Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation
Background Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury-respi...
Gespeichert in:
| Veröffentlicht in: | PloS one 2021-10, Vol.16 (10), p.e0256027-e0256027 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0256027 |
|---|---|
| container_issue | 10 |
| container_start_page | e0256027 |
| container_title | PloS one |
| container_volume | 16 |
| creator | Curtis, Kate Kourouche, Sarah Asha, Stephen Considine, Julie Fry, Margaret Middleton, Sandy Mitchell, Rebecca Munroe, Belinda Shaban, Ramon Z. D’Amato, Alfa Skinner, Clare Wiseman, Glen Buckley, Thomas |
| description | Background Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury-respiratory support, analgesia and complication prevention. ChIP was implemented using a multi-faceted implementation plan developed using the Behaviour Change Wheel. Methods This controlled pre-and post-test study (two intervention and two non-intervention sites) was conducted from July 2015 to June 2019. The primary outcome measures were unplanned Intensive Care Unit (ICU) admissions, non-invasive ventilation use and mortality. Results There were 1790 patients included. The intervention sites had a 58% decrease in non-invasive ventilation use in the post- period compared to the pre-period (95% CI 0.18-0.96). ChIP was associated with 90% decreased odds of unplanned ICU admissions (95% CI 0.04-0.29) at the intervention sites compared to the control groups in the post- period. There was no significant change in mortality. There were higher odds of health service team reviews (surgical OR 6.6 (95% CI 4.61-9.45), physiotherapy OR 2.17 (95% CI 1.52-3.11), ICU doctor OR 6.13 (95% CI 3.94-9.55), ICU liaison OR 55.75 (95% CI 17.48-177.75), pain team OR 8.15 (95% CI 5.52 --12.03), analgesia (e.g. patient controlled analgesia OR 2.6 (95% CI 1.64-3.94) and regional analgesia OR 8.8 (95% CI 3.39-22.79), incentive spirometry OR 8.3 (95% CI 4.49-15.37) and, high flow nasal oxygen OR 22.1 (95% CI 12.43-39.2) in the intervention group compared to the control group in the post- period. Conclusion The implementation of a chest injury care bundle using behaviour change theory was associated with a sustained improvement in evidence-based practice resulting in reduced unplanned ICU admissions and non-invasive ventilation requirement. Trial registration ANZCTR: ACTRN12618001548224, approved 17/09/2018 |
| doi_str_mv | 10.1371/journal.pone.0256027 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2580001133</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A678258839</galeid><doaj_id>oai_doaj_org_article_799be2a7c31a4cbd96e660b234f267d7</doaj_id><sourcerecordid>A678258839</sourcerecordid><originalsourceid>FETCH-LOGICAL-c570t-519d3599c18e371c8f704670112c18e88bcada9ffd92a01d83a3501c3e0d38d03</originalsourceid><addsrcrecordid>eNptkk1vEzEQhlcIREvhHyBhiUt7SPDHrj84IEVRgUiV4ABny2t7E0dee7F3W_Xf4yQLIqjywdb49TPzjqeq3iK4RIShD_s4paD8cojBLiFuKMTsWXWJBMELiiF5_s_5onqV8x7ChnBKX1YXpKaIc9xcVg-bflB6BLEDCmiVLGinYLwFXUxgUKOzYczgwY070PopjEDvbB6BC_spPYLr9W7z_eYjWIF-8qPTRVwIOpYtem8NcP3gbV_ChRQDsPfKT8fj6-pFp3y2b-b9qvr5-fbH-uvi7tuXzXp1t9ANg-OiQcKQRgiNuC2mNe8YrCmDCOFDiPNWK6NE1xmBFUSGE0UaiDSx0BBuILmq3p24g49Zzj3LEjccwkIhpCg2J4WJai-H5HqVHmVUTh4DMW2lSsWbt5IJ0VqsmCZI1bo1glpKYYtJ3WHKDCusT3O2qe2tOfZD-TPo-U1wO7mN95LXgnKMCuB6BqT4ayqdlr3L2nqvgo3TqW4qUMMO0vf_SZ92N6u2qhhwoYslrz5A5YqyMgKcE1FUyydUZRnbu_KdtnMlfvagPj3QKeacbPfXI4LyMJ5_ipGH8ZTzeJLfOiLYog</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2580001133</pqid></control><display><type>article</type><title>Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Curtis, Kate ; Kourouche, Sarah ; Asha, Stephen ; Considine, Julie ; Fry, Margaret ; Middleton, Sandy ; Mitchell, Rebecca ; Munroe, Belinda ; Shaban, Ramon Z. ; D’Amato, Alfa ; Skinner, Clare ; Wiseman, Glen ; Buckley, Thomas</creator><creatorcontrib>Curtis, Kate ; Kourouche, Sarah ; Asha, Stephen ; Considine, Julie ; Fry, Margaret ; Middleton, Sandy ; Mitchell, Rebecca ; Munroe, Belinda ; Shaban, Ramon Z. ; D’Amato, Alfa ; Skinner, Clare ; Wiseman, Glen ; Buckley, Thomas</creatorcontrib><description>Background Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury-respiratory support, analgesia and complication prevention. ChIP was implemented using a multi-faceted implementation plan developed using the Behaviour Change Wheel. Methods This controlled pre-and post-test study (two intervention and two non-intervention sites) was conducted from July 2015 to June 2019. The primary outcome measures were unplanned Intensive Care Unit (ICU) admissions, non-invasive ventilation use and mortality. Results There were 1790 patients included. The intervention sites had a 58% decrease in non-invasive ventilation use in the post- period compared to the pre-period (95% CI 0.18-0.96). ChIP was associated with 90% decreased odds of unplanned ICU admissions (95% CI 0.04-0.29) at the intervention sites compared to the control groups in the post- period. There was no significant change in mortality. There were higher odds of health service team reviews (surgical OR 6.6 (95% CI 4.61-9.45), physiotherapy OR 2.17 (95% CI 1.52-3.11), ICU doctor OR 6.13 (95% CI 3.94-9.55), ICU liaison OR 55.75 (95% CI 17.48-177.75), pain team OR 8.15 (95% CI 5.52 --12.03), analgesia (e.g. patient controlled analgesia OR 2.6 (95% CI 1.64-3.94) and regional analgesia OR 8.8 (95% CI 3.39-22.79), incentive spirometry OR 8.3 (95% CI 4.49-15.37) and, high flow nasal oxygen OR 22.1 (95% CI 12.43-39.2) in the intervention group compared to the control group in the post- period. Conclusion The implementation of a chest injury care bundle using behaviour change theory was associated with a sustained improvement in evidence-based practice resulting in reduced unplanned ICU admissions and non-invasive ventilation requirement. Trial registration ANZCTR: ACTRN12618001548224, approved 17/09/2018</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0256027</identifier><identifier>PMID: 34618825</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Analgesia ; Biology and Life Sciences ; Chest ; Emergency services ; Evaluation ; Evidence-based medicine ; Feasibility studies ; Health services ; High flow ; Hospitals ; Infectious diseases ; Injuries ; Injury prevention ; Intervention ; Mechanical ventilation ; Medical care ; Medicine ; Medicine and Health Sciences ; Midwifery ; Morbidity ; Mortality ; Nursing schools ; Oxygen ; Pain ; Pain management ; Pain perception ; Patient safety ; Physical Sciences ; Physical therapy ; Quality management ; Teams ; Trauma ; Ventilation</subject><ispartof>PloS one, 2021-10, Vol.16 (10), p.e0256027-e0256027</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Curtis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Curtis et al 2021 Curtis et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c570t-519d3599c18e371c8f704670112c18e88bcada9ffd92a01d83a3501c3e0d38d03</citedby><cites>FETCH-LOGICAL-c570t-519d3599c18e371c8f704670112c18e88bcada9ffd92a01d83a3501c3e0d38d03</cites><orcidid>0000-0001-6210-6191</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496821/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496821/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids></links><search><creatorcontrib>Curtis, Kate</creatorcontrib><creatorcontrib>Kourouche, Sarah</creatorcontrib><creatorcontrib>Asha, Stephen</creatorcontrib><creatorcontrib>Considine, Julie</creatorcontrib><creatorcontrib>Fry, Margaret</creatorcontrib><creatorcontrib>Middleton, Sandy</creatorcontrib><creatorcontrib>Mitchell, Rebecca</creatorcontrib><creatorcontrib>Munroe, Belinda</creatorcontrib><creatorcontrib>Shaban, Ramon Z.</creatorcontrib><creatorcontrib>D’Amato, Alfa</creatorcontrib><creatorcontrib>Skinner, Clare</creatorcontrib><creatorcontrib>Wiseman, Glen</creatorcontrib><creatorcontrib>Buckley, Thomas</creatorcontrib><title>Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation</title><title>PloS one</title><description>Background Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury-respiratory support, analgesia and complication prevention. ChIP was implemented using a multi-faceted implementation plan developed using the Behaviour Change Wheel. Methods This controlled pre-and post-test study (two intervention and two non-intervention sites) was conducted from July 2015 to June 2019. The primary outcome measures were unplanned Intensive Care Unit (ICU) admissions, non-invasive ventilation use and mortality. Results There were 1790 patients included. The intervention sites had a 58% decrease in non-invasive ventilation use in the post- period compared to the pre-period (95% CI 0.18-0.96). ChIP was associated with 90% decreased odds of unplanned ICU admissions (95% CI 0.04-0.29) at the intervention sites compared to the control groups in the post- period. There was no significant change in mortality. There were higher odds of health service team reviews (surgical OR 6.6 (95% CI 4.61-9.45), physiotherapy OR 2.17 (95% CI 1.52-3.11), ICU doctor OR 6.13 (95% CI 3.94-9.55), ICU liaison OR 55.75 (95% CI 17.48-177.75), pain team OR 8.15 (95% CI 5.52 --12.03), analgesia (e.g. patient controlled analgesia OR 2.6 (95% CI 1.64-3.94) and regional analgesia OR 8.8 (95% CI 3.39-22.79), incentive spirometry OR 8.3 (95% CI 4.49-15.37) and, high flow nasal oxygen OR 22.1 (95% CI 12.43-39.2) in the intervention group compared to the control group in the post- period. Conclusion The implementation of a chest injury care bundle using behaviour change theory was associated with a sustained improvement in evidence-based practice resulting in reduced unplanned ICU admissions and non-invasive ventilation requirement. Trial registration ANZCTR: ACTRN12618001548224, approved 17/09/2018</description><subject>Analgesia</subject><subject>Biology and Life Sciences</subject><subject>Chest</subject><subject>Emergency services</subject><subject>Evaluation</subject><subject>Evidence-based medicine</subject><subject>Feasibility studies</subject><subject>Health services</subject><subject>High flow</subject><subject>Hospitals</subject><subject>Infectious diseases</subject><subject>Injuries</subject><subject>Injury prevention</subject><subject>Intervention</subject><subject>Mechanical ventilation</subject><subject>Medical care</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Midwifery</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Nursing schools</subject><subject>Oxygen</subject><subject>Pain</subject><subject>Pain management</subject><subject>Pain perception</subject><subject>Patient safety</subject><subject>Physical Sciences</subject><subject>Physical therapy</subject><subject>Quality management</subject><subject>Teams</subject><subject>Trauma</subject><subject>Ventilation</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptkk1vEzEQhlcIREvhHyBhiUt7SPDHrj84IEVRgUiV4ABny2t7E0dee7F3W_Xf4yQLIqjywdb49TPzjqeq3iK4RIShD_s4paD8cojBLiFuKMTsWXWJBMELiiF5_s_5onqV8x7ChnBKX1YXpKaIc9xcVg-bflB6BLEDCmiVLGinYLwFXUxgUKOzYczgwY070PopjEDvbB6BC_spPYLr9W7z_eYjWIF-8qPTRVwIOpYtem8NcP3gbV_ChRQDsPfKT8fj6-pFp3y2b-b9qvr5-fbH-uvi7tuXzXp1t9ANg-OiQcKQRgiNuC2mNe8YrCmDCOFDiPNWK6NE1xmBFUSGE0UaiDSx0BBuILmq3p24g49Zzj3LEjccwkIhpCg2J4WJai-H5HqVHmVUTh4DMW2lSsWbt5IJ0VqsmCZI1bo1glpKYYtJ3WHKDCusT3O2qe2tOfZD-TPo-U1wO7mN95LXgnKMCuB6BqT4ayqdlr3L2nqvgo3TqW4qUMMO0vf_SZ92N6u2qhhwoYslrz5A5YqyMgKcE1FUyydUZRnbu_KdtnMlfvagPj3QKeacbPfXI4LyMJ5_ipGH8ZTzeJLfOiLYog</recordid><startdate>20211007</startdate><enddate>20211007</enddate><creator>Curtis, Kate</creator><creator>Kourouche, Sarah</creator><creator>Asha, Stephen</creator><creator>Considine, Julie</creator><creator>Fry, Margaret</creator><creator>Middleton, Sandy</creator><creator>Mitchell, Rebecca</creator><creator>Munroe, Belinda</creator><creator>Shaban, Ramon Z.</creator><creator>D’Amato, Alfa</creator><creator>Skinner, Clare</creator><creator>Wiseman, Glen</creator><creator>Buckley, Thomas</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6210-6191</orcidid></search><sort><creationdate>20211007</creationdate><title>Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation</title><author>Curtis, Kate ; Kourouche, Sarah ; Asha, Stephen ; Considine, Julie ; Fry, Margaret ; Middleton, Sandy ; Mitchell, Rebecca ; Munroe, Belinda ; Shaban, Ramon Z. ; D’Amato, Alfa ; Skinner, Clare ; Wiseman, Glen ; Buckley, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c570t-519d3599c18e371c8f704670112c18e88bcada9ffd92a01d83a3501c3e0d38d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Analgesia</topic><topic>Biology and Life Sciences</topic><topic>Chest</topic><topic>Emergency services</topic><topic>Evaluation</topic><topic>Evidence-based medicine</topic><topic>Feasibility studies</topic><topic>Health services</topic><topic>High flow</topic><topic>Hospitals</topic><topic>Infectious diseases</topic><topic>Injuries</topic><topic>Injury prevention</topic><topic>Intervention</topic><topic>Mechanical ventilation</topic><topic>Medical care</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Midwifery</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Nursing schools</topic><topic>Oxygen</topic><topic>Pain</topic><topic>Pain management</topic><topic>Pain perception</topic><topic>Patient safety</topic><topic>Physical Sciences</topic><topic>Physical therapy</topic><topic>Quality management</topic><topic>Teams</topic><topic>Trauma</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Curtis, Kate</creatorcontrib><creatorcontrib>Kourouche, Sarah</creatorcontrib><creatorcontrib>Asha, Stephen</creatorcontrib><creatorcontrib>Considine, Julie</creatorcontrib><creatorcontrib>Fry, Margaret</creatorcontrib><creatorcontrib>Middleton, Sandy</creatorcontrib><creatorcontrib>Mitchell, Rebecca</creatorcontrib><creatorcontrib>Munroe, Belinda</creatorcontrib><creatorcontrib>Shaban, Ramon Z.</creatorcontrib><creatorcontrib>D’Amato, Alfa</creatorcontrib><creatorcontrib>Skinner, Clare</creatorcontrib><creatorcontrib>Wiseman, Glen</creatorcontrib><creatorcontrib>Buckley, Thomas</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Curtis, Kate</au><au>Kourouche, Sarah</au><au>Asha, Stephen</au><au>Considine, Julie</au><au>Fry, Margaret</au><au>Middleton, Sandy</au><au>Mitchell, Rebecca</au><au>Munroe, Belinda</au><au>Shaban, Ramon Z.</au><au>D’Amato, Alfa</au><au>Skinner, Clare</au><au>Wiseman, Glen</au><au>Buckley, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation</atitle><jtitle>PloS one</jtitle><date>2021-10-07</date><risdate>2021</risdate><volume>16</volume><issue>10</issue><spage>e0256027</spage><epage>e0256027</epage><pages>e0256027-e0256027</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Background Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury-respiratory support, analgesia and complication prevention. ChIP was implemented using a multi-faceted implementation plan developed using the Behaviour Change Wheel. Methods This controlled pre-and post-test study (two intervention and two non-intervention sites) was conducted from July 2015 to June 2019. The primary outcome measures were unplanned Intensive Care Unit (ICU) admissions, non-invasive ventilation use and mortality. Results There were 1790 patients included. The intervention sites had a 58% decrease in non-invasive ventilation use in the post- period compared to the pre-period (95% CI 0.18-0.96). ChIP was associated with 90% decreased odds of unplanned ICU admissions (95% CI 0.04-0.29) at the intervention sites compared to the control groups in the post- period. There was no significant change in mortality. There were higher odds of health service team reviews (surgical OR 6.6 (95% CI 4.61-9.45), physiotherapy OR 2.17 (95% CI 1.52-3.11), ICU doctor OR 6.13 (95% CI 3.94-9.55), ICU liaison OR 55.75 (95% CI 17.48-177.75), pain team OR 8.15 (95% CI 5.52 --12.03), analgesia (e.g. patient controlled analgesia OR 2.6 (95% CI 1.64-3.94) and regional analgesia OR 8.8 (95% CI 3.39-22.79), incentive spirometry OR 8.3 (95% CI 4.49-15.37) and, high flow nasal oxygen OR 22.1 (95% CI 12.43-39.2) in the intervention group compared to the control group in the post- period. Conclusion The implementation of a chest injury care bundle using behaviour change theory was associated with a sustained improvement in evidence-based practice resulting in reduced unplanned ICU admissions and non-invasive ventilation requirement. Trial registration ANZCTR: ACTRN12618001548224, approved 17/09/2018</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34618825</pmid><doi>10.1371/journal.pone.0256027</doi><orcidid>https://orcid.org/0000-0001-6210-6191</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-10, Vol.16 (10), p.e0256027-e0256027 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2580001133 |
| source | Public Library of Science (PLoS) Journals Open Access; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analgesia Biology and Life Sciences Chest Emergency services Evaluation Evidence-based medicine Feasibility studies Health services High flow Hospitals Infectious diseases Injuries Injury prevention Intervention Mechanical ventilation Medical care Medicine Medicine and Health Sciences Midwifery Morbidity Mortality Nursing schools Oxygen Pain Pain management Pain perception Patient safety Physical Sciences Physical therapy Quality management Teams Trauma Ventilation |
| title | Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T20%3A29%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20a%20care%20bundle%20for%20patients%20with%20blunt%20chest%20injury%20(ChIP):%20A%20multicentre%20controlled%20implementation%20evaluation&rft.jtitle=PloS%20one&rft.au=Curtis,%20Kate&rft.date=2021-10-07&rft.volume=16&rft.issue=10&rft.spage=e0256027&rft.epage=e0256027&rft.pages=e0256027-e0256027&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0256027&rft_dat=%3Cgale_plos_%3EA678258839%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2580001133&rft_id=info:pmid/34618825&rft_galeid=A678258839&rft_doaj_id=oai_doaj_org_article_799be2a7c31a4cbd96e660b234f267d7&rfr_iscdi=true |