Comparing the Effectiveness of Medication Use Systems in Small Rural Hospitals

小型乡村医院用药系统的有效性比较

• 批准号: 7880185
• 负责人: Gary Lowell Cochran
• 金额: $ 13.15万
• 依托单位: UNIVERSITY OF NEBRASKA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7880185
• 关键词: Comparing; Effectiveness; Medication; Use; Systems

DESCRIPTION (provided by applicant): My career objective is to develop an independent research program focusing on the safe and effective use of medications in rural communities. More than 400,000 harmful medication errors occur each year. While significant advances have been made in large hospitals, little research has been conducted in the nation's 1,300 critical access hospitals where differences in personnel, infrastructure, and care delivery processes make the generalizeability of findings observed in large urban facilities difficult. The lOM has recognized the need for comparative effectiveness data, recommending that future research should focus on "how to select an individual application, such as CPOE, bar coding, and smart pumps." The purpose of the proposed research is to compare the effectiveness of two medication use technologies used by critical access hospitals - bedside bar-code administration and telepharmacy. This proposal directly addresses the lOM's recommendation and four of the seven areas of research interest listed by AHRQ. To complete this research, a career development plan has been developed that combines didactic coursework, mentoring, and applied research. New analytic techniques needed to address limitations of observational study designs - including propensity scoring, instrumental variables, and hierarchical modeling - will be learned. Practice Based Evidence for Clinical Practice Improvement (PBE-CPl) is a methodology that incorporates natural variation from routine clinical practice to determine what works, for whom, when, and at what cost. This promising study design will be incorporated into the research program. UNMC provides an excellent training and research environment for individuals interested in health services research. Senior investigators in the College of Public Health including the Department of Biostatistics, and the College of Pharmacy will provide mentoring throughout the program. The "hands-on" experience and formal training described in this research and mentoring plan will provide me with the specialized expertise necessary to conduct an independent line of research. RELEVANCE (See instructions): The results of the proposed research will provide small hospitals with the information they need to choose the most cost-effective technology to reduce medication errors in their facilities. This program will improve medication safety, reduce harmful medication errors, and improve the quality and efficiency of healthcare for those living in, and traveling through, rural America.

描述（由申请人提供）：我的职业目标是开发一个独立的研究项目，重点是在农村社区安全有效地使用药物。每年发生40多万起有害的用药错误。虽然在大型医院取得了重大进展，但在全国1，300家关键接入医院中进行的研究很少，这些医院在人员，基础设施和护理提供过程方面的差异使得在大型城市设施中观察到的结果难以普遍化。IOM已经认识到需要比较有效性数据，建议未来的研究应该集中在“如何选择个人应用，如CPOE，条形码和智能泵。“拟议研究的目的是比较两种药物使用技术的有效性，由关键访问医院-床边条形码管理和远程药房。这项建议直接涉及观察团的建议和人权问题咨询委员会所列七个研究领域中的四个。为了完成这项研究，职业发展计划已经制定，结合教学课程，辅导和应用研究。将学习解决观察性研究设计局限性所需的新分析技术-包括倾向评分，工具变量和分层模型。基于实践的临床实践改进证据（PBE-CPl）是一种方法学，它结合了常规临床实践的自然变化，以确定什么有效，对谁有效，何时有效以及成本如何。这一有前途的研究设计将被纳入研究计划。联合国医务中心为对保健服务研究感兴趣的个人提供了一个极好的培训和研究环境。公共卫生学院的高级研究员，包括生物统计学系和药学院将在整个计划中提供指导。本研究和指导计划中描述的“实践”经验和正式培训将为我提供进行独立研究所需的专业知识。相关性（参见说明）：拟议研究的结果将为小型医院提供所需的信息，以选择最具成本效益的技术来减少其设施中的用药错误。该计划将提高用药安全性，减少有害的用药错误，并提高那些生活在美国农村地区的人的医疗保健质量和效率。