Implementation of Coordinated Spontaneous Awakening and Breathing Trials Using Telehealth-Enabled, Real-Time Audit and Feedback for Clinician Adherence: A Type II Hybrid Effectiveness-Implementation
Intermountain Health Care, Inc.
Summary
The purpose of this trial is to evaluate if augmenting a usual audit and feedback implementation approach with telehealth-enabled support improves coordinated spontaneous awakening/breathing trials and patient outcomes for mechanically ventilated patients.
Description
Sedation and analgesia are utilized with invasive mechanical ventilation (IMV) to improve patient comfort and synchrony with the mechanical ventilator. Prolonged sedation, however, may result in increased time on IMV and increased risk for ventilator associated pneumonia, delirium, and poor long-term cognitive outcomes. Daily interruptions in sedation \[spontaneous awakening trials (SAT)\] coordinated with daily spontaneous breathing trials (SBT) reduce mortality, increase ventilator free days, decrease intensive care unit (ICU) length of stay, and reduces ventilator-associated events. Coordin…
Eligibility
- Age range
- 16+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion criteria: * Patient age \>=16 years admitted to study hospital ICU * Intubated and mechanically ventilated Exclusion criteria: * Patient with pre-existing brain death admitted to study hospital for organ donation * Died within 24 hours of intubation
Interventions
- OtherTelehealth- enabled support for SAT/SBT adherence
Telehealth-enabled support over and above usual audit and feedback includes identifying candidates for spontaneous awakening and breathing trials, prompting bedside providers and guiding execution of the coordinated spontaneous awakening and breathing trials as needed.
- OtherUsual audit and feedback for SAT/SBT adherence
Usual audit and feedback
Locations (11)
- American Fork HospitalAmerican Fork, Utah
- Cedar City HospitalCedar City, Utah
- Layton HospitalLayton, Utah
- Logan Regional HospitalLogan, Utah
- Intermountain Medical CenterMurray, Utah
- Mckay Dee HospitalOgden, Utah