Table 2.
Association of outcomes with implementation intervention
| Parameter | Preintervention (n = 197) |
Postintervention (n = 249) |
P Value | Adjusted Change or aOR for Outcome* (95% CI) |
P Value |
|---|---|---|---|---|---|
| Adherence to LTVV,† mean (SD) | 80.3% (30.8%) | 89.8% (24.4%) | <0.001 | +9.2% (+3.8% to +14.5%) | <0.001 |
| Adherence to prescribed PEEP/FiO2,† mean (SD) | 65.3% (28.9%) | 78.2% (24.6%) | <0.001 | +11.9% (+7.2% to +16.5%) | <0.001 |
| Time receiving harmful tidal volumes,† mean (SD) | 14.4% (26.0%) | 6.1% (17.4%) | <0.001 | −8.5% (−12.7% to −4.3%) | <0.001 |
| Use of ventilation CDS tool, mean (SD) | 21.1% (27.7%) | 60.6% (30.3%) | <0.001 | +41.3% (+35.9% to +46.7%) | <0.001 |
| Use of oxygenation CDS tool,‡ mean (SD) | 23.9% (22.2%) | 77.3% (19.2%) | <0.001 | +54.3% (+50.9% to +57.7%) | <0.001 |
| LTVV adherence ⩾90%,† n (%) | 121 (63.0) | 201 (81.7) | <0.001 | aOR, 2.58 (1.64 to 4.10) | <0.001 |
| PEEP/FiO2 adherence ⩾70%,† n (%) | 99 (51.6) | 187 (76.0) | <0.001 | aOR, 3.60 (2.27 to 5.78) | <0.001 |
| Time receiving harmful tidal volumes ⩾10%,† n (%) | 57 (29.7) | 32 (13.0) | <0.001 | aOR, 0.35 (0.21 to 0.58) | <0.001 |
| Ventilator-free days through day 28, median (IQR) | 17 (−1 to 24) | 18 (−1 to 24) | 0.84 | aOR, 1.15 (0.81 to 1.64) | 0.42 |
| Hospital-free days through day 28, median (IQR) | 5 (−1 to 18) | 6 (−1 to 17) | 0.76 | aOR, 1.06 (0.75 to 1.50) | 0.76 |
| 28-d mortality, n (%) | 75 (38.1) | 88 (35.3) | 0.55 | aOR, 0.78 (0.50 to 1.20) | 0.25 |
Definition of abbreviations: aOR = adjusted odds ratio; CDS = clinical decision support; CI = confidence interval; FiO2 = fraction of inspired oxygen; IQR = interquartile range; LTVV = low tidal volume ventilation; PaO2 = arterial partial pressure of oxygen; PEEP = positive end-expiratory pressure; SD = standard deviation.
Adjusted for patient age, acute physiology score, PaO2/FiO2 ratio, primary acute respiratory distress syndrome risk factor, sex, hospital, body mass index, and Charlson Comorbidity Index.
Eight subjects on appropriate continuous positive airway pressure or pressure support for all ventilator checks were excluded from the analysis.
One subject with a missing outcome variable was excluded from the analysis.