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Completed

NCT Number: NCT00157612

A Clinical Pathway for Nursing Home Acquired Pneumonia

Nursing home residents are frequently transferred to hospital for management of pneumonia. This often leads to hospital related complications and is a burden on the acute care health system. The purpose of this study is to assess whether managing residents with pneumonia and lower respiratory tract infection on site in the nursing home can reduce hospital admissions and can reduce complications and improve quality of life for residents. We have randomized residents with nursing home acquired pneumonia to on-site management, using a clinical pathway, versus usual care.

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Key information

Conditions

Pneumonia Infections Lower Respiratory Tract Infection Lung Diseases Respiratory Tract Diseases Respiratory Tract Infections

Age range

64 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

We conducted a cluster-randomized controlled trial where nursing homes were randomized to either use of a clinical pathway or usual care for management of nursing home acquired pneumonia. The clinical pathway included chest radiographs performed on-site in the nursing home by a mobile x-ray unit, use of hypodermocylysis (subcutaneous infusion) for re-hydration, administration of an oral antimicrobials, and use of pulse oximetry to assess oxygenation. The main outcomes were hospital admission rate and length of stay. Secondary outcomes included health related quality of life, rates of both infectious and non-infectious complications within four weeks of onset of symptoms; mortality rate of residents with pneumonia (death from all causes within 30 days of onset of symptoms. Time to stabilization of vital signs, as well as functional status at four weeks, were assessed.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Symptoms or signs of lower respiratory tract infection as defined by standardized criteria.

Exclusion criteria

  • Residents were excluded if they were not expected to live longer than 30 days from the date of enrollment, had a previous anaphylactic or serious allergic reaction to quinolones, had advanced directives that they are not be transferred to hospital for treatment.

Treatment and study plan

a clinical pathway nursing home acquired pneumonia

Procedure

treatment in nursing homes according to a clinical pathway, which included use of oral anti-microbials, portable chest radiographs, oxygen saturation monitoring, rehydrations and close monitoring by research nurse

Other names: Nursing Home Residents with Pneumonia

Primary outcomes

  1. Hospital admission, length of stay

Secondary outcomes

  1. Health related quality of life,

  2. complication rates,

  3. mortality,

  4. functional status,

  5. time to stabilization of vital signs

Sponsors and collaborators

Lead sponsor

McMaster University

Other

Collaborators

  • Canadian Institutes of Health Research (CIHR)

Registry information

Official study title

A Randomized Control Trial of a Clinical Pathway for Nursing Home Pneumonia.

Important dates

Study start
2001
Primary completion
2005
Study completion
2005
First posted
Sep 12, 2005
Registry last updated
Oct 29, 2018

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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