Deimplementing CXR After CVC (DRAUP) in the ICU
Adapting and Testing a Deimplementation Program in the Intensive Care Unit
Washington University School of Medicine
100 participants
Jan 2, 2024
INTERVENTIONAL
Conditions
Summary
This study proposes adapting and testing an innovative, behavioral theory-driven deimplementation program called DRAUP in two intensive care units for proof of concept and support that the program can help providers and hospital organizations address context determinants of deimplementation. Study data will be used to optimize the intervention for a subsequent larger trials.
Eligibility
Inclusion Criteria12
- Measure the effectiveness and cost effectiveness of DRAUP on discontinuation of CXRs
- (1) ICU faculty, fellows, senior residents (post graduate year 3) and advanced practice practitioners
- ICU inclusion for DRAUP program:
- Availability of ultrasound machines with archiving capability (DICOM)
- A minimum of 100 supradiaphragmatic CVC insertions annually in adult patients (age \>18)
- Capacity to access digital archiving (PICOM)
- Patient inclusion for DRAUP program:
- supradiaphragmatic CVC placed
- Patient exclusion for DRAUP program:
- severe instability (cardiac arrest, severe shock) where CVC would be used without CXR,
- level 1 trauma;
- burn patients with no viable skin surface for imaging
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Interventions
DRAUP deimplementation strategy bundle includes: 1) education and training, 2) supervision and in-person decision support, and 3) audit and feedback to target capability. Opportunity is addressed by 4) algorithm development and 5) organizational support. Finally, 6) facilitators and 7) planned adaptation after interval program assessment address the motivations needed to change behavior.
Locations(1)
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NCT06146348