A Decision Support Tool for Adult Sickle Cell Emergency Department Patients

成人镰状细胞急诊科患者的决策支持工具

• 批准号: 7797647
• 负责人: Paula Tanabe
• 金额: $ 11.77万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-20 至 2011-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7797647
• 关键词: Accident and Emergency department; Acute Pain; Addictive Behavior; Address; Admission activity; Adult; Age; Analgesics; Area; Biological; Caring; Comorbidity; Complex; Complication; Comprehensive Health Care; Data Reporting; Discipline; Disease; Doctor of Philosophy; Education; Emergency Medicine; Emergency Situation; Evaluation; Feeling; Female; Frequencies; Genotype; Goals; Health Personnel; Health Services; Health Services Needs; Hematology; Hospitalization; Hour; Incidence; Individual; Interview; Knowledge; Lead; Life; Life Expectancy; Medication Management; Mentorship; Methodology; Needs Assessment; Nurses; Pain; Pain Measurement; Pain management; Paper; Pastoral Care; Patient Education; Patients; Persons; Pharmaceutical Preparations; Physical therapy; Physicians; Physiological; Positioning Attribute; Psychiatry; Psychometrics; Reporting; Research; Research Personnel; Risk; Risk Factors; Sampling; Services; Sickle Cell; Sickle Cell Anemia; Social Health Services; Social Work; Specialist; Techniques; Testing; Time; Training; United States; United States National Institutes of Health; Universities; Visit; addiction; career; career development; drug addict; experience; hospital admission rate; improved; male; mortality; neglect; professor; programs; psychologic; satisfaction; social; tool; tool development

DESCRIPTION (provided by applicant): The applicant is a Research Assistant Professor in Emergency Medicine at Northwestern University. The applicant's long-term goal is to become an independent investigator with a primary focus on improving the care for persons with Sickle Cell disease (SCO) in the emergency department (ED) setting. Acute pain episodes are the most frequent complication associated with SCD. These painful episodes are severe and often require care in the emergency department (ED) setting. ED clinicians frequently perceive persons with SCD to be drug seeking and patients often perceive the ED experience as frustrating. Some patients with SCD also have complex co-morbidities and bio-psycho-social needs that may contribute to frequent ED visits. Clinicians are often unprepared to manage the acute pain in the ED setting for persons with SCD and are not trained in how to perform an adequate bio-psycho-social assessment that would identify individual patient education and referral needs upon ED discharge. Identification of these needs may lead to improved care and decreased return ED visits when provided with proper referrals. The goal of this project is to develop and pilot test a bio-psycho-social decision support tool (the Sickle Cell Assessment of Needs and Strengths, SCANS) to be used by emergency clinicians. The SCANS will 1) objectively assess and guide ED analgesic management and 2) identify education and referral service delivery needs for adult patients with SCD. The SCANS will be beneficial to both emergency clinicians and patients with SCD, in particular for patients with complex needs that currently may result in frequent ED visits. Under the mentorship of established investigators in the areas of hematology, emergency medicine pain management, psychometrics and addiction the candidate proposes a career development program that addresses the applicants' long- term goal of becoming an independent investigator. Primary goals of the proposed training are to 1) increase knowledge in SCD, 2) gain an in-depth understanding of the complex relationship between addiction and pain, and 3) receive training in qualitative and decision support tool development methodologies. This knowledge will position the candidate to launch a research career as an investigator who will conduct projects aimed at scientifically evaluating mechanisms to improve the care of persons with SCD in the ED setting.

描述（由申请人提供）： 申请人是西北大学急诊医学研究助理教授。申请人的长期目标是成为一名独立研究者，主要重点是改善急诊科（ED）环境中镰状细胞病（SCO）的护理。急性疼痛发作是与SCD相关的最常见并发症。这些痛苦的发作很严重，通常需要在急诊科（ED）设置中进行护理。 ED临床医生经常认为SCD患者是寻求药物，患者经常认为ED经历令人沮丧。一些SCD患者还具有复杂的合并症和生物心理社会需求，可能会导致经常访问。临床医生通常没有准备好管理ED环境中SCD患者的急性疼痛，并且未经培训如何进行足够的生物心理社会评估，以确定ED出院后的患者教育和转诊需求。确定这些需求可能会导致改善的护理，并在提供适当的推荐后减少回报访问。该项目的目的是开发和试点测试一种生物心理社会决策支持工具（镰状细胞评估需求和优势，扫描），以供紧急临床医生使用。扫描将1）客观地评估和指导ED止痛药管理，2）确定SCD成年患者的教育和转诊服务提供需求。扫描将对急诊临床医生和SCD患者均有益，特别是对于目前可能导致ED访问的复杂患者。在血液学，急诊医学疼痛管理，心理计量学和成瘾领域的既定研究者的指导下，候选人提出了一项职业发展计划，以解决申请人成为独立研究者的长期目标。拟议培训的主要目标是1）增加SCD的知识，2）对成瘾与疼痛之间的复杂关系有深入的了解，以及3）接受定性和决策支持工具开发方法的培训。这些知识将使候选人成为研究人员的研究职业，该研究人员将开展旨在科学评估机制以改善ED环境中SCD人员护理机制的项目。

项目成果

Adult emergency department patients with sickle cell pain crisis: results from a quality improvement learning collaborative model to improve analgesic management.

患有镰状细胞疼痛危机的成人急诊科患者：改善镇痛管理的质量改进学习协作模型的结果。

• DOI: 10.1111/j.1553-2712.2012.01330.x
• 发表时间: 2012
• 期刊: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
• 作者: Tanabe,Paula;Hafner,JohnW;Martinovich,Zoran;Artz,Nicole
• 通讯作者: Artz,Nicole

The Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS): reliability and validity.

急诊科镰状细胞病需求和优势评估 (ED-SCANS)：可靠性和有效性。

• DOI: 10.1097/tme.0b013e31828ecbd5
• 发表时间: 2013
• 期刊: Advanced emergency nursing journal
• 影响因子: 0.5
• 作者: Tanabe,Paula;Thornton,VictoriaL;Martinovich,Zoran;Todd,KnoxH;Wun,Ted;Lyons,JohnS
• 通讯作者: Lyons,JohnS

Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS), a focus group and decision support tool development project.

急诊科镰状细胞需求和优势评估 (ED-SCANS)，焦点小组和决策支持工具开发项目。

• DOI: 10.1111/j.1553-2712.2010.00779.x
• 发表时间: 2010
• 期刊: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
• 作者: Tanabe,Paula;Reddin,Christopher;Thornton,VictoriaL;Todd,KnoxH;Wun,Ted;Lyons,JohnS
• 通讯作者: Lyons,JohnS