Category: Newsletter

PEAChY – O: Pharmacological Emergency management of Agitation in Children and Young people – A randomised controlled trial of Oral medication

Co-ordinating PI:  Elyssia Bourke

Study Co-ordinator: Kate Klein

Study design:

Randomised, controlled, open-label, multi-centre, phase III superiority effectiveness trial of: ORAL olanzapine vs ORAL diazepam.

For further background information see: https://www.predict.org.au/projects/peachy-o-and-peachy-m-studies/

Current status:

• Study target sample size of 348 participants currently at 94% (N = 325 recruited). Nearing completion, over 12 months ahead of schedule!
• PEAChY-O is on track to be complete by mid-September 2023.
• Data cleaning is set to be finalised at all participating sites by late October, ready for final analysis.
• An abstract is planned for presentation at the PAS in January 2024.

 

PEAChY- M: Pharmacological Emergency management of Agitation in Children and Young people – A randomised controlled trial of IntraMuscular medication

Study design:

Randomised, controlled, open-label, multi-centre, phase III superiority effectiveness trial of: INTRAMUSCULAR olanzapine vs INTRAMUSCULAR droperidol.

For further background information see: https://www.predict.org.au/projects/peachy-o-and-peachy-m-studies/

Current status:

• Currently, 36% of the total number of participants required to meet the target sample size of 348 have been recruited.
• Low recruitment across all sites due to several reasons. For example, management of ASBD events in the ED environment can be challenging and, commonly, many enrolled participants subsequently de-escalate (in behaviour) and no longer require IM medication (i.e. they either accept oral medication or no longer require any medication).
• Education of clinical staff related to PEAChY-M continues at all sites to improve recruitment rates.

Congratulations to the following PREDICT authors:

Borland ML, O’Brien S, Tavender E, Haskell L, Babl FE, Schembri R, Smedley B, Mitenko H, Robertson T, Mukherjee A, Dalziel SR. Evaluation of targeted implementation interventions for reducing investigations and therapies in infants with bronchiolitis. Acta Paediatr. 2023 Apr 6. doi: 10.1111/apa.16786. Epub ahead of print. PMID: 37026175.

O’Brien SL, Haskell L, Tavender EJ, Wilson S, Borland ML, Oakley E, Dalziel SR, Gill FJ. Factors influencing health professionals’ use of high-flow nasal cannula therapy for infants with bronchiolitis – A qualitative study. Frontiers in Pediatrics. 2023; 11: 1098577. 

Bourke EM, Douglas N, Wilson CL, Anderson D, Nehme Z, Babl FE; Paediatric Research in Emergency Departments International Collaborative (PREDICT). Acute Severe Behavioral Disturbance Requiring Parenteral Sedation in Pediatric Mental Health Presentations to Emergency Medical Services: A Retrospective Chart Review. Ann Emerg Med. 2023 Jun 30:S0196-0644(23)00355-4. doi: 10.1016/j.annemergmed.2023.04.028. Epub ahead of print. PMID: 37389492.

Craig S, Delardes B, Nehme Z, Wilson C, Dalziel S, Nixon GM, Powell C, Graudins A, Babl FE; PREDICT Network. Acute paediatric asthma treatment in the prehospital setting: a retrospective observational study. BMJ Open. 2023 Jun 22;13(6):e073029. doi: 10.1136/bmjopen-2023-073029. PMID: 37349099; PMCID: PMC10314617.

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Rebecca Gridley from the Queensland Children’s Hospital.

“I am currently an Advanced Trainee in Emergency Medicine and have been working at Queensland Children’s Hospital for the past 12 months. I have been very lucky to be involved in the data collection for some current studies within paediatric care, fostering an interest in research. I will be moving hospitals as part of my training but would like to stay linked in with research projects and remain up to date with evidence to provide the best possible care to all patients that I see. I hope to be able to contribute to research and continue to support advances in health care as my career progresses.”

Welcome to PREDICT Rebecca!

 

 

 

 

 

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Helen Goldsmith from the Sydney Children’s Hospital Network.

“I have been a registered nurse for over 25 years, and I have more than 20 years of experience conducting clinical trials, research projects and quality improvement initiatives with hospital clinicians, patients, and carers in a variety of disciplines and settings. I have always had an interest in emergency/trauma research; and I completed my PhD in 2018 investigating “The Incidence, Impact and Experience of Pain in Recently Discharged Adult Trauma Patients”. I have only recently commenced working in paediatrics. I am currently the Research Development Manager with the Sydney Children’s Hospitals Network, and my role involves promoting, encouraging, embedding, and supporting clinical research.”

Welcome to PREDICT Helen!

 

 

 

 

 

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Samantha Luck from Toowoomba Hospital and QCH.

“My name is Samantha Luck, and I work part-time in Toowoomba, a regional mixed Emergency Department, as an emergency staff specialist and part-time as a paediatric emergency medicine fellow in Queensland Children’s Hospital to complete post-fellowship PEM training. I am passionate about ensuring that regional and mixed Emergency Departments provide the highest possible standard of care, and so am looking forward to engaging with this network.”

Welcome to PREDICT Samantha!

Sustaining improvements in the management of infants with bronchiolitis – a PREDICT study

Co-ordinating PI:

Emma Tavender, Sandy Middleton, Stuart Dalziel.

Study Co-ordinator

Emma Tavender, PhD student: Victoria Ramsden.

Project aim/s:

The aim of this study is to:
i) determine if the use of targeted interventions from the PREDICT Bronchiolitis KT Study have been effective at sustaining improvements in evidence-based practices in Australasian paediatric acute care settings one and two years after completion of the trial at intervention group hospitals (n=13);
ii) determine if there are any improvements in control group hospitals (n=13);
iii) understand the factors which influenced the sustainability of improvements in intervention group hospitals and;
iv) explore factors which may have contributed to improvements at control group hospitals.

Study design:

A mixed-methods study design: retrospective medical record audit (approximately 150 infants per site for the years 2018 and 2019) and qualitative semi-structured individual or group interviews (3-5 individuals per site).

Primary outcome:

Outcomes: medical record audit
The proportion of infants presenting with bronchiolitis to intervention and control group hospitals, who received care that adhered with five inappropriate therapies (chest X-ray, salbutamol, glucocorticoids, antibiotics, and adrenaline) one year (2018) and two years (2019) following delivery of an intervention designed to promote evidence-based practice adherence (composite of all five practices).
Outcomes: Qualitative interviews:
Factors that contributed to sustainability of improvements of evidence-based practice adherence at intervention group hospitals four years post-implementation; Factors that contributed to improvements/deterioration of evidence-based practice adherence at control group hospitals four years           post-implementation; Fidelity and adaptation to the PREDICT Bronchiolitis KT Study implementation strategy at intervention and control group hospitals four years following intervention delivery (2018, 2019, 2020, 2021) (Control group hospitals received the intervention materials post trial completion).

Current status:

16 Australian and 6 New Zealand sites recruited. All sites have completed governance and commenced the study. Medical Record Audit data collection has been completed at 18 sites. Remaining four sites should be completed soon. Qualitative interviews are now completed at the 9 Australian and 2 New Zealand intervention hospitals.

Publications:

Ramsden, V., Babl, F.E., Dalziel, S.R. et al. Sustainability of evidence-based practices in the management of infants with bronchiolitis in hospital settings – a PREDICT study protocol. BMC Health Serv Res 22, 1099 (2011).

https://doi.org/10.1186/s12913-022-08450-z