Improving Pressure Ulcer Care in Nursing Homes

描述(由申请者提供)：NIA职业发展奖(CDA)申请的目的是为申请者提供必要的知识、分析技能和初步数据库，以开发有助于将干预措施转移到疗养院(NHS)实践中的技术，特别是监测压疮(PU)护理过程的质量评估(QA)系统。拟议的CDA将允许申请人在四个主要领域接受培训，每个领域都与她现有的知识相辅相成：1)专家共识方法，基于她在国家PU小组和研究开发PU评估工具的经验；2)与改变提供者行为和在NHS实施实践指南相关的医疗服务研究，其基础是她的临床和教学经验；3)成本效益和成本效益分析；4)运营研究建模，以便能够确定实施QA系统所需的相关成本和人力资源，这两者都扩展了她现有的研究方法知识，并将加强她的统计分析知识。具体地说，这份CDA申请旨在为申请者提供必要的知识和分析技能，以实现她的直接职业目标，即完善和验证用于监控NHS PU护理流程的QA系统。拟议的CDA培训计划结合了正式的课程和个性化的教程，为申请者提供必要的知识和技能，以实现她直接的职业目标。John F.Schnelle博士是NHS的行为心理学家和行为和环境干预方面的专家，他将作为申请者的赞助人和主要导师，提供焦点小组方法方面的培训，以及设计、实施和评估NHS的干预措施。护士和NH人员配备专家Charlene Harrington博士将在NHS的护士人员配备问题和QA系统实施所需的护士人员配置比例方面担任导师。George Xakellis博士和Laurence Rubenstein博士将在实施实践指南、NH组织结构和与QA系统实施相关的成本效益分析方面担任她的导师。她将与克劳德·B·佩珀老年美国独立中心(OAIC)数据管理核心合作开发软件，并与两名顾问合作完善移动监控技术，这两项技术都是在NHS实施该系统所必需的。玛丽·卡多根博士将为护士专家组提供指导。兰德公司的高级数学家Emmett Keeler博士将提供与干预和运营研究建模技术相关的成本分析方面的培训，以确定系统成本和必要的人力资源。这类培训将使申请者能够实现她的长期职业目标，即制定行为和环境干预措施，以改善住院老人的生活质量，并确定在医院护理环境中实施此类干预措施所需的卫生保健工作人员资源和相关费用。因此，拟议的CDA培训将是申请人在其选定的老年学研究领域内发展为独立科学家的能力的核心。

DESCRIPTION (provided by applicant): The purpose of the NIA Career Development Award (CDA) application is to provide the applicant with the knowledge, analytical skills, and preliminary database necessary to develop technology that will facilitate the transfer of interventions, specifically a quality assessment (QA) system for monitoring pressure ulcer (PU) care processes, into practice in nursing homes (NHs). The proposed CDA will allow the applicant to receive training in four primary areas, each of which compliments her existing knowledge: 1) expert consensus methodology, which builds on her experience with national PU panels and research developing a tool for assessing PUs; 2) health service research relevant to changing provider behavior and implementing practice guidelines in NHs, which builds on her clinical and teaching experience; 3) cost effectiveness and cost benefit analysis and 4) operations research modeling such that associated costs and staffing resources required for implementing the QA system can be determined, both of which expand her existing knowledge of research methodology and will strengthen her knowledge of statistical analysis. Specifically, this CDA application is designed to provide the applicant with the necessary knowledge and analytical skills to pursue her immediate career goal of refining and validating the QA system for monitoring PU care processes in NHs. The proposed CDA program of training incorporates formal coursework and individualized tutorials to provide the applicant with the requisite knowledge and skills to accomplish her immediate career goals. Dr. John F. Schnelle, PhD, a behavioral psychologist and expert in behavioral and environmental interventions in NHs, will serve as the applicant's sponsor and primary mentor, providing training in focus group methodology as well as designing, implementing, and evaluating interventions in NHs. Dr. Charlene Harrington, a nurse and expert in NH staffing, will serve as a mentor in nurse staffing issues in NHs and nurse staffing ratios needed for implementation of the QA system. Drs. George Xakellis, and Laurence Rubenstein will be her mentors in implementing practice guidelines, NH organizational structure, and cost benefit analysis related to implementation of the QA system. She will work with the Claude B. Pepper Older American Independence Center (OAIC) Data Management Core in developing software, and with two consultants to refine movement monitoring technology both of which are necessary for implementation of the system in NHs. Dr. Mary Cadogan will provide guidance for the nurse expert panel. Dr. Emmett Keeler, a senior mathematician at RAND, will provide training in cost analysis related to the intervention and operations research modeling techniques to determine systems costs and the necessary staff resources. Such training will permit the applicant to pursue her long-term career goal of developing behavioral and environmental interventions that improve the quality of life among institutionalized elders, and determine the NH staff resources and the associated costs necessary to implement such interventions in the NH setting. Thus, the proposed CDA training would be central to the applicant's ability to develop as an independent scientist within her chosen area of gerontologic research.