An Email Intervention to Prevent Iatrogenic Malnutrition in the ICU

• ClinicalTrials.gov Identifier: NCT02277535
• Recruitment Status: Completed
• First Posted: October 29, 2014
• Last Update Posted: February 2, 2017
• Sponsor: Massachusetts General Hospital
• Information provided by (Responsible Party): Daniel Dante Yeh, Massachusetts General Hospital

Study Description

Brief Summary:

This is a quality improvement research project evaluating if a targeted feedback email to clinicians impacts their nutrition delivery in the ICU.

Condition or disease	Intervention/treatment	Phase
Malnutrition	Other: Feedback/Reminder email.	Not Applicable

Detailed Description:

This prospective study looks to determine if a targeted email to clinicians taking care of critically ill patients will allow reduce malnutrition in the Intensive Care Units (ICU). Four ICUs will be included: medical ICU (MICU), coronary care unit (CCU) and two surgical ICUs. The investigators will rotate a 2 month period intervention amongst the aforementioned participating ICUs and follow simultaneous cohorts to evaluate the effect of our intervention (email feedback to treating clinicians) on nutrition delivery in the ICU. After the completion of the intervention, there will be a six-month follow-up of nutritional adequacy to assess the durability of changes in behavior.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 197 participants
• Allocation: Randomized
• Intervention Model: Crossover Assignment
• Masking: None (Open Label)
• Primary Purpose: Prevention
• Official Title: An Email Intervention to Prevent Iatrogenic Malnutrition in the ICU
• Study Start Date: December 2014
• Actual Primary Completion Date: April 2015
• Actual Study Completion Date: April 2015

Arms and Interventions

Arm	Intervention/treatment
Experimental: E-mail intervention; ICU clinicians caring for patients who have not yet been initiated on nutrition 48 hours after ICU admission will receive a reminder email. ICU clinicians caring for patients who accumulate a caloric deficit greater than 4000 calories or 150 g protein deficit will receive a feedback email	Other: Feedback/Reminder email.
No Intervention: No E-mail intervention; Nutrition status of patients will be assessed but no reminder or feedback emails will be sent

Outcome Measures

Primary Outcome Measures :

1. Patients started on nutrition within 72 h of ICU admission [ Time Frame: After completing the intervention for each ICU (2 months) ]
   The ICU admission date and EN initiation date will be collected in a data base which will later be analyzed to assess the percentange of patients initiated on EN within 72 hours of admission to the ICU. This will be reported as rates and will be compared amongst intervention and no-intervention arms using Fisher's Exact test or Chi-sq Test

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Clinicians taking care of patients admitted to the ICU within the past 48hrs
• Clinicians taking care of patients in whom enteral nutrition is prescribed

Exclusion Criteria:

• Clinicians taking care of patients in whom enteral nutrition is not prescribed.

Contacts and Locations

No Contacts or Locations Provided

More Information

• Responsible Party: Daniel Dante Yeh, Trauma and Critical Care Surgeon, Massachusetts General Hospital
• ClinicalTrials.gov Identifier: NCT02277535
• Other Study ID Numbers: 2014P001702
• First Posted: October 29, 2014
• Last Update Posted: February 2, 2017
• Last Verified: January 2017

Keywords provided by Daniel Dante Yeh, Massachusetts General Hospital:

Malnutrition in the ICU (caloric deficit >4000 kcal or 150 g protein deficit) or >48hrs of admission without receiving nutrition

Additional relevant MeSH terms:

Malnutrition; Nutrition Disorders