Acute Respiratory Distress Syndrome (ARDS)
Conditions
Brief summary
Approximately 300,000 Hispanic individuals experience respiratory failure each year in the U.S. Hispanic patients are twice as likely to die from respiratory failure as non-Hispanic patients. There is an urgent need to identify and remediate mechanisms that increase risk of death from respiratory failure. The team's preliminary work identified two potential mechanisms: Hispanic patients with respiratory failure are more likely to be deeply sedated and less likely to receive physical therapy than non-Hispanic patients, which are both associated with mortality and poor long-term functional outcomes. The overall objective of this proposal is to improve outcomes for patients with respiratory failure through changes in intensive care unit (ICU) practice. This trial will refine and pilot an intervention to promote guideline-concordant care. The team's preliminary intervention will be iteratively refined through patient, family, and clinician engagement and piloted at two U.S. ICUs. The outcome of this study will be an intervention aimed at reducing mortality from respiratory failure.
Interventions
OTHERSafer sedation bundle
This is a unit-level quality improvement intervention to facilitate evidence-based sedation delivery. The quality improvement intervention consists of identification of a safe sedation champion among clinical staff, initiation of sedation rounds, and tools to facilitate structured assessment of sedation depth, delirium, and pain.
Sponsors
New York University
National Heart, Lung, and Blood Institute (NHLBI)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* We will include physicians, nurses, and other staff at participating ICUs who consent to participate.
Exclusion criteria
* We will exclude potential participants who cannot speak either English or Spanish.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility and acceptability | From enrollment to 3 months | The co-primary endpoints are acceptability and feasibility. We will measure acceptability and feasibility in surveys using construct definitions from the Consolidated Framework for Implementation Research (CFIR) . |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient safety culture score | Enrollment through 3 months. | Measured using AHRQ's Survey on Patient Safety Culture. |
Contacts
CONTACTChelsea Chobany, MPH
PRINCIPAL_INVESTIGATORMari Armstrong-Hough, PhD, MPH
New York University School of Global Public Health
PRINCIPAL_INVESTIGATORThomas Valley, MD, MSc
University of Colorado Anschutz School of Medicine
Outcome results
None listed