Reducing chest X-rays after central venous catheter placement in the ICU
Adapting and Testing a Deimplementation Program in the Intensive Care Unit
This study is testing a new program to see if using ultrasound instead of chest X-rays can help ICU patients after getting central venous catheters, making the process faster and more efficient.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Washington University School of Medicine Academic / other |
| Locations | 1 site (St Louis, Missouri) |
| Trial ID | NCT06146348 on ClinicalTrials.gov |
What this trial studies
This study aims to adapt and test a behavioral program called DRAUP in two intensive care units to reduce unnecessary chest X-rays after central venous catheter insertions. The program focuses on implementing ultrasound as a faster and more efficient alternative for confirming catheter placement. By addressing the contextual factors that hinder the adoption of this practice, the study seeks to optimize the intervention for future larger trials. Qualitative and mixed methods will be employed to evaluate the program's effectiveness and cost-effectiveness in the ICU setting.
Who should consider this trial
Good fit: Ideal candidates include adult patients undergoing supradiaphragmatic central venous catheter placement in the ICU.
Not a fit: Patients experiencing severe instability or trauma, where immediate CVC use is critical, may not benefit from this study.
Why it matters
Potential benefit: If successful, this program could significantly reduce unnecessary imaging, improve patient care efficiency, and lower healthcare costs.
How similar studies have performed: Previous studies have shown success with similar deimplementation approaches in emergency departments, suggesting potential for success in the ICU setting.
Eligibility criteria
Show full inclusion / exclusion criteria
-Measure the effectiveness and cost effectiveness of DRAUP on discontinuation of CXRs Inclusion Criteria for DRAUP training: (1) ICU faculty, fellows, senior residents (post graduate year 3) and advanced practice practitioners * ICU inclusion for DRAUP program: * Availability of ultrasound machines with archiving capability (DICOM) * A minimum of 100 supradiaphragmatic CVC insertions annually in adult patients (age \>18) * Capacity to access digital archiving (PICOM) * Patient inclusion for DRAUP program: * supradiaphragmatic CVC placed * Patient exclusion for DRAUP program: * severe instability (cardiac arrest, severe shock) where CVC would be used without CXR, * level 1 trauma; * burn patients with no viable skin surface for imaging
Where this trial is running
St Louis, Missouri
- Washington University School of Medicine — St Louis, Missouri, United States (Recruiting)
Study contacts
- Principal investigator: Enyo Ablordeppey, MD MPH — Washington University School of Medicine
- Study coordinator: Enyo Ablordeppey, MD MPH
- Email: ablordeppeye@wustl.edu
- Phone: 314-362-7021
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.