METEOR Think NIV Pilot
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About
This study will pilot test three strategies designed to speed implementation of preventive post-extubation noninvasive ventilation (NIV): one control strategy (traditional online continuing medical education) and two novel strategies (interprofessional education and just-in-time education).
Full description
During a one-month intervention period, the investigators will pilot test the educational strategies in three participating UPMC ICUs. Prior to receiving education, participants will be invited to complete a short online survey. Participants in the control group will be invited to complete a 30-minute online continuing education module, which will conclude with a survey. Participants in the interprofessional education group will be invited to attend a 90-minute, in-person, interprofessional education session that will occur in or near the participating ICU. A trained advance practice provider will provide participants in the just-in-time education group with 5-10 minutes of education in the ICU when the ICU team is rounding on a patient who is identified to be high risk for extubation failure. The just-in-time education may occur more than once per day, depending on the number of high-risk patients identified. All educational strategies will include content on the benefits of preventive post-extubation NIV, the indications and contraindications for preventive post-extubation NIV, and the value of working together as an interprofessional ICU team when implementing preventive post-extubation NIV. Each educational intervention will include a survey designed to determine the feasibility, acceptability, and preliminary impact of the educational strategies. The investigators will also directly observe instances of interprofessional and just-in-time education and conduct in-person interviews to assess these factors in a qualitative manner. Lastly, during the intervention period and the 6 months before and after the intervention period, the investigators will collect data from the electronic health record and analyze changes in percent of high-risk patients who receive preventive post-extubation NIV, reintubation rate, duration of mechanical ventilation, ventilator-associated pneumonia, and in-hospital mortality.
Enrollment
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Inclusion and exclusion criteria
Two study populations will be included.
Learners (population 1) will include:
- frontline care providers, including physicians, advanced practice providers, nurses, and respiratory therapists
- working in a participating ICU.
Frontline care providers will be excluded if they:
- have not worked in their current UPMC ICU for more than one month prior to the current study
- have not directly cared for a mechanically ventilated patient in a UPMC ICU during the three months preceding the current study.
Patients (population 2) will include:
- mechanically ventilated patients
- treated in the participating ICUs
- surviving to extubation
Trial design
Primary purpose
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Interventional model
Masking
1,328 participants in 3 patient groups
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Data sourced from clinicaltrials.gov
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