权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Comparing the Effectiveness of Medication Use Systems in Small Rural Hospitals

小型乡村医院用药系统的有效性比较

基本信息

批准号：
8454225
负责人：
Gary Lowell Cochran
金额：
$ 14.12万
依托单位：
UNIVERSITY OF NEBRASKA MEDICAL CENTER
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 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8454225
关键词：
Comparing Effectiveness Medication Use Systems

项目摘要

DESCRIPTION (provided by applicant): My career objective is to develop an independent research program focusing on the safe and effective use of medications in rural communities. More than 400,000 harmful medication errors occur each year. While significant advances have been made in large hospitals, little research has been conducted in the nation's 1,300 critical access hospitals where differences in personnel, infrastructure, and care delivery processes make the generalizeability of findings observed in large urban facilities difficult. The lOM has recognized the need for comparative effectiveness data, recommending that future research should focus on "how to select an individual application, such as CPOE, bar coding, and smart pumps." The purpose of the proposed research is to compare the effectiveness of two medication use technologies used by critical access hospitals - bedside bar-code administration and telepharmacy. This proposal directly addresses the lOM's recommendation and four of the seven areas of research interest listed by AHRQ. To complete this research, a career development plan has been developed that combines didactic coursework, mentoring, and applied research. New analytic techniques needed to address limitations of observational study designs - including propensity scoring, instrumental variables, and hierarchical modeling - will be learned. Practice Based Evidence for Clinical Practice Improvement (PBE-CPl) is a methodology that incorporates natural variation from routine clinical practice to determine what works, for whom, when, and at what cost. This promising study design will be incorporated into the research program. UNMC provides an excellent training and research environment for individuals interested in health services research. Senior investigators in the College of Public Health including the Department of Biostatistics, and the College of Pharmacy will provide mentoring throughout the program. The "hands-on" experience and formal training described in this research and mentoring plan will provide me with the specialized expertise necessary to conduct an independent line of research. RELEVANCE (See instructions): The results of the proposed research will provide small hospitals with the information they need to choose the most cost-effective technology to reduce medication errors in their facilities. This program will improve medication safety, reduce harmful medication errors, and improve the quality and efficiency of healthcare for those living in, and traveling through, rural America.

描述（由申请人提供）：我的职业目标是开发一个独立的研究项目，重点关注农村社区药物的安全有效使用。每年发生超过 400,000 起有害用药错误。虽然大型医院取得了重大进展，但在全国 1,300 家关键医院中开展的研究却很少，这些医院的人员、基础设施和护理服务流程存在差异，使得在大型城市设施中观察到的研究结果难以推广。 lOM 已经认识到需要比较有效性数据，建议未来的研究应重点关注“如何选择单独的应用，例如 CPOE、条形码和智能泵”。拟议研究的目的是比较关键医院使用的两种药物使用技术（床边条形码管理和远程药房）的有效性。该提案直接针对国际医学组织的建议以及 AHRQ 列出的七个研究兴趣领域中的四个领域。为了完成这项研究，我们制定了一项职业发展计划，其中结合了教学课程、指导和应用研究。将学习解决观察性研究设计局限性所需的新分析技术，包括倾向评分、工具变量和分层建模。基于实践的临床实践改进证据 (PBE-CPl) 是一种方法，它结合了常规临床实践的自然变化，以确定什么有效、对谁有效、何时有效以及以什么成本有效。这一有前途的研究设计将被纳入研究计划。 UNMC 为对卫生服务研究感兴趣的个人提供了良好的培训和研究环境。公共卫生学院（包括生物统计系和药学院）的高级研究人员将在整个项目中提供指导。本研究和指导计划中描述的“实践”经验和正式培训将为我提供进行独立研究所需的专业知识。相关性（参见说明）：拟议研究的结果将为小型医院提供他们所需的信息，以选择最具成本效益的技术来减少其设施中的用药错误。该计划将改善用药安全，减少有害的用药错误，并提高生活在美国农村和穿越美国农村的人们的医疗保健质量和效率。