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Published (Version of record)CC BY V4.0, Open Access
Published (Version of record)CC BY V4.0, Open
Journal article
The Emergency nurse Protocols Initiating Care—Sydney Triage to Admission Risk Tool (EPIC-START) trial: protocol for a stepped wedge implementation trial
Implementation science communications, Vol.4, 70
20/06/2023
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Abstract
Introduction
Emergency department (ED) overcrowding is a global problem and a threat to the quality and safety of emergency care. Providing timely and safe emergency care therein is challenging. To address this in New South Wales (NSW), Australia, the Emergency nurse Protocol Initiating Care—Sydney Triage to Admission Risk Tool (EPIC-START) was developed. EPIC-START is a model of care incorporating EPIC protocols, the START patient admission prediction tool, and a clinical deterioration tool to support ED flow, timely care, and patient safety. The aim of this study is to evaluate the impact of EPIC-START implementation across 30 EDs on patient, implementation, and health service outcomes.
Methods and analysis
This study protocol adopts an effectiveness-implementation hybrid design (Med Care 50: 217-226, 2012) and uses a stepped–wedge cluster randomised control trial of EPIC-START, including uptake and sustainability, within 30 EDs across four NSW local health districts spanning rural, regional, and metropolitan settings. Each cluster will be randomised independently of the research team to 1 of 4 dates until all EDs have been exposed to the intervention. Quantitative and qualitative evaluations will be conducted on data from medical records and routinely collected data, and patient, nursing, and medical staff pre- and post-surveys.
Ethics and dissemination
Ethical approval for the research was received from the Sydney Local Health District Research Ethics Committee (Reference Number 2022/ETH01940) on 14 December 2022.
Trial registration
Australian and New Zealand Clinical trial, ACTRN12622001480774p. Registered on 27 October 2022.
Details
- Title
- The Emergency nurse Protocols Initiating Care—Sydney Triage to Admission Risk Tool (EPIC-START) trial: protocol for a stepped wedge implementation trial
- Creators
- Kate Curtis - The University of SydneyMichael M Dinh - New South Wales Institute of Trauma and Injury Management (Chatswood)Amith Shetty - NSW Ministry of HealthSarah Kourouche - The University of SydneyMargaret Fry - The University of SydneyJulie Considine - Deakin UniversityLing Li - Macquarie UniversityThomas Lung - The University of SydneyTimothy Shaw - The University of SydneyMary K. Lam - RMIT UniversityMargaret Murphy - Western Sydney Local Health DistrictHatem Alkhouri - University of New South WalesChristina Aggar - Southern Cross UniversitySaartje Berendsen Russell - Sydney Local Health DistrictRadhika V. Seimon - Sydney Local Health DistrictJames A. Hughes - Queensland University of TechnologyWayne Varndell - Prince of Wales HospitalRamon Z Shaban - The University of Sydney
- Publication Details
- Implementation science communications, Vol.4, 70
- Publisher
- Biomed Central Springer Nature
- Grant note
- National Health and Medical Research Council, Medical Research Future Fund (MRFF). Australian Department of Health (MRFF), grant number 2017845 https://www.health.gov.au/our-work/medical-research-future-fund (Supplementary material 4).
- Identifiers
- 991013124610702368
- Copyright
- © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, (http://creativecommons.org/licenses/by/4.0/).
- Academic Unit
- Nursing; Faculty of Health
- Language
- English
- Resource Type
- Journal article