A Multifaceted Intervention to Reduce Ventilator-Associated Pneumonia in the ICU

减少 ICU 呼吸机相关肺炎的多方面干预措施

基本信息

批准号：
8278545
负责人：
SEAN M BERENHOLTZ
金额：
$ 47.63万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-07-01 至 2016-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8278545
关键词：
Adherence Adult American Back Behavior Blood Caregivers Caring Childhood Clinical Cohort Studies Collaborations Communication Community Hospitals Consensus Data Data Collection Databases Delphi Technique Environmental Risk Factor Funding Geographic state Goals Guidelines Health Healthcare Hospitals Incidence Infection Infection Control Intervention Knowledge Learning Measurable Mechanical ventilation Michigan Modeling NIH Program Announcements Nosocomial Infections Online Systems Outcome Patient Care Patients Performance Pneumonia Policies Prevention Prevention Guidelines Preventive Intervention Process Process Measure Protocols documentation Public Health Publishing Recommendation Reporting Research Research Project Grants Safety Sampling Series Stream Structure Surveys Time Translating United States Agency for Healthcare Research and Quality United States Dept. of Health and Human Services Update Ventilator Work base care systems caregiver education checkup examination cohort contextual factors dissemination research evidence base experience implementation research implementation science improved instrument multi-component intervention novel patient safety programs prospective public health priorities response success tool

项目摘要

DESCRIPTION (provided by applicant): This application, titled "A Multifaceted Intervention to Reduce Ventilator-Associated Pneumonia in the ICU is in response to PAR-10-038_ Dissemination and Implementation Research in Health (R01) program announcement". Prevention of healthcare-associated infections (HAIs) has become a national public health priority. Ventilator-associated pneumonia (VAP) is the second most common, and the most lethal HAI. The proposed research seeks to reduce the public health burden of VAP. Numerous guidelines provide recommendations for the prevention of VAP. Despite these guidelines, many patients do not receive these recommended interventions. Our research team has previously developed and applied a multifaceted intervention that includes a novel integrated model for translating research evidence into practice and a comprehensive unit-based safety program (CUSP) to improve local safety and teamwork culture. This multifaceted intervention includes several key attributes; converting evidence into behavior specific bundles, focusing on systems of care, engagement of local interdisciplinary teams, centralized support for technical work, local adaptation of the intervention, and creating a culture of safety. The use of this intervention has been associated with substantial and sustained reductions in VAP and the third most common HAI, central line associated blood stream infections (CLABSI) in a over 100 Michigan ICUs. Our interdisciplinary team is currently leading efforts to disseminate the CUSP:CLABSI intervention in all 50 U.S. states. The approach of the proposed research will be to update our previously successful multifaceted model to reflect current recommendations for the prevention of VAP, modify this model so that it is scalable, evaluate the impact of implementation on clinical outcomes in a statewide cohort of ICUs, and evaluate contextual factors associated with successful implementation and sustainability. Successful completion of the proposed research will reduce the incidence of VAP in a large cohort of ICUs and generate a scalable model and new knowledge about can be used to disseminate the intervention nationally.

描述（由申请人提供）：本申请的标题为“减少ICU中与呼吸机相关的肺炎的多方面干预措施，是针对PAR-10-038_卫生中的PAR-10-038_传播和实施研究（R01）计划公告”。预防医疗相关感染（HAI）已成为国家公共卫生的重点。呼吸机相关的肺炎（VAP）是第二常见，也是最致命的HAI。拟议的研究旨在减轻VAP的公共卫生负担。许多指南为预防VAP提供了建议。尽管有这些准则，许多患者仍未接受这些建议的干预措施。我们的研究团队以前已经开发并应用了多方面的干预措施，其中包括一个新颖的集成模型，用于将研究证据转化为实践，并采用了一项基于单位的安全计划（CUSP），以改善当地的安全和团队合作文化。这种多方面的干预包括几个关键属性；将证据转换为特定行为的捆绑包，重点关注护理系统，当地跨学科团队的参与，对技术工作的集中支持，对干预的本地改编以及创造安全文化。这种干预措施的使用与超过100多个密歇根州ICU中的VAP和第三大常见的HAI相关血流感染（CLABSI）的大幅减少有关。我们的跨学科团队目前正在领导努力在美国所有50个州中传播尖峰：CLABSI干预。拟议研究的方法将是更新我们以前成功的多方面模型，以反映当前预防VAP的建议，修改该模型，以使其具有可扩展性，评估实施对ICU的临床结果的影响，并评估与成功实施和可持续性相关的上下文因素。拟议研究的成功完成将减少大量ICU中VAP的发生率，并产生可扩展模型，并且可以使用有关全国范围内的新知识来传播干预措施。