Implementation of evidence-based practice for benign paroxysmal positional vertigo: DIZZTINCT- A study protocol for...

Area of Science:

• Neurology
• Vestibular Disorders
• Clinical Trials

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common cause of dizziness, leading to significant patient disability.
• Established diagnostic (Dix-Hallpike Test, DHT) and therapeutic (Canalith Repositioning Maneuver, CRM) procedures for BPPV exist but are underutilized.
• Current BPPV care processes often fall short of guideline recommendations.

Purpose of the Study:

• To evaluate the effectiveness of a multi-faceted intervention aimed at improving the implementation of evidence-based BPPV care in emergency departments.
• To increase the documentation rates of the DHT and CRM for patients presenting with dizziness.

Main Methods:

• A stepped-wedge, randomized clinical trial involving six hospitals.
• Hospitals were randomized into five waves to receive a multi-faceted educational and care-process intervention.
• The primary outcome was the documentation of either the DHT or CRM in individual patient records.

Main Results:

• The study aims to determine if the intervention safely increases the documentation of the DHT and CRM.
• Secondary outcomes include referral rates for CRM and 90-day stroke rates.
• Formative evaluations will assess factors influencing implementation effectiveness.

Conclusions:

• Successful implementation of this intervention could significantly improve the use of evidence-based BPPV treatments.
• Positive findings would support larger studies assessing patient outcomes.
• The study provides data on implementation influences for future BPPV care improvements.