Geriatric Pain Care in the Emergency Department

急诊科的老年疼痛护理

• 批准号: 8113357
• 负责人: Ula Y Hwang
• 金额: $ 12.93万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8113357
• 关键词: Absence of pain sensation; Accident and Emergency department; Address; Advocate; Affect; Age; Aging; Area; Award; Awareness; Beds; Cancer Patient; Caring; Censuses; Characteristics; Clinical; Collaborations; Comorbidity; Complement; Conflict (Psychology); Crowding; Data; Data Set; Decubitus ulcer; Delirium; Education; Educational Curriculum; Elderly; Emergency Medicine; Emergency Situation; Environmental Risk Factor; Evaluation; Five-Year Plans; Foundations; Future; Geriatrics; Goals; Healthcare; Healthcare Systems; Hospitalization; Hospitals; Impaired cognition; Intervention; Knowledge; Length of Stay; Measures; Medical; Mentors; Mentorship; Methodology; Methods; Modeling; Observational Study; Outcome; Pain; Pain Measurement; Pain Research; Pain management; Palliative Care; Patient Care; Patients; Polypharmacy; Process; Quality of Care; Reporting; Research; Research Personnel; Research Project Grants; Research Training; Risk; Role; Severities; Testing; Time; Training; Training Programs; Translating; Work; care delivery; career; design; experience; hospital patient care; improved; insight; patient oriented; pressure; prospective; therapy design

DESCRIPTION (provided by applicant): This application proposes a mentoring and training program for Dr. Ula Hwang in patient-oriented aging research in the emergency department (ED). The long-term career goals of Dr. Hwang are to become an independent investigator with a focus on understanding and improving pain management for older adults seen in the ED. The evaluation of factors (both patient-related characteristics and environmental conditions in the ED) associated with poorer pain care will allow Dr. Hwang to develop and target future interventions to improve pain management for older adults. This award will provide her with the data, training, experience, and credibility to become an advocate and leader for promoting better quality of care for older adults in the ED. This application details a five-year plan that includes extensive mentoring, research training, geriatrics education activities, and two research projects - all building upon Dr. Hwang's previous training and current research. Under the mentorship of leaders in both the fields of geriatrics (Dr. R. Sean Morrison, primary mentor) and emergency medicine (Dr. Lynne D. Richardson), she will receive strong guidance throughout the award period in the areas of methodology, aging research, and elder care in the ED. She will be additionally supported by a content mentor in emergency pain research (Dr. Knox Todd) and a statistical mentor (Dr. Gary Winkel). Formal coursework will strengthen her foundation in biostastitical methods using large data sets, utilizing time data and hierarchical models, and focusing on outcomes and statistical principles specific to the older adult. A geriatrics educational curriculum tailored for Dr. Hwang by her educational mentor (Dr. Roseanne Leipzig) will allow her to expand her knowledge and understanding of aging research, providing her with a Geriatrician's perspective on ED care for older adults and Geriatric-Emergency Medicine research. The two proposed studies of the application complement each other, while building and expanding on previous work by Dr. Hwang. The specific aims of Project One are to study how patient-related characteristics and ED crowding factors affect pain care for older adults, while Project Two will examine short-term clinical outcomes associated with ED pain care. Both projects involve collaborations with existing research groups. Project One involves a collaboration with a multicenter consortium of academic EDs studying crowding, while Project Two uses data from a prospective multicenter observational study of palliative care outcomes for hospitalized cancer patients. The results of both projects will permit the testing of several hypotheses related to ED pain management for older adults and its outcomes. These results will also provide the foundation from which major studies evaluating pain care interventions may be designed and targeted for the older adult. Pain care is a model condition for evaluating the quality of care. Investigating how pain care delivery for the older adult in the ED setting is affected by patient-related and ED environmental factors, and understanding the relevance of ED pain care in the continuum of hospital care can make an important contribution to preparing the ED, and the healthcare system in general, to focus on the challenges of providing high quality geriatric patient care.

描述（由申请人提供）：本申请建议在急诊科（ED）中为Ula Hwang博士提供指导和培训计划。 Hwang博士的长期职业目标是成为一名独立研究者，重点是理解和改善ED中老年人的疼痛管理。与较差的疼痛护理相关的因素（与患者相关的特征和环境状况）的评估将使Hwang博士能够制定并针对未来的干预措施，以改善老年人的疼痛管理。该奖项将为她提供数据，培训，经验和信誉，以成为促进ED中老年人更好的护理质量的倡导者和领导者。该应用程序详细介绍了一项五年计划，其中包括广泛的指导，研究培训，老年教育活动以及两个研究项目 - 所有这些都基于Hwang博士以前的培训和当前研究。在老年医学领域的领导者（R. Sean Morrison博士，小学导师）和急诊医学（Lynne D. Richardson博士）的指导下，她将在整个奖项期间在方法论，老龄化研究和ED中的老年护理领域获得强有力的指导。她还将得到紧急疼痛研究（Knox Todd博士）和统计导师（Gary Winkel博士）的内容导师的支持。正式的课程将使用大型数据集，利用时间数据和分层模型来增强她在生物统计方法中的基础，并专注于成年人特定的结果和统计原理。她的教育导师（Roseanne Leipzig博士）为Hwang量身定制的老年医学教育课程将使她能够扩大自己的知识和对衰老研究的了解，从而为她提供老年医生对老年人和老年人疗效医学研究的ED护理的看法。对应用程序的两项拟议研究相互补充，同时在Hwang博士的先前工作中建立和扩展。项目ONE的具体目的是研究与患者相关的特征和ED拥挤因素如何影响老年人的疼痛护理，而第二个项目将检查与ED疼痛护理相关的短期临床结果。这两个项目都涉及与现有研究小组的合作。项目第一涉及与研究拥挤的多中心联盟的合作，而第二个项目则使用了来自预期的多中心观察性研究的数据，用于住院癌症患者的姑息治疗结果。这两个项目的结果将允许测试与老年人及其结果有关的几种与ED疼痛管理有关的假设。这些结果还将为评估疼痛护理干预措施的重大研究为老年人设计和针对性。疼痛护理是评估护理质量的模型条件。调查在ED环境中为老年人提供疼痛护理如何受到与患者有关的环境因素和ED环境因素的影响，并了解ED疼痛护理在医院护理的连续性中的相关性可以为准备ED和医疗保健系统做出重要贡献，并集中于提供高质量的高质量患者护理的挑战。