Clinical trial NCT06512805: Implementation Study of Intra-hospital Transfer of Pediatric Inpatients
Official title: Implementation Study of Intra-hospital Transfer of Pediatric Inpatients Based on the EPIS Model
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Implementation Science
Transportation of Patients
Lead sponsor: Children's Hospital of Fudan University
Sponsor class: OTHER
First posted: 2024-07-22
Enrollment: 214
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: OTHER

Brief summary: This study implemented the "Clinical Practice Guidelines for In-hospital Transfer of Pediatric Inpatients (2023 edition)" released by the research team in June 2023 in real clinical settings. It employed an effectiveness-implementation hybrid research design to evaluate the process and effects of the guidelines in clinical practice. The research objectives include the following aspects:

Identifying barriers to the implementation of the guidelines in clinical practice.

Constructing implementation strategies to facilitate the application of the guidelines based on identified barriers.

Evaluating the impact of implementation strategies on clinical healthcare personnel and the clinical environment.

Assessing the effect of in-hospital transfer of pediatric inpatients based on the guidelines on reducing adverse events related to in-hospital transfers and other clinical outcomes.

Participants will:

In the control group, healthcare personnel conduct transfers according to the routine management and working mode of the emergency department and pediatric intensive care unit (PICU).

In the intervention group, nurses receive implementation strategies developed during the preparation phase. These strategies are aimed at modifying the behavior of healthcare personnel through implementation, thereby conducting in-hospital transfers for pediatric patients based on the guidelines.

Detailed description: The demand for in-hospital transfers is high, and their occurrence rate is frequent, making them an unavoidable routine in hospital settings due to emergency patients, postoperative patients, and those highly dependent on specialized medical equipment. Research statistics indicate that out of 371 patients admitted to the neonatal ward, there were 1402 transfers, while 506 emergency department patients accounted for 2715 in-hospital transfers. Additionally, 43.5% of patients in the intensive care unit required repeated transfers, with 45% of them needing two or more transfers. According to a systematic review by Haydar et al., adverse event rates during in-hospital pediatric transfers ranged from 0.11% to 75%, with the most common events being hypoxemia (13%-21%), hypotension (3.3%-37.5%), chest compressions (7.5%), dislodgement/accidental removal of catheters (3.8%), and interruption of vasopressor infusions (5%). Therefore, ensuring the safety of in-hospital transfers for pediatric patients is a crucial aspect of healthcare workers' responsibilities. Standardizing the in-hospital transfer process to minimize adverse events is vital for the well-being of pediatric patients.

Thus, this study focuses on in-hospital transfers of pediatric patients, aiming to identify current clinical issues and implement strategies based on the "Clinical Practice Guidelines for In-hospital Transfer of Pediatric Inpatients (2023 edition)." Conducted at the Children's Hospital affiliated with Fudan University, the research aims to develop implementation strategies and evaluate the impact of evidence and implementation strategies on pediatric inpatients, the evidence-based practice behavior of clinical healthcare personnel, and changes in the hospital organizational environment. The goal is to alter current clinical practices, standardize the in-hospital transfer process for pediatric patients, and further reduce adverse events associated with in-hospital transfers.

Eligibility criteria: Inclusion Criteria:

* Those who had worked in the study site for more than 1 year;

  * Those who can carry out intra-hospital transport independently;

    * Staff on duty during the study period

Exclusion Criteria:

* Those who have not obtained a practicing qualification certificate;

  * Refusal to participate in the study；

Primary outcomes:
measure: The compliance of healthcare personnel with evidence-based practice.
timeFrame: Three months before and three months after the intervention
measure: Intra-hospital transfer time
timeFrame: Three months before and three months after the intervention
measure: Bedside handover time
timeFrame: Three months before and three months after the intervention
measure: Completeness of information handover
timeFrame: Three months before and three months after the intervention
measure: Rate of adverse events during in-hospital transfers
timeFrame: Three months before and three months after the intervention
measure: Healthcare personnel's knowledge level of in-hospital transfers
timeFrame: One month before and one month after the intervention
Secondary outcomes:
Other outcomes:
Locations:
city: Shanghai
country: China
facility: Children's Hospital of Fudan University
Study officials:
affiliation: Children's Hospital of Fudan University
name: Ying Gu, Doctor
role: STUDY_DIRECTOR
References: