RecruitingNot ApplicableNCT05975671

Reducing Empiric VAncomycin Use in Pediatric Suspected Sepsis

Reducing Empiric VAncomycin Use in Pediatric Suspected Sepsis (REVAMP-Sepsis)

Sponsor

Children's Hospital of Philadelphia

Enrollment

52,500 participants

Start Date

Aug 21, 2023

Study Type

INTERVENTIONAL

Conditions

Sepsis Septic Shock Sepsis Mrsa Sepsis Bacteremia Antimicrobial - Induced Nephropathy Sepsis, Severe Septic Syndrome

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.

Eligibility

Inclusion Criteria4

Admitted to one of the participating PICUs during the study period
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
Age ≥ 18 years old
Employed by one of the participating sites

Exclusion Criteria3

None
Volunteers or other non-employee hospital staff
Limited English proficiency

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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.