Improving Patient Safety and Disease Management While on Contact Isolation

这份K08建议书旨在提供教学课程和研究指导 加强丹尼尔·摩根成为医院流行病学独立研究员的努力 质量提升。他是传染病内科医生和流行病学讲师 马里兰大学的预防医学。他的长期目标是引导和传播 医院获得性感染的研究和导致全面质量改进的干预措施。在这 职业奖，在结果研究人员的指导下，Eli Perencevich博士，Anthony Harris博士和 丽莎·迪克森和一个专家顾问团队，他建议完成临床研究和 通过他的研究目标，获得在衡量护理质量、不良事件和精神病学方面的专业知识 放映。已知带有耐抗生素细菌的患者的接触隔离是 用于防止这些微生物传播给其他患者，并限制医院获得的 感染。目前，约有25%的急性护理医院的住院患者使用该系统。这些病人 医学上很复杂，有多种疾病，经常接触医疗机构。病人在 接触隔离不太可能看到医护人员，护理质量流程措施较低， 更有可能变得抑郁，患者满意率低。因此，被隔离的患者 可能会对保护其他病人造成伤害。该项目旨在限制这种危害。一个 提出了一种方法严谨的方法来量化隔离的影响和关系 使用加州大学经过验证的临床数据库对患者状态和不良结局的研究 马里兰医疗中心为解决不良事件的历史队列和预期队列， 疾病管理、精神筛查和患者满意度。使用来自这些研究的数据 摩根博士将在一个新的队列中开发并验证一种新的、易于应用的预测规则来识别 那些被隔离的患者有发生不良事件的高风险。在这个奖项结束时，他将是 准备调查干预措施以减少不良事件并潜在地改善整体护理 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(请参阅说明)： 接触者隔离是预防医院获得性感染的重要工具。然而，在医学上， 被置于接触隔离状态的复杂患者似乎因为隔离而受到更差的护理。使用 在全国范围内接触隔离的患者数量不断增加，确定其性质非常重要 不良后果和预防这种后果的方法，以便改进感染控制方法 整体的病人安全。

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.