Nurse-led Antimicrobial Stewardship Intervention to Increase Antibiotic Appropriateness in Residential Aged Care Facilities
NCT ID: NCT03941509
Last Updated: 2022-01-13
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
NA
700 participants
INTERVENTIONAL
2021-01-01
2022-06-30
Brief Summary
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Detailed Description
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The antimicrobial stewardship intervention will include the following components:
1. Education
* Focused on antimicrobial stewardship and appropriate antimicrobial use
* Delivered face-to-face, via workbooks and fact sheets to aged care staff, general practitioners (GPs), pharmacists, and residents and families. Education will be delivered by the research coordinator.
2. Guidelines
* Aged care-specific guidelines for the assessment and antimicrobial management of urinary tract infections, respiratory tract infections and skin and soft tissue infections.
* Antimicrobial management recommendations including empirical oral therapy, doses and duration of therapy.
3. Communication
* Documentation for the assessment and antimicrobial management of infections.
* Nurse-led engagement with residents and families.
* Newsletters and online updates to highlight evidence-based prescribing practice
4. Audit and feedback - Surveillance and feedback to prescribers on antimicrobial use and facility-level antimicrobial susceptibility data.
The intervention bundle will first be implemented and tested for feasibility and acceptability over a 3-month period in two RACFs in Victoria, Australia. This tailored intervention will then be assessed in a stepped-wedge cluster randomised controlled trial across 12 RACFs over an 16-month period.
A cluster of two facilities will each transition through three phases over the 16 month trial:
* Control phase: baseline data collection. Usual care at each facility.
* Transition phase: Delivery of education and integration of the intervention. No data collection.
* Intervention phase: implementation of the intervention and outcome data collection. Ongoing education to new and existing staff will be provided as required.
Following the 16-month trial, the refined intervention bundle will be implemented nationally across a network of RACFs.
Conditions
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Study Design
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RANDOMIZED
CROSSOVER
TREATMENT
NONE
Study Groups
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Control
All facilities will receive usual care during the control phase of the trial.
No interventions assigned to this group
Antimicrobial stewardship
Implementation of the nurse-led bundled antimicrobial stewardship intervention
Antimicrobial stewardship
Education, guidelines, communication tools and audit and feedback
Interventions
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Antimicrobial stewardship
Education, guidelines, communication tools and audit and feedback
Eligibility Criteria
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Inclusion Criteria
* All residents from 12 RACFs will have de-identified data collected including antimicrobial use, infection, hospitalisation and mortality.
* Residents or their guardians who provide informed consent to monthly biospecimen sampling and participation in one-on-one interviews or focus groups.
Health professionals:
\- Health professionals (including aged care staff and GPs) who provide informed consent to participate in one-on-one interviews or focus groups.
Exclusion Criteria
* Health professionals who do not consent to participate in interviews/focus groups.
ALL
No
Sponsors
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Bupa Aged Care Australia
UNKNOWN
Monash University
OTHER
Bayside Health
OTHER_GOV
Responsible Party
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Principal Investigators
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Anton Peleg, MBBS, PhD, FRACP, PhD
Role: PRINCIPAL_INVESTIGATOR
Monash University
Locations
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Bupa residential aged care facilities
Melbourne, Victoria, Australia
Countries
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Central Contacts
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References
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Jokanovic N, Haines T, Cheng AC, Holt KE, Hilmer SN, Jeon YH, Stewardson AJ, Stuart RL, Spelman T, Peel TN, Peleg AY; START Trial Group. Multicentre stepped-wedge cluster randomised controlled trial of an antimicrobial stewardship programme in residential aged care: protocol for the START trial. BMJ Open. 2021 Mar 2;11(3):e046142. doi: 10.1136/bmjopen-2020-046142.
Other Identifiers
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591/18
Identifier Type: -
Identifier Source: org_study_id
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