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A cluster randomized trial for the implementation of an antibiotic checklist based on validated quality indicators: the AB-checklist
BACKGROUND: Recently we developed and validated generic quality indicators that define ‘appropriate antibiotic use’ in hospitalized adults treated for a (suspected) bacterial infection. Previous studies have shown that with appropriate antibiotic use a reduction of 13% of length of hospital stay can...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369057/ https://www.ncbi.nlm.nih.gov/pubmed/25888180 http://dx.doi.org/10.1186/s12879-015-0867-2 |
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author | van Daalen, Frederike V Prins, Jan M Opmeer, Brent C Boermeester, Marja A Visser, Caroline E van Hest, Reinier M Hulscher, Marlies E J L Geerlings, Suzanne E |
author_facet | van Daalen, Frederike V Prins, Jan M Opmeer, Brent C Boermeester, Marja A Visser, Caroline E van Hest, Reinier M Hulscher, Marlies E J L Geerlings, Suzanne E |
author_sort | van Daalen, Frederike V |
collection | PubMed |
description | BACKGROUND: Recently we developed and validated generic quality indicators that define ‘appropriate antibiotic use’ in hospitalized adults treated for a (suspected) bacterial infection. Previous studies have shown that with appropriate antibiotic use a reduction of 13% of length of hospital stay can be achieved. Our main objective in this project is to provide hospitals with an antibiotic checklist based on these quality indicators, and to evaluate the introduction of this checklist in terms of (cost-) effectiveness. METHODS/DESIGN: The checklist applies to hospitalized adults with a suspected bacterial infection for whom antibiotic therapy is initiated, at first via the intravenous route. A stepped wedge study design will be used, comparing outcomes before and after introduction of the checklist in nine hospitals in the Netherlands. At least 810 patients will be included in both the control and the intervention group. The primary endpoint is length of hospital stay. Secondary endpoints are appropriate antibiotic use measured by the quality indicators, admission to and duration of intensive care unit stay, readmission within 30 days, mortality, total antibiotic use, and costs associated with implementation and hospital stay. Differences in numerical endpoints between the two periods will be evaluated with mixed linear models; for dichotomous outcomes generalized estimating equation models will be used. A process evaluation will be performed to evaluate the professionals’ compliance with use of the checklist. The key question for the economic evaluation is whether the benefits of the checklist, which include reduced antibiotic use, reduced length of stay and associated costs, justify the costs associated with implementation activities as well as daily use of the checklist. DISCUSSION: If (cost-) effective, the AB-checklist will provide physicians with a tool to support appropriate antibiotic use in adult hospitalized patients who start with intravenous antibiotics. TRIAL REGISTRATION: Dutch trial registry: NTR4872 |
format | Online Article Text |
id | pubmed-4369057 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43690572015-03-22 A cluster randomized trial for the implementation of an antibiotic checklist based on validated quality indicators: the AB-checklist van Daalen, Frederike V Prins, Jan M Opmeer, Brent C Boermeester, Marja A Visser, Caroline E van Hest, Reinier M Hulscher, Marlies E J L Geerlings, Suzanne E BMC Infect Dis Study Protocol BACKGROUND: Recently we developed and validated generic quality indicators that define ‘appropriate antibiotic use’ in hospitalized adults treated for a (suspected) bacterial infection. Previous studies have shown that with appropriate antibiotic use a reduction of 13% of length of hospital stay can be achieved. Our main objective in this project is to provide hospitals with an antibiotic checklist based on these quality indicators, and to evaluate the introduction of this checklist in terms of (cost-) effectiveness. METHODS/DESIGN: The checklist applies to hospitalized adults with a suspected bacterial infection for whom antibiotic therapy is initiated, at first via the intravenous route. A stepped wedge study design will be used, comparing outcomes before and after introduction of the checklist in nine hospitals in the Netherlands. At least 810 patients will be included in both the control and the intervention group. The primary endpoint is length of hospital stay. Secondary endpoints are appropriate antibiotic use measured by the quality indicators, admission to and duration of intensive care unit stay, readmission within 30 days, mortality, total antibiotic use, and costs associated with implementation and hospital stay. Differences in numerical endpoints between the two periods will be evaluated with mixed linear models; for dichotomous outcomes generalized estimating equation models will be used. A process evaluation will be performed to evaluate the professionals’ compliance with use of the checklist. The key question for the economic evaluation is whether the benefits of the checklist, which include reduced antibiotic use, reduced length of stay and associated costs, justify the costs associated with implementation activities as well as daily use of the checklist. DISCUSSION: If (cost-) effective, the AB-checklist will provide physicians with a tool to support appropriate antibiotic use in adult hospitalized patients who start with intravenous antibiotics. TRIAL REGISTRATION: Dutch trial registry: NTR4872 BioMed Central 2015-03-19 /pmc/articles/PMC4369057/ /pubmed/25888180 http://dx.doi.org/10.1186/s12879-015-0867-2 Text en © van Daalen et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Study Protocol van Daalen, Frederike V Prins, Jan M Opmeer, Brent C Boermeester, Marja A Visser, Caroline E van Hest, Reinier M Hulscher, Marlies E J L Geerlings, Suzanne E A cluster randomized trial for the implementation of an antibiotic checklist based on validated quality indicators: the AB-checklist |
title | A cluster randomized trial for the implementation of an antibiotic checklist based on validated quality indicators: the AB-checklist |
title_full | A cluster randomized trial for the implementation of an antibiotic checklist based on validated quality indicators: the AB-checklist |
title_fullStr | A cluster randomized trial for the implementation of an antibiotic checklist based on validated quality indicators: the AB-checklist |
title_full_unstemmed | A cluster randomized trial for the implementation of an antibiotic checklist based on validated quality indicators: the AB-checklist |
title_short | A cluster randomized trial for the implementation of an antibiotic checklist based on validated quality indicators: the AB-checklist |
title_sort | cluster randomized trial for the implementation of an antibiotic checklist based on validated quality indicators: the ab-checklist |
topic | Study Protocol |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369057/ https://www.ncbi.nlm.nih.gov/pubmed/25888180 http://dx.doi.org/10.1186/s12879-015-0867-2 |
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