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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

基本信息

批准号：
8464171
负责人：
Daniel J Morgan
金额：
$ 10.5万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-01 至 2015-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8464171
关键词：
Improving Patient Safety Disease Management

项目摘要

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.

该 K08 提案旨在为以下学生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，质量改进。他是一名传染病医生和流行病学讲师马里兰大学预防医学。他的长期目标是开展和传播关于医院获得性感染和导致整体质量提高的干预措施的研究。在这个职业奖，在结果研究人员的指导下，博士。伊莱·佩伦塞维奇、安东尼·哈里斯丽莎迪克森和顾问专家团队，他建议完成临床研究硕士学位通过他的研究目标，获得衡量护理质量、不良事件和精神科方面的专业知识筛选。对已知感染抗生素耐药细菌的患者进行接触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感染。目前，急症护理医院约 25% 的住院患者使用该技术。这些患者病情复杂，患有多种疾病，并且经常接触医疗机构。患者在接触隔离不太可能见到医护人员，护理质量流程措施较低，更有可能变得抑郁并且患者满意度较低。因此，隔离患者为了保护其他患者而可能受到伤害。该项目旨在限制此类危害。一个提出了方法论上严格的方法来量化隔离之间的影响和关系使用大学经过验证的临床数据存储库来了解患者的状况和不良结果马里兰医学中心的历史队列和前瞻性队列来解决不良事件，疾病管理、精神科筛查和患者满意度。使用这些研究的数据摩根博士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来识别那些发生不良事件的高风险的孤立患者。在这个奖项结束时，他将准备调查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经历不良后果。相关性（参见说明）：接触隔离是预防医院获得性感染的重要手段。然而，医学上接受接触隔离的复杂患者似乎因隔离而受到更差的护理。和全国范围内接受接触隔离的患者数量不断增加，确定接触者的性质非常重要不良结果和预防此类结果的方法，以便改进感染控制方法整体患者安全。