Deimplementing CXR After CVC (DRAUP) in the ICU | NCT06146348

Studies
Deimplementing CXR After CVC (DRAUP) in the ICU

NCT06146348

Sponsor

Washington University School of Medicine

Status

Completed

Last Update Posted

Apr 21, 2026Actual

Enrollment

101Actual

Phase

Not Applicable

Conditions

Implementation Science
Behavior and Behavior Mechanisms

Interventions

adapted DRAUP strategy bundle

Countries

United States

Protocol Section

Identification Module Status Module Sponsor/Collaborators Module Oversight Module Description Module Conditions Module Design Module Arms/Interventions Module Outcomes Module Eligibility Module Contacts/Locations Module References Module IPD Sharing Statement Module

Results Section

Participant Flow Module Baseline Characteristics Module Outcome Measures Module Adverse Events Module More Info Module

Annotation Section

Annotation Module

Document Section

Large Document Module

Derived Section

Miscellaneous Info Module Condition Browse Module Intervention Browse Module

Protocol Section

Identification Module

NCT ID

Results Section

No data available

No data is available for this block.

Annotation Section

No data available

No data is available for this block.

Document Section

No data available

No data is available for this block.

Derived Section

Miscellaneous Info Module

Version Holder

ID	Type	Description	Link
5K01HL161026-02	U.S. NIH Grant/Contract		View source

Status Module

Record Verification Date

Apr 2026

Overall Recruitment Status or Expanded Access Status

Completed

Last Known Status

Not provided

Delayed Posting

Not provided

Why Stopped

Not provided

Expanded Access Info

Start Date

Jan 1, 2024Actual

Primary Completion Date

Dec 31, 2025Actual

Completion Date

Dec 31, 2025Actual

First Submitted Date

Nov 17, 2023

First Submission Date that Met QC Criteria

Nov 17, 2023

First Posted Date

Nov 24, 2023Actual

Results Waived

Not provided

Results First Submitted Date

Not provided

Results First Submitted that Met QC Criteria

Not provided

Results First Posted Date

Not provided

Certification/Extension (aka Delayed Results) First Submitted Date

Not provided

Certification/Extension First Submitted that Passed QC Review

Not provided

Certification/Extension First Posted Date

Not provided

Last Update Submitted Date

Apr 17, 2026

Last Update Posted Date

Apr 21, 2026Actual

Sponsor/Collaborators Module

Responsible Party, by Official Title

Enyo Ablordeppey, Assoc Prof of Anesthesiology, Washington University School of MedicinePrincipal Investigator

Lead Sponsor

Washington University School of MedicineOTHER

Collaborators

Name	Class
National Heart, Lung, and Blood Institute (NHLBI)	NIH

Oversight Module

Has Data Monitoring Committee (DMC)

Yes

Is FDA Regulated Drug

Is FDA Regulated Device

Is Unapproved Device

Not provided

Pediatric Postmarket Surveillance of a Device Product

Not provided

Product Exported from US

Not provided

FDAAA801 Violation

Not provided

Description Module

Brief Summary

This study proposes adapting and testing an innovative, behavioral theory-driven deimplementation program called DRAUP in two intensive care units for proof of concept and support that the program can help providers and hospital organizations address context determinants of deimplementation. Study data will be used to optimize the intervention for a subsequent larger trials.

Detailed Description

There are millions of critically ill patients annually who require imaging confirmation after central venous catheter insertion. Emerging literature demonstrates that ultrasound is a faster alternative to historical chest xray, thus serving as the ideal confirmation for catheter use. When able to confirm catheter position, ultrasound decreases the number of unnecessary chest radiographs, cumulative resources (technologist, radiologist, equipment), and patient care delays. However, providers are not adopting this practice. Previously, we developed and initiated a successful evidence-based deimplementation program for ultrasound in lieu of chest xray called DRAUP in the Emergency Department. We now move to adapt the deimplementation bundle in the new environment of the Intensive Care Unit (ICU) with hopeful continued success.

In experiment 1, qualitative analysis will be employ a systematic approach to DRAUP component refinement dosed to the unique context of the Intensive Care Unit and implementation outcomes as well as cost will be evaluated. In experiment 3, mixed methods will be used to evaluate the mechanism of impact of the refined program in the new environment.

Design Module

Study Type

Interventional

Number of References to an Expanded Access Study

Not provided

Expanded Access Types

Not provided

Patient Registry

Not provided

Target Follow-Up Duration

Not provided

Phases

Not Applicable

Interventional Study Design

Allocation

Biospecimen

No data available

No data is available for this block.

Enrollment

101Actual

Arms/Interventions Module

Arm Groups

Label	Type	Description	Intervention Names
CVC confirmed by DRAUP	Experimental	new mode of CVC confirmation for correct location and excluding pneumothorax	Behavioral: adapted DRAUP strategy bundle
CVC confirmed by CXR	Experimental	traditional mode of CVC confirmation for correct location and excluding pneumothorax	Behavioral: adapted DRAUP strategy bundle

Interventions

Name	Type	Description	Arm Group Labels	Other Names
adapted DRAUP strategy bundle	Behavioral	DRAUP deimplementation strategy bundle includes: 1) education and training, 2) supervision and in-person decision support, and 3) audit and feedback to target capability. Opportunity is addressed by 4) algorithm development and 5) organizational support. Finally, 6) facilitators and 7) planned adaptation after interval program assessment address the motivations needed to change behavior.

Outcomes Module

Primary Outcomes

Measure	Description	Time Frame
DRAUP in	Deadoption of CXR after US guided CVC confirmation	24 months

Secondary Outcomes

Measure	Description	Time Frame
Fidelity	Percentage of DRAUP non-adherence	24 months

Other Outcomes

Not provided

Eligibility Module

Eligibility Criteria

-Measure the effectiveness and cost effectiveness of DRAUP on discontinuation of CXRs

Inclusion Criteria for DRAUP training:

(1) ICU faculty, fellows, senior residents (post graduate year 3) and advanced practice practitioners

ICU inclusion for DRAUP program:
Availability of ultrasound machines with archiving capability (DICOM)
A minimum of 100 supradiaphragmatic CVC insertions annually in adult patients (age >18)
Capacity to access digital archiving (PICOM)
Patient inclusion for DRAUP program:
supradiaphragmatic CVC placed
Patient exclusion for DRAUP program:
severe instability (cardiac arrest, severe shock) where CVC would be used without CXR,
level 1 trauma;
burn patients with no viable skin surface for imaging

Accepts Healthy Volunteers

Sex

All

Sex/Gender Based

Not provided

Sex/Gender Description

Not provided

Minimum Age

18 Years

Maximum Age

Not provided

Standard Ages

AdultOlder Adult

Study Population

Not provided

Sampling Method

Not provided

Contacts/Locations Module

Central Contacts

Not provided

Overall Officials

Name	Affiliation	Role
Enyo Ablordeppey, MD MPH	Washington University School of Medicine	Principal Investigator

Locations

Facility	Status	City	State	ZIP	Country	Contacts
Washington University School of Medicine		St Louis	Missouri	63108	United States

IPD Sharing Statement Module

Plan to Share IPD

Yes

Description

IPD sharing upon request

Types

Study Protocol

Time Frame

Not provided

Access Criteria

Not provided

URL

Not provided

Condition Browse Module

MeSH Terms

ID	Term
D001519	Behavior

Ancestor Terms

Not provided

Browse Leaves

Not provided

Browse Branches

Not provided