Hospital Enhancement of Resuscitation Outcomes for In-Hospital Cardiac Arrest (HE

医院增强院内心脏骤停 (HE) 的复苏效果

• 批准号: 8757524
• 负责人: Paul Sheung-Yan Chan
• 金额: $ 47.99万
• 依托单位: SAINT LUKE'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8757524
• 关键词: Address; Adopted; Adoption; American Heart Association; Baseline Surveys; Cardiology; Caring; Characteristics; Clinical; Code Blue; Communication; Continuity of Patient Care; Critical Care; Data; Databases; Discipline of Nursing; Event; Feedback; Foundations; Future; Goals; Guidelines; Heart Arrest; Hospitals; Incidence; Institution; Interview; Leadership; Medicine; Methods; National Heart, Lung, and Blood Institute; Outcome; Patient Care; Patients; Policies; Prevalence; Prevention; Process; Qualitative Research; Registries; Research; Resources; Rest; Resuscitation; Risk; Sampling; Site; Site Visit; Structure; Surveys; Survival Rate; Time; Work; clinical epidemiology; experience; high risk; improved; innovation; insight; instrument; multidisciplinary; novel; prevent; programs; public health relevance; routine practice

DESCRIPTION (provided by applicant): In-hospital cardiac arrest (IHCA) is a common event that is associated with poor patient outcomes. Yet, some hospitals have been consistently more successful in preventing and treating IHCA than others. While this is thought to be explained by the adoption of key strategies that improve care processes for IHCA, how these strategies are actually utilized in routine practice and the underlying factors contributing to their successful implementation remain largely unknown. Further, an integrative approach that examines strategies used during IHCA and those employed before and after these events has not been previously undertaken. This study will build on extensive prior work by our investigative team using the American Heart Association's Get With The Guidelines (GWTG)- Resuscitation registry and leverage our team's expertise in IHCA and qualitative research. The proposed HEROICA study will lay the foundation for future quality improvement efforts in IHCA by defining 'best practices' adopted by top-performing hospitals to address these events as well as potential barriers to their implementation. We will use a sequential mixed-methods approach to accomplish this goal, integrating quantitative and qualitative analyses. Its 3 Aims will: (1) identfy top- performing hospitals in preventing and treating IHCA within the GWTG-Resuscitation registry; (2) identify 'best practices' at the top-performing sites through semi-structured qualitative interviews; and (3) validate the practices associated with low IHCA incidence and high IHCA survival at top-performing sites. Findings from the study will be used to construct a toolkit of 'best practices' - the Code Blue Bundle. Upon successful completion of this research, we will partner closely with the American Heart Association (AHA) and the GWTG-Resuscitation registry to develop a national quality improvement program that will implement the Code Blue Bundle. Thus, the HEROICA study will increase the capacity of the NHLBI to improve outcomes for patients who suffer an IHCA by providing hospitals with practical and actionable strategies that can be implemented broadly to reduce the incidence and improve the survival of IHCA.

描述（由申请人提供）：院内心脏骤停（IHCA）是一种常见事件，与患者预后不良相关。然而，一些医院在预防和治疗IHCA方面一直比其他医院更成功。虽然这被认为是通过采取改善IHCA护理流程的关键策略来解释的，但这些策略如何在日常实践中实际使用以及促成其成功实施的潜在因素在很大程度上仍然未知。此外，以前还没有采取综合办法，审查在国际人道主义援助期间使用的战略以及在这些活动之前和之后使用的战略。这项研究将建立在我们的调查团队使用美国心脏协会的指南（GWTG）-复苏登记的广泛先前工作的基础上，并利用我们团队在IHCA和定性研究方面的专业知识。拟议的HEROICA研究将通过定义顶级医院采用的“最佳实践”来解决这些事件以及实施这些事件的潜在障碍，为IHCA未来的质量改进工作奠定基础。我们将使用一个连续的混合方法来实现这一目标，结合定量和定性分析。其三个目标是：（1）在GWTG-复苏登记中识别在预防和治疗IHCA方面表现最好的医院;（2）通过半结构化定性访谈识别表现最好的地点的“最佳实践”;以及（3）验证表现最好的地点与低IHCA发病率和高IHCA存活率相关的实践。研究结果将用于构建一个“最佳实践”工具包-Code Blue Bundle。在成功完成这项研究后，我们将与美国心脏协会（AHA）和GWTG复苏登记处密切合作，制定一项国家质量改进计划，以实施Code Blue Bundle。因此，HEROICA研究将通过为医院提供可以广泛实施的实用且可操作的策略来提高NHLBI改善IHCA患者预后的能力，以降低IHCA的发生率并提高生存率。