Evaluation of the Clinical Impact of Different Telemedicine Practices in Intensive Care Units

Summary

The objective of this study is to assess whether an intervention package via telemedicine consisting of daily multidisciplinary rounds with a specialist in intensive care medicine, an intervention package provided by a specialized multiprofessional team (nursing, physical therapy and clinical pharmacy) and a management intervention package, focused on quality and safety, reduces the length of stay in ICU patients in Brazil. Our hypothesis is that the intervention package via telemedicine has the potential to decrease the length of stay in ICU patients in Brazil.

The study provides for the implementation of three interventions in association via telemedicine.

* Daily multidisciplinary rounds conducted by a physician specialized in intensive care medicine
* Intervention package by specialized multidisciplinary team (nursing, physiotherapy and clinical pharmacy).
* Management intervention package (quality and safety).

The main questions it aims to answer are:

* Length of stay in ICU
* ICU mortality.
* In-hospital mortality.
* Ventilator-free days during the first 28 days.
* ICU readmission within 48 hours.
* Early reintubation (\<48h after elective extubation).
* Ventilator-associated events.
* Accidental extubation rate.
* Patient Mobilization Density.
* Adherence to maintaining the head-of-bed elevation.
* Adequate prevention of venous thromboembolism.
* Rate of patient-days under adequate sedation.
* Rate of patients-days with oral or enteral nutrition.
* Rate of patients with adequate glycemic control.
* Rate of patients-days within normoxemia.
* Rate of central venous catheter use.
* Central venous catheter dwell time.
* Rate of indwelling urinary catheter use.
* Indwelling urinary catheter dwell time.
* Standard resource use.
* Standardized mortality rate.

Conditions

• Telemedicine
• Critical Care
• Intensive Care Units

Interventions

OTHER

Intervention period

During the intervention period, three interventions will be implemented through telemedicine. 1. A daily multidisciplinary round conducted by a physician specialized in intensive care medicine. 2. A intervention package administered by a specialized multidisciplinary team, consisting of nursing, physiotherapy, and clinical pharmacy. 3. A management intervention package will be implemented, with a specific focus on enhancing quality and safety.

Sponsors & Collaborators

• Ministry of Health, Brazil

  collaborator OTHER_GOV

• Hospital Israelita Albert Einstein

  lead OTHER

Principal Investigators

• Adriano J Pereira, MD, PhD · Hospital Israelita Albert Einstein

• Renato CF Chaves, MD, PhD, MBA · Hospital Israelita Albert Einstein

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-01-08

Primary Completion

2026-01-31

Completion

2026-05-01

Countries

• Brazil

Study Locations