pediatric, Telemedicine
Conditions
Keywords
Telemedicine, Pediatric Intensive Care Units, Randomized Controlled Clinical Trial, Technology
Brief summary
This study will be a cluster randomized controlled trial to assess the impact of telemedicine in Pediatric Intensive Care Units (PICU), through daily tele-rounds with a board certified physician and educational activities, in improving clinical-assistance indicators, as well as reducing the length of stay in the PICU.
Detailed description
This is a parallel cluster randomized controlled trial in pediatric intensive care units in Brazil. PICUs is the unit of randomization. All patients admitted to the PICUs selected to participate in the project will be included in the study allocated to the control or intervention group as their respective hospitals are randomized. Intervention group: Tele-rounds are case discussions with remote pediatric intensive care physicians and physicians from other specialties, such as a radiologist, infectious disease specialist, for the debate on conducts based on the best scientific evidence. Additionally, concurrently with the period of application of the intervention, continuing education activities will be made available to all professionals from the teams of the participating centers. Education activities are held monthly and consist of video classes and discussions of complex cases. Control group: This group will maintain the usual care offered by the participating centers.
Interventions
BEHAVIORALTelemedicine Intervention
Tele-Critical Care: 1) establishing a diagnosis 2) guiding the therapeutic approach and 3) performing clinical follow-up. Physicians will discuss all patients in the unit, bed by bed, evaluating the specific clinical situation of each hospitalized patient, according to the protocol developed by the study.The proposal is to maintain horizontal care (the patient is monitored from the 1st day of hospitalization until discharge) for all patients in the unit. \+ Continuing education activities: video classes and discussions of complex cases.
Sponsors
Hospital Moinhos de Vento
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label)
Eligibility
Sex/Gender
ALL
Age
29 Days to 18 Years
Healthy volunteers
No
Inclusion criteria
* All children admitted to the pediatric ICU aged ≥29 days and \<18 years * Length of stay of more than 8 hours and, in case of death, with a length of stay of more than 24 hours
Exclusion criteria
* Patients with incomplete medical records * Incomplete data in the institution's database * Patients whose guardians did not accept to participate in the study and/or who did not sign the informed consent form and the image use term.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lenght of stay | From PICU admission until the date of PICU discharge or death, whichever comes first, assessed up to 90 days | Time until discharge from the Pediatric intensive care unit |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To measure PICU mortality | From PICU admission until the date of PICU discharge or death, whichever comes first, assessed up to 90 days | To measure the mortality rate in PICUs |
| To check the days free from mechanical ventilation | From PICU admission until the date of PICU discharge or death, whichever comes first, assessed up to 90 days | To check the days free from mechanical ventilation of patients hospitalized in PICUs |
| To measure the time of use of vasoactive drugs | From PICU admission until the date of PICU discharge or death, whichever comes first, assessed up to 90 days | To measure the time of use of vasoactive drugs by patients hospitalized in PICUs |
| To measure the time of use of broad-spectrum antibiotics | From PICU admission until the date of PICU discharge or death, whichever comes first, assessed up to 90 days | To measure the time of use of broad-spectrum antibiotics in patients hospitalized in PICUs |
| To measure the time of use of sedation/analgesia | From PICU admission until the date of PICU discharge or death, whichever comes first, assessed up to 90 days | To measure the time of use of sedation/analgesia in patients hospitalized in PICUs |
Contacts
Primary ContactFelipe C Cabral
Backup ContactTaís C Moreira
Outcome results
None listed