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BrighT STAR LIBRA: Leveraging Implementation Science for Blood Culture Reduction Approaches
Sponsor: Children's Hospital of Philadelphia
Summary
This study will compare two strategies that target distinct determinants of blood culture overuse in an exploratory, hybrid, pilot trial in 8 PICUs. It aims to determine if there is any association between specific strategies used to reduce blood culture overuse on unit-wide blood culture rates, patient safety, and concurrently explore aspects of the implementation process (acceptability, feasibility, appropriateness).
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
8
Start Date
2023-01-01
Completion Date
2027-04
Last Updated
2025-10-31
Healthy Volunteers
Yes
Interventions
Checklist
This intervention consists of a checklist to guide blood culture decisions, that a clinician in a site randomized to Arm A will be asked to consult and complete prior to ordering or not ordering a blood culture; as the relevant clinical scenario occurs. Meaning, if a clinician in Arm A is faced with a scenario in which it is customary or usual care to consider a blood culture, the clinician will be asked to first review this checklist. The checklist is not a binding or absolute process - the clinician should use both the checklist and typical clinical judgment to decide if the blood culture test is needed or not. The checklist is based on prototypes used in the completed parent study, BrighT STAR and the earlier preliminary studies at Johns Hopkins.
Targeted Messaging
This intervention consists of targeted messaging and education that the primary study team will create and ask the Arm B sites to deliver to the PICU clinicians, which focuses on the importance of diagnostic stewardship and the current evidence for the benefit/low risk nature of the stewardship program to date.
Locations (8)
UCLA Mattel Children's Hospital
Los Angeles, California, United States
UCSF Benioff Children's Hospital Mission Bay
San Francisco, California, United States
Nemours / AI DuPont Hospital for Children
Wilmington, Delaware, United States
Riley Hospital for Children
Indianapolis, Indiana, United States
Norton Children's Hospital
Louisville, Kentucky, United States
Kravis Children's Hospital
New York, New York, United States
New York-Presbyterian Morgan Stanley Children's Hospital
New York, New York, United States
Children's Hospital of Wisconsin
Milwaukee, Wisconsin, United States