Behavioral Economic and Staffing Strategies To Increase Adoption of an Evidence Based Bundle in the Intensive Care Unit (BEST ICU): A Stepped Wedge Cluster Randomized Controlled Trial
University of Nebraska
Summary
The overarching goal of this study is to support the "real world" assessment of strategies used to foster adoption of several highly efficacious evidence-based practices in healthcare systems that provide care to critically ill adults with known health disparities. Investigators will specifically evaluate two discrete strategies grounded in behavioral economic and implementation science theory (i.e., real-time audit and feedback and registered nurse implementation facilitation) to increase adoption of the ABCDEF bundle in critically ill adults.
Description
Millions of survivors of critical illness worldwide experience profound and frequently persistent physical, mental, and cognitive health impairments that are often preventable through the application of existing knowledge. These impairments are commonly acquired in the intensive care unit (ICU) and are often initiated and/or exacerbated by known racial and socioeconomic health disparities and outdated mechanical ventilation (MV) liberation and symptom management practices. Indeed, ICU-acquired pain, anxiety, delirium, and weakness are associated with numerous adverse health outcomes including…
Eligibility
- Age range
- 19+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age \>19 years at time of ICU admission * Received invasive mechanical ventilation while in the ICU * Admitted to participating cluster ICU * ICU length of stay of at least 24 hours Exclusion Criteria: * Patient who is admitted to the hospital who is already receiving chronic long-term mechanical ventilation from the home, assisted living, or long-term care setting * Prisoners
Interventions
- BehavioralRealtime audit and feedback
ICUs randomized to this arm will receive and electronic dashboard that displays realtime ABCDEF bundle performance data
- BehavioralRN Implementation Facilitator
ICUs randomized to this arm will receive a RN who will assist with ABCDEF bundle implementation
Locations (3)
- University of Iowa Hospitals and ClinicsIowa City, Iowa
- University of Nebraska Medical CenterOmaha, Nebraska
- Ohio State UniversityColumbus, Ohio