6/28/23, 1:19 AM De-escalating Vital Sign Checks Pathway Feedback Search Clinical Topics Home Studies De-escalating Vital Sign Checks De-escalating Vital Sign Checks Disease ICU delirium Trial question Can a real-time predictive algorithm reduce delirium and help physicians identify patients who can safely forgo their vital signs checks? Study design Single center Open label RCT Population Characteristics of study participants 42.0% female N = 1930 58.0% male 1930 patients (818 female, 1112 male) Inclusion criteria: hospitalized adults who were not in the ICU Key exclusion criteria: admission to the ICU Interventions N=966 clinical decision support notification (informs the physician that the patient is predicted to have normal nighttime vital signs and offers sleep-promoting vitals order) N=964 usual care (the physician does not receive a clinical decision support notification about vital sign prediction) Primary outcome https://web.pathway.md/studies/rec7eKWW5dXteYUdd 1/2 6/28/23, 1:19 AM De-escalating Vital Sign Checks Pathway Delirium 13.0 % 13 11 9.8 % 6.5 % 3.3 % No significant difference 0.0 % Clinical decision support notification Usual care No significant difference in delirium (11% vs. 13%; RR 0.85, 95% CI -0.81 to 2.51) Secondary outcomes Significant decrease in the number of nighttime vital sign checks (0.97 vs. 1.41; RR 0.69, 95% CI 0.28 to 1.1) No significant difference in ICU transfers (5% vs. 5%; RR 1, 95% CI -16.93 to 18.93) Borderline significant decrease in code blue alarms (0.2% vs. 0.9%; RR 0.22, 95% CI -0.02 to 0.46) Conclusion In hospitalized adults who were not in the ICU, clinical decision support notification was not superior to usual care with respect to delirium. Reference Nader Najafi, Andrew Robinson, Mark J Pletcher et al. Effectiveness of an Analytics-Based Intervention for Reducing Sleep Interruption in Hospitalized Patients: A Randomized Clinical Trial. JAMA Intern Med. 2022 Feb 1;182(2):172-177. Open reference URL https://web.pathway.md/studies/rec7eKWW5dXteYUdd 2/2