Blood Culture Reduction Approaches for Sepsis
(LIBRA Trial)

Recruiting in Palo Alto (17 mi)

+7 other locations

Overseen byCharlotte Woods-Hill, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Children's Hospital of Philadelphia

No Placebo Group

Trial Summary

What is the purpose of this trial?This study will compare two strategies that target distinct determinants of blood culture overuse in an exploratory, hybrid, pilot trial in 8 PICUs. It aims to determine if there is any association between specific strategies used to reduce blood culture overuse on unit-wide blood culture rates, patient safety, and concurrently explore aspects of the implementation process (acceptability, feasibility, appropriateness).

Eligibility Criteria

This trial is for male or female clinicians over 18 years old who work in Pediatric Intensive Care Units (PICUs) and have direct patient care roles. It's not open to those who don't speak English or PICU clinicians reporting directly to the investigator.

Inclusion Criteria

I am over 18 years old.

PICU clinicians with direct patient care roles

Exclusion Criteria

I do not speak English.

PICU clinicians who report to the investigator

Participant Groups

The study compares two strategies: a checklist and targeted messaging, aimed at reducing unnecessary blood culture tests in PICUs. It explores how these strategies affect test rates, patient safety, and evaluates their acceptability and feasibility.

2Treatment groups

Experimental Treatment

Group I: Loss AversionExperimental Treatment2 Interventions

This intervention consists of targeted messaging and education that the primary study team will create and ask the Arm B sites to deliver to the PICU clinicians, which focuses on the importance of diagnostic stewardship and the current evidence for the benefit/low risk nature of the stewardship program to date. Sites in this arm will also receive a checklist to guide blood culture decisions, that clinicians at sites will be asked to consult and complete prior to ordering or not ordering a blood culture.

Group II: Default BiasExperimental Treatment1 Intervention

This intervention consists of a checklist to guide blood culture decisions, that a clinician in a site randomized to Arm A will be asked to consult and complete prior to ordering or not ordering a blood culture; as the relevant clinical scenario occurs.