UTI in Nursing Home Residents: Research Training and Clinical Investigation

疗养院居民的尿路感染：研究培训和临床调查

• 批准号: 7470348
• 负责人: MANISHA JUTHANI-MEHTA
• 金额: $ 15.97万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-15 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7470348
• 关键词: Acute; Adverse drug effect; Americas; Antibiotic Therapy; Antibiotic-resistant organism; Area; Bacteremia; Bacteria; Bacteriuria; Burn injury; Caring; Cessation of life; Chronic Disease; Clinical; Clinical Trials; Clinical Trials Design; Colony-forming units; Communicable Diseases; Consensus; Count; Data; Development; Development Plans; Diagnosis; Discipline of Nursing; Dysuria; Elderly; Environment; Epidemiology; Expenditure; Fatigue; Fever; Flank Pain; Frequencies; Future; Geriatrics; Goals; Gold; Growth; Healthcare; Hematuria; Increased frequency of micturition; Indwelling Catheter; Infection; Infection Control; Infectious Disease Epidemiology; Inflammatory Response; Interview; Investigation; Laboratories; Lead; Left; Leukocytes; Licensed Practical Nurse; Long-Term Care; Longitudinal Studies; Malaise; Medical; Medical Surveillance; Mentors; Mentorship; Methodology; Nurses; Nursing Homes; Odors; Outcome; Pain; Pattern; Personal Satisfaction; Physicians; Psyche structure; Public Health; Pyuria; Rate; Registered nurse; Research; Research Design; Research Personnel; Research Training; Risk; Sepsis; Societies; Specimen; Standards of Weights and Measures; Symptoms; Temperature; Time; Training; Universities; Urinalysis; Urinary Incontinence; Urinary tract; Urinary tract infection; Urination; Urine; Validation; Vulnerable Populations; base; career; clinical epidemiology; cohort; functional decline; functional status; health care delivery; improved; member; milliliter; mortality; pathogen; patient oriented; programs; skills

DESCRIPTION (provided by applicant): Improving health care delivery for older adults requires investigation by both trained geriatricians and subspecialists with a geriatric focus. Infections in older adults are a common public health problem that lead to functional decline, mortality, and healthcare expenditures. Nursing home residents, in particular, are a vulnerable population in whom further investigation is warranted to optimize medical care. Urinary tract infection (UTI) in nursing home residents is an investigatively understudied topic. The primary objective of this application is to train Dr. Juthani-Mehta, the candidate, to be an investigative leader in geriatric infectious diseases and to advance multidisciplanary research in UTI in nursing home residents. The goals of this career development plan are: 1) to establish the candidate as a patient-oriented investigator at the interface of infectious diseases, geriatric medicine, and nursing home practice; 2) to gain additional training and mentorship in chronic disease epidemiology, infectious diseases epidemiology, and longitudinal study design; 3) to obtain skills in clinical trial design, geriatric medicine, and infection control methodology in nursing homes; and 4) to prepare the candidate to conduct multi-center observational and interventional clinical trials in long-term care facilities. The specific aims of the research plan are: 1) to determine the reliability of urinary tract specific (e.g. flank pain or tenderness) and urinary tract non-specific (e.g., change in mental status) clinical features as assessed by nursing home staff in nursing home residents with suspected UTI; and 2) to identify and validate those reliable clinical features in residents with suspected UTI that are associated with laboratory evidence of UTI (i.e., bacteriuria plus pyuria). Supplementary aims are to identify residents with suspected UTI that have adverse outcomes related to UTI, to treatment, or to either. The combination of reliable and validated clinical features, bacteriuria, and pyuria will be the basis for an evidence-based definition of UTI. The candidate is an emerging patient-oriented investigator with unique training in infectious diseases and geriatric clinical epidemiology. Since she has been recognized nationally by the Infectious Diseases Society of America as a Williams Scholar, she is an ideal candidate to be an investigative leader in this field. The renowned mentors she has assembled and the environment at Yale University will allow for outstanding training and the successful completion of the proposed study.

描述（由申请人提供）：改善老年人的医疗保健服务需要经过培训的老年病学家和以老年病为重点的亚专科医生进行调查。老年人的感染是一个常见的公共卫生问题，会导致功能下降、死亡和医疗支出。疗养院居民尤其是弱势群体，需要进一步调查以优化医疗服务。疗养院居民的尿路感染（UTI）是一个尚未得到充分研究的话题。该应用程序的主要目标是培训候选人 Juthani-Mehta 博士成为老年传染病的研究领导者，并推进疗养院居民尿路感染的多学科研究。该职业发展计划的目标是：1）将候选人培养成为传染病、老年医学和疗养院实践领域以患者为中心的研究者； 2) 获得慢性病流行病学、传染病流行病学和纵向研究设计方面的额外培训和指导； 3) 获得临床试验设计、老年医学和疗养院感染控制方法方面的技能； 4) 帮助候选人做好在长期护理机构进行多中心观察和介入临床试验的准备。该研究计划的具体目标是： 1) 确定疗养院工作人员对疑似尿路感染的疗养院居民评估的泌尿道特异性（例如胁腹疼痛或压痛）和泌尿道非特异性（例如精神状态变化）临床特征的可靠性； 2) 识别和验证疑似尿路感染居民中与尿路感染实验室证据相关的可靠临床特征（即菌尿加脓尿）。补充目标是识别患有与尿路感染、治疗或两者相关的不良后果的疑似尿路感染居民。可靠且经过验证的临床特征、菌尿和脓尿的结合将成为 UTI 循证定义的基础。该候选人是一位新兴的以患者为中心的研究人员，在传染病和老年临床流行病学方面接受过独特的培训。由于她已被美国传染病学会在全国范围内认可为威廉姆斯学者，因此她是成为该领域研究领导者的理想人选。她召集的著名导师和耶鲁大学的环境将为她提供出色的培训和成功完成拟议的研究。