Status:

COMPLETED

Improving Morbidity During Post-Acute Care Transitions for Sepsis

Lead Sponsor:

Wake Forest University Health Sciences

Conditions:

Clinical Sepsis

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

The purpose of this study is to improve transitions of care for the highest risk, complex patients with suspected sepsis. Atrium Health has developed a nurse-navigator facilitated care transition stra...

Detailed Description

BACKGROUND Sepsis is a common and life-threatening condition defined by organ dysfunction due to a dysregulated response to infection (Fleischmann, 2016). Aggressive early sepsis identification and t...

Eligibility Criteria

Inclusion

  • Admitted from the emergency department to inpatient or observation status at one of: Carolinas Medical Center, Carolinas Medical Center - Mercy, or Atrium Health Northeast;
  • ≥18 years of age upon admission;
  • oral/parenteral antibiotic or bacterial culture order within 24 hours of emergency department presentation and
  • culture drawn first, antibiotics ordered within 48 hours or
  • antibiotics ordered first, culture ordered within 48 hours (adapted from criteria applied in development of the Third International Consensus Definitions for Sepsis and Septic Shock)
  • deemed as high-risk for 30-day readmission (i.e., ≥ 20%) or 30-day mortality (i.e., ≥ 10%) using risk-scoring models
  • not discharged at the time of patient list generation

Exclusion

  • prior randomization to either STAR or usual care study arms;
  • not a North Carolina resident or residence \>2.5-hour drive time from treating hospital;
  • the only antibiotic associated with patient is administered in the operating room as this likely represents pre-operative infection prophylaxis and not presumed infection;
  • patients transferred from other acute care hospitals;
  • patients with a change in code status (i.e., do not resuscitate, do not intubate) within 24 hours after admission due to the general assumption of increased risk of exposure to less aggressive treatment;
  • patients with infection ruled out during the index hospitalization.

Key Trial Info

Start Date :

January 29 2019

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

December 31 2021

Estimated Enrollment :

712 Patients enrolled

Trial Details

Trial ID

NCT03865602

Start Date

January 29 2019

End Date

December 31 2021

Last Update

April 25 2022

Active Locations (1)

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Atrium Health

Charlotte, North Carolina, United States, 28203