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Trial registered on ANZCTR
Registration number
ACTRN12619001314112
Ethics application status
Approved
Date submitted
29/08/2019
Date registered
26/09/2019
Date last updated
13/04/2021
Date data sharing statement initially provided
26/09/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Lessons learned following episodes of intensive care unit crisis: what experienced Intensivists can teach their peers
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Scientific title
Lessons learned following episodes of intensive care unit crisis: what experienced Intensivists can teach their peers
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Secondary ID [1]
299340
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Nil known or none
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Mental health
314209
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Condition category
Condition code
Mental Health
312571
312571
0
0
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Studies of normal psychology, cognitive function and behaviour
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This study will
1. Analyse personal recounts of senior Intensivists where they each describe episodes of care where patient management was compromised secondary to human error.
2. Explore the manner in which the senior clinicians dealt with the personal effects of the particular clinical events they describe, thereby providing an overview of the manner by which they mitigated their own adverse mental response.
3. Explore a framework for human factor training that will aid in the upstream preparation of future intensive care doctors.
Research personnel will undertake face-to-face interviews of individual Intensivists who have had more than 4 years of clinical experience working in the intensive care domain using a semi-scripted set of questions. There will be only one interview undertaken per participant, the duration of which will approximate 1 hour. Interviews will take place privately in office-space adjacent to the participants usual workplace, within their institution.
All interviews will be audio-recorded. Each recording will be transcribed into an individually encrypted electronic word document by one of the investigators (DD). The complete unedited electronic transcript will then be sent to the participant via email. Participants will then have the opportunity to edit the transcript before it is de-identified and analysed.
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Intervention code [1]
315418
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
321219
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Qualitative data will be collected using a semi-structured interview guide, developed following a substantial literature review of the evidence and existing tools to measure/report recovery of the healthcare provider following adverse patient events.
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Assessment method [1]
321219
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Timepoint [1]
321219
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Each participant will be interviewed once, for one hour.
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Secondary outcome [1]
374353
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Qualitative data may be collected during ad-hoc informal interviews between participants and the respective site investigator, after all primary data collection at all sites has been finalised around a potential simulation-based framework for future training of future intensive care doctors.
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Assessment method [1]
374353
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Timepoint [1]
374353
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Ad hoc discussions from completion of data collection for up to 1 year.
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Eligibility
Key inclusion criteria
Participants will need to be
1. Intensive Care Consultants (Intensivists) who have had a minimum of 4 years’ experience in the Intensive Care Unit environment.
2. Available to be interviewed within the period of time when Co-investigators are available to undertake site data collection.
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Minimum age
30
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Participants who are
1. Intensive Care Consultants (Intensivists) who have had less than 4 years’ experience in the Intensive Care Unit environment.
2. Unavailable to be interviewed within the period of time when Co-investigators are available to undertake site data collection.
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Study design
Purpose
Psychosocial
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
Interview data analysis will be undertaken using a thematic content approach, whereby the interviews will be transcribed and organised according to the questions posed, and then read and re-read to generate a start-list of codes.
Data will then be coded by at least 2 investigators according to this start-list (using nVivo software program). Emergent themes that fit the broad pattern of meaning will then be identified and then reviewed again to make sure they fit the data. Inter-relating themes will also be recognised to interpret the meaning of the themes.
It is planned that there will be between 5-8 participants enrolled at each site (minimum 15 sample size), representing approximately 60% of the incumbent number of Intensivists at each site. We feel that this number of participants from each site will represent a saturation of data. That is, the sampling of more data will not lead to more information related to the research questions, but rather a repetition of the same categories of information. There was no power calculation undertaken in reflection of a qualitative study, and no level of significance required as analysis is qualitative.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
21/10/2018
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Date of last participant enrolment
Anticipated
14/02/2020
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Actual
14/02/2020
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Date of last data collection
Anticipated
14/02/2020
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Actual
14/02/2020
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Sample size
Target
37
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Accrual to date
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Final
41
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Recruitment in Australia
Recruitment state(s)
WA,VIC
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Recruitment hospital [1]
14665
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment hospital [2]
14666
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Austin Health - Austin Hospital - Heidelberg
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Recruitment postcode(s) [1]
27694
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6009 - Nedlands
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Recruitment postcode(s) [2]
27695
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3084 - Heidelberg
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Recruitment outside Australia
Country [1]
21817
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Israel
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State/province [1]
21817
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Jerusalem
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Country [2]
21818
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United States of America
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State/province [2]
21818
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Illinois; Birmingham; Kentucky
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Funding & Sponsors
Funding source category [1]
303683
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Charities/Societies/Foundations
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Name [1]
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Raine Foundation
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Address [1]
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Suite 24, Hollywood Specialist Centre
95 Monash Avenue
Nedlands WA 6009
Western Australia
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Country [1]
303683
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Australia
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Primary sponsor type
Hospital
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Name
Sir Charles Gairdner Hospital
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Address
Hospital Avenue
Nedlands
Western Australia 6009
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Country
Australia
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Secondary sponsor category [1]
303990
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None
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Name [1]
303990
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Address [1]
303990
0
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Country [1]
303990
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
304208
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Sir Charles Gairdner and Osborne Park Health Care Group Human Research Ethics Committee
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Ethics committee address [1]
304208
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2nd Floor A Block Hospital Avenue NEDLANDS Western Australia 6009
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Ethics committee country [1]
304208
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Australia
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Date submitted for ethics approval [1]
304208
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19/12/2017
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Approval date [1]
304208
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01/05/2018
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Ethics approval number [1]
304208
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Summary
Brief summary
Healthcare providers may be vulnerable to psychological trauma in the aftermath of an adverse critical clinical incident, particularly if it is associated with a poor patient outcome. This may be especially evident amongst the medical fraternity, who often lead the management of the acutely deteriorating patient, and there is evidence of stress within this cohort in the literature, and the need for upstream preparation. This project will involve interviewing experienced intensive care doctors about adverse critical clinical incidents whereby patient management was potentially compromised secondary to human error. The aims of the interview will be to explore the impact of the events on them, in terms of their thoughts and feelings and also to explore the coping mechanisms they applied to enable them to emerge from the event with some deeper understanding and resolution. These personal recounts will be transcribed, reviewed and qualitatively analysed in order to identify common human factor gaps in clinical management during adverse critical clinical incidents, and the manner in which the personal effects of these events were mitigated. Results will inform the development of a framework of human factor training, possibly utilising simulation-based training that will aid in the upstream preparation of future critical care doctors.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Diane Dennis
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Address
96142
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Intensive Care Unit
4th floor, G Block
Sir Charles Gairdner Hospital
Hospital Ave
Nedlands 6009
Western Australia
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Country
96142
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Australia
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Phone
96142
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+61 418895086
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Fax
96142
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Email
96142
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[email protected]
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Contact person for public queries
Name
96143
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Diane Dennis
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Address
96143
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Intensive Care Unit
4th floor, G Block
Sir Charles Gairdner Hospital
Hospital Ave
Nedlands 6009
Western Australia
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Country
96143
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Australia
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Phone
96143
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+61 418895086
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Fax
96143
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Email
96143
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[email protected]
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Contact person for scientific queries
Name
96144
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Diane Dennis
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Address
96144
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Intensive Care Unit
4th floor, G Block
Sir Charles Gairdner Hospital
Hospital Ave
Nedlands 6009
Western Australia
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Country
96144
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Australia
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Phone
96144
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+61 418895086
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Fax
96144
0
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Email
96144
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
No permission to do so.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Advice for doctors working or planning to work in intensive care: Summation from a qualitative study.
2022
https://dx.doi.org/10.5114/ait.2022.113278
N.B. These documents automatically identified may not have been verified by the study sponsor.
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