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Trial registered on ANZCTR
Registration number
ACTRN12609000808246
Ethics application status
Approved
Date submitted
12/09/2009
Date registered
17/09/2009
Date last updated
9/07/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Prospective controlled trial of effect of the use of the Modified Early Warning Score on morbidity and mortality rates
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Scientific title
The effect of the modified early warning score on unplanned admissions to the intensive care unit in general medical and surgical patients.
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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:
Patient Deterioration
243821
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Condition category
Condition code
Cardiovascular
239994
239994
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
4 months duration (February to June 2007).
The installation of a new observation chart into 4 wards (two at The Canberra Hospital and two at Calvary Hosptial) which was colour coded for a modified early warning score.
The modified early warning score was utilised as a track and trigger system whereby if the score reached more than 4, a junior doctor was contacted by the bedside nurse to review and manage the patient within a 30 minute timeframe. The Medical Emergency Team (MET) could be contacted if the patient fulfilled standard MET criteria.
In order for the wards to be part of the pilot program, more than 50% of the healthcare workers needed to have undertaken a novel education package, COMPASS. This was a program that bought physiology to the bedside and informed people of the use of the SBAR communication tool. (Situation, Background, Assessment, Response).
The data will be collected from case records of the patients in a deidentified manner.
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Intervention code [1]
241292
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Early detection / Screening
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Comparator / control treatment
The historical group was obtained from the same four wards during the same part of calendar in 2006 (Feb to June 2006)
During this time, there was no change to the usual patient care so that there was no added education on the deteriorating patient and the general observation chart was utilised with no colour coding and no track and trigger system. Patient review relied on either the nurse contacting the doctor with their concerns or calling for a Medical Emergency Team (MET) if they fulfilled the standard criteria for a MET.
The data will be collected from the patient's case records in a deidentified manner.
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Control group
Historical
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Outcomes
Primary outcome [1]
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Unplanned admissions to the intensive care unit.
The data will be collected from the two hospitals' intensive care databases. Unplanned admissions are those that are not elective surgical patients or those that come from the emergency department.
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Assessment method [1]
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Timepoint [1]
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Hospital Discharge
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Secondary outcome [1]
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Hospital Mortality
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Assessment method [1]
257177
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Timepoint [1]
257177
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Hospital Discharge
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Secondary outcome [2]
257178
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Patient Adverse Events
eg: Medical Emergency Team Review
From data from the hospitals' switch board and followed up with the relevant patient case record.
eg: Unexpected Death
From the hospitals' list of deaths and subsequent follow up with the relevant patient case record.
Cardiac Arrest
From data from the hospitals' switch board and followed up with the relevant patient case record.
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Assessment method [2]
257178
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Timepoint [2]
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Hospital Discharge
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Secondary outcome [3]
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Frequency of Vital Sign Measurements
The patient records identified initially from four pilot wards admission data for the relevant time periods and then 25%randomly selected to record all vital sign measurements for the length of stay from the observation charts in the patients' case record.
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Assessment method [3]
257581
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Timepoint [3]
257581
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Admission to hospital discharge
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Eligibility
Key inclusion criteria
Admission to four pilot wards
Two from The Canberra Hospital
Two from Calvary Hospital ACT
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Minimum age
18
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?
No
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Key exclusion criteria
Patients admitted for palliative care
Aged under 18 years old
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not applicable
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/02/2007
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
800
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
2006
0
2605
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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ACT Health
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Address [1]
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11 Moore Street
Canberra
ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Mr Mark Cormack
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Address
Chief Executive, ACT Health
11 Moore Street
Canberra
ACT 2601
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Mr Ian Thompson
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Address [1]
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Deputy Chief Executive, ACT Health
11 Moore Street
Canberra
ACT 2601
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Country [1]
237086
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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ACT Health Human Research Ethics Committee
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Ethics committee address [1]
239609
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11 Moore Street Canberra ACT 2601
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Ethics committee country [1]
239609
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Australia
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Date submitted for ethics approval [1]
239609
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Approval date [1]
239609
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22/02/2007
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Ethics approval number [1]
239609
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ETH1/07.120
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Ethics committee name [2]
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Calvary HealthCare ACT
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Ethics committee address [2]
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Mary Potter Circuit Cnr Belconnen Way & Haydon Drive Bruce ACT 2617
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
239610
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Approval date [2]
239610
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22/02/2007
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Ethics approval number [2]
239610
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HREC 3-2007
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Summary
Brief summary
Patient adverse events occur in up to 17% of all hospital admissions. One contributing factor is the failure to recognise and appropriately manage deteriorating patients on the general ward. The ability to detect early deterioration allows early appropriate intervention and reduces unplanned admissions to intensive care unit (ICU) and unexpected deaths. In this study, a new ward observation chart will be installed into four wards (2 at The Canberra Hospital [TCH], 2 at Calvary Hospital [CH]), which will allow the recording of a modified early warning score. High scores will automatically trigger the nurse at the bedside to call an appropriately qualified medical practitioner for a timely review of the patient and initiate earlier management. We will review the morbidity and mortality of patients before and after this intervention
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Imogen Mitchell
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Address
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Department of Intensive Care
The Canberra Hospital
Yamba Drive
Garran
ACT 2605
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Country
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Australia
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Phone
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+61 2 62443423
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Fax
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+61 2 62443507
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Imogen Mitchell
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Address
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Department of Intensive Care
The Canberra Hospital
Yamba Drive
Garran
ACT 2605
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Country
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Australia
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Phone
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+61 2 62443423
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Fax
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+61 2 62443507
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Email
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[email protected]
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No information has been provided regarding IPD availability
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
No additional documents have been identified.
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