Reducing Empiric VAncomycin Use in Pediatric Suspected Sepsis (REVAMP-Sepsis)
Children's Hospital of Philadelphia
Summary
The goal of this quasi-experimental interventional study is to determine the effectiveness of a multifaceted stewardship intervention in reducing overall vancomycin use in five tertiary care Pediatric Intensive Care Units (PICU). There are two groups of subjects in this study: PICU clinicians/sepsis stakeholders and patients admitted to one of the participating PICUs during the study period. The intervention will at a minimum include: * Implementation of a clinical guideline indicating when vancomycin should and should not be used * Unit-level feedback on overall vancomycin use within and across centers * Clinician education.
Description
Vancomycin is among the most commonly prescribed antibiotics in United States children's hospitals, and inappropriate use of vancomycin is common. Given the high prevalence of acute kidney injury associated with vancomycin of up to 25%, reducing vancomycin overuse is a key opportunity to reduce preventable patient harm. The primary objective of this study is to determine the effectiveness of a multifaceted stewardship intervention in reducing overall vancomycin use in five tertiary care PICUs. This intervention will be informed by baseline data surrounding vancomycin use and infections due to…
Eligibility
- Age range
- Not specified
- Sex
- All
- Healthy volunteers
- No
Patient Inclusion Criteria: * Admitted to one of the participating PICUs during the study period Patient Exclusion Criteria: * None Clinician Inclusion Criteria: 1. PICU prescribing clinician (including attending physicians, fellows, residents, nurse practitioners, and physician assistants) OR sepsis stakeholder (leader of sepsis quality improvement work, medical director) at one of the participating sites at the time the survey is deployed 2. Age ≥ 18 years old 3. Employed by one of the participating sites Clinician Exclusion Criteria: 1. Volunteers or other non-employee hospital staff…
Interventions
- BehavioralMultifaceted de-implementation strategy to reduce vancomycin overuse
* Clinical guidelines and group-level feedback on vancomycin use will be provided to clinicians/sepsis stakeholders at each site. * The semi-structured interviews will be performed by a trained member of the research team, under the supervision of a medical sociologist who is one of the co-investigators. A semi-structured interview guide will be used during the interviews. Interviews will be recorded and transcribed, then uploaded to a qualitative analysis software for management and coding. Names will not be recorded, and pseudonyms will be used in notes, communications about the study, and any presentations. Verbal consent will be obtained before conducting and recording the interviews. * The surveys will be performed using REDCap survey software, and participation will be voluntary. No identifiers will be collected.
Locations (4)
- Children's Healthcare of AtlantaAtlanta, Georgia
- Johns Hopkins Children's CenterBaltimore, Maryland
- St. Louis Children's HospitalSt Louis, Missouri
- Children's Hospital of PhiladelphiaPhiladelphia, Pennsylvania