Improving Patient Safety and Disease Management While on Contact Isolation

改善接触隔离期间的患者安全和疾病管理

• 批准号: 8263680
• 负责人: Daniel J Morgan
• 金额: $ 13.05万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 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/8263680
• 关键词: Improving; Patient; Safety; Disease; Management

This K08 proposal is designed to provide the didactic coursework and research mentoring to enhance Daniel Morgan's efforts to become an independent researcher in hospital epidemiology and quality improvement. He is an infectious diseases physician and Instructor of Epidemiology and Preventive Medicine at the University of Maryland. His long-term goal is to conduct and disseminate research on hospital-acquired infections and interventions that lead to overall quality improvement. In this career award, under the mentoring of outcomes researchers, Drs. Eli Perencevich, Anthony Harris and Lisa Dixon and an expert team of advisors, he proposes completing a Masters in Clinical Research and through his research aims, gaining expertise in measuring quality-of-care, adverse events and psychiatric screening. Contact isolation of patients who are known to be colonized with antibiotic-resistant bacteria is used to prevent transmission of these microorganisms to other patients and limit hospital-acquired infections. It is currently used for approximately 25% of inpatients in acute-care hospitals. These patients are medically complex with multiple illnesses and frequent exposure to healthcare facilities. Patients on contact isolation are less likely to see healthcare workers, have lower quality-of-care process measures, are more likely to become depressed and have low rates of patient satisfaction. Thus, isolated patients are potentially harmed to protect other patients. This project is designed to limit such harm. A methodologically rigorous approach is proposed to quantify the impact and relationship between isolation status of patients and adverse outcomes using a validated clinical data repository of the University of Maryland Medical Center for a historical cohort and a prospective cohort to address adverse events, management of disease, psychiatric screening and patient satisfaction. Using the data from these studies Dr. Morgan will develop and, in a new cohort, validate a novel, easily applied prediction rule to identify those isolated patients at high-risk of developing adverse events. At the end of this award he will be prepared to investigate interventions to decrease adverse events and potentially improve the overall care of the up to 10-15% of hospitalized patients who experience adverse outcomes while on contact isolation. RELEVANCE (See Instructions): Contact isolation is an important tool for preventing hospital-acquired infections. However, the medically complex patient who is placed on contact isolation appears to receive worse care because of isolation. With an increasing number of patients on contact isolation nationwide, it is important to determine the nature of adverse outcomes and methods to prevent such outcomes so that infection control methods can improve overall patient safety.

本K 08提案旨在提供教学课程和研究指导， 加强丹尼尔摩根的努力，成为一个独立的研究人员在医院流行病学， 质量改进。他是一名传染病医生和流行病学讲师， 马里兰州大学的预防医学。他的长期目标是引导和传播 研究医院获得性感染和干预措施，导致整体质量的提高。在这 职业奖，在成果研究人员的指导下，Eli Perencevich博士，Anthony Harris博士和 丽莎狄克逊和顾问专家团队，他建议完成临床研究硕士学位， 通过他的研究目标，获得测量护理质量，不良事件和精神疾病的专业知识， 筛选对已知定植有耐药性细菌的患者进行接触性隔离， 用于防止这些微生物传播给其他患者，并限制医院获得性 感染.目前，它用于约25%的急性护理医院的住院患者。这些患者 医学上复杂，患有多种疾病，经常接触医疗机构。病人 接触隔离者不太可能见到医护人员，护理过程质量较低， 更有可能变得抑郁，患者满意度也较低。因此，隔离患者 保护其他患者的潜在伤害。该项目旨在限制这种伤害。一 方法上严格的方法，提出了量化的影响和隔离之间的关系 使用经验证的大学临床数据存储库评估患者状况和不良结局 马里兰州医学中心的历史队列和前瞻性队列，以解决不良事件， 疾病管理、精神病筛查和患者满意度。利用这些研究的数据 博士Morgan将开发并在一个新的队列中验证一种新颖的，易于应用的预测规则，以识别 这些孤立的患者有发生不良事件的高风险。在这个奖项结束时，他将 准备研究干预措施，以减少不良事件，并可能改善整体护理 高达10-15%的住院患者在接触隔离期间出现不良后果。 相关性（见说明）： 接触隔离是预防医院获得性感染的重要工具。然而，医学上 被置于接触隔离的复杂患者似乎因为隔离而得到更差的护理。与 由于全国范围内接触隔离的患者越来越多，因此确定 不良后果和预防这种后果的方法，以便感染控制方法可以改善 患者整体安全。