Clinical Trial: Turning Night Into Day: Transcontinental Provision of Telehealth By and For the Emory Community

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Turning Night Into Day: Transcontinental Provision of Telehealth By and For the Emory Community

Brief Summary: The purpose of the study is to determine if temporarily relocating clinicians who deliver remote care using the eICU telehealth system to Sydney, Australia will lead to greater job satisfaction, reduced physiologic stress, and improve performance. Four nurses and six physicians will be sent to a site in Sydney Australia on a rotating basis to determine whether providing care during the Australian daytime is more efficient and precise than providing care during the night in the United States.

Detailed Summary:

The purpose of the study is to determine if temporarily relocating clinicians who deliver remote care using the eICU telehealth system to Sydney Australia will lead to greater job satisfaction, reduced physiologic stress, and improve performance. Four nurses and six physicians will be sent to a site in Sydney Australia on a rotating basis to determine whether providing care during the Australian daytime is more efficient and precise than providing care during the night in the United States.

As part of this pilot, each participant will undergo a series of evaluations before leaving, while in Australia, and after returning. The evaluations will include questionnaires related to well-being, task assessment (such as completing a paper maze or performing arithmetic), physiology assessment (such as continuous measure of heart rate by a wristwatch type device), and stress assessment (by sampling saliva and measuring cortisol and interleukin-1 Beta).

The researchers would like to determine whether normalization of the provider's (physician or nurse who are the research subjects) sleep-wake cycle improves subjective and objective well-being. Additionally, investigators seek to determine whether normalization of the provider's (physician or nurse who are the research subjects) sleep-wake cycle improves alertness and focus, and determine whether normalization of the provider's (physician or nurse who are the research subjects) sleep-wake cycle improves job performance.


Sponsor: Emory University

Current Primary Outcome: Change in Salivary Cortisol Levels [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]

Saliva will be collected via a mouth swab and tested for cortisol levels. Cortisol is a stress biomarker.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Change in Stanford Sleepiness Scale Score [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    The Stanford Sleepiness Scale is a seven point scale that asks participants to assess how alert they are feeling throughout the day. A result of 4 or below may indicate that a participant could be suffering from a lack of sleep
  • Change in the Trail Making Test A Score [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    During the Trail Making Test A, participants will be asked to draw lines to connect circled numbers in a numerical sequence (i.e., 1-2-3, etc.) as rapidly in possible. A shorter time indicates better cognition.
  • Change in the Trail Making Test B Score [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    During the Trail Making Test B, participants will be asked to draw lines to connect circled numbers and letters in an alternating numeric and alphabetic sequence (i.e., 1-A-2-B, etc.) as rapidly as possible. A shorter time indicates better cognition.
  • Change in Physical Activity assessed by Multi-Scale Entropy [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    Multi-scale entropy will be measured using a Jawbone wristband device provided to participants upon enrollment.
  • Change in Physical Activity assessed by Multi-Scale Complexity [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    Multi-scale complexity will be measured using a Jawbone wristband device provided to participants upon enrollment.
  • Change in Heart Rate Variability assessed by Deceleration Capacity [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    Deceleration capacity will be measured using a Jawbone wristband device provided to participants upon enrollment.
  • Change in Heart Rate Variability assessed by Acceleration Capacity [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    Acceleration capacity will be measured using a Jawbone wristband device provided to participants upon enrollment.
  • Frequency of Arrhythmias [ Time Frame: Duration of Study (Up to 31 Days) ]
    The frequency of arrhythmias will be collected using a Jawbone wristband device provided to participants upon enrollment.
  • Change in Sleep Latency [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    Sleep latency is the length of time it takes to accomplish the transition from full wakefulness to sleep. This will be measured in minutes using a Jawbone wristband device provided to participants upon enrollment.
  • Number of Awakenings per Hour [ Time Frame: Duration of Study (Up to 31 Days) ]
    The number of times a participants awakes during sleep will be monitored at every hour using a Jawbone wristband device provided to participants upon enrollment.
  • Change in Percent of Non Rapid Eye Movement (REM) Sleep [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    Change is the difference between the percentage of non REM sleep taken during performance phases.
  • Change in Mood Symptom Questionnaire Score [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    The Mood Symptom Questionnaire was originally designed to diagnose bipolar disorder. The questionnaire takes about five minutes to complete, and can provide important insights into diagnosis and treatment.If the patient answers "Yes" to seven or more of the 13 items in question number 1 AND "Yes" to question number 2 AND "Moderate" or "Serious" to question number 3, there is a positive screen.
  • Change in Patient Health Questionnaire-9 (PHQ-9) Score [ Time Frame: Baseline, Post Intervention (Up to 8 weeks) ]
    The PHQ-9 is a multi-purpose instrument for screening, diagnosing, monitoring, and measuring the severity of depression. A score of 5-9 represents signs of minimal depression symptoms. A score of 10-14 represents symptoms of minor depression. A score of 15-19 represents symptoms of major depression, moderately severe. A score of greater than 20 represents symptoms of major depression, severe.
  • Change in Number of Camera Sessions [ Time Frame: Day 1, Day 31 ]
    Difference in the number of camera sessions completed during performance phases.
  • Change in Duration of Camera Sessions [ Time Frame: Day 1, Day 31 ]
    Difference in the duration of camera sessions during performance phases measured in minutes.
  • Change in Urgency of Clinical Contacts [ Time Frame: Day 1, Day 31 ]

    Original Secondary Outcome: Same as current

    Information By: Emory University

    Dates:
    Date Received: September 1, 2016
    Date Started: June 2016
    Date Completion: December 2018
    Last Updated: September 6, 2016
    Last Verified: September 2016