The Examination of Infection Prevention and Crowding in the Emergency Department
急诊科感染预防与拥挤情况检查
基本信息
- 批准号:8705274
- 负责人:
- 金额:$ 1.67万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2013
- 资助国家:美国
- 起止时间:2013-07-01 至 2014-10-15
- 项目状态:已结题
- 来源:
- 关键词:Academic Medical CentersAccident and Emergency departmentAddressAdherenceAdmission activityAffectAreaAwardCaringCathetersCause of DeathClient satisfactionCrowdingDataDevicesDiscipline of NursingDiseaseDoctor of PhilosophyEnsureEvidence based practiceFutureFuture GenerationsGoalsGuidelinesHandHealth PersonnelHealthcareHospitalsHygieneIndividualInfectionInfection preventionInstitute of Medicine (U.S.)InterruptionInterventionJointsLeftLengthLinear RegressionsLogistic RegressionsMeasuresMentorsMethodsMissionModelingMorbidity - disease rateMuscle CrampNational Institute of Nursing ResearchNursesOutcome MeasurePatient CarePatientsPeripheralPoliciesPresbyterian ChurchPrevention ResearchProcessPublic HealthQuality of CareRecommendationResearchResearch TrainingResourcesScientistStudentsTechniquesTestingTimeTrainingUnited StatesUnited States Dept. of Health and Human ServicesUniversitiesVenousWorld Health Organizationbasecare seekingcareercomputerized data processingdisorder preventionevidence baseevidence based guidelineshealth care qualityimprovedinstrumentinterestmeetingsmortalitypatient safetypreventpublic health relevanceshift worksoundurinary
项目摘要
DESCRIPTION (provided by applicant): Healthcare associated infections (HAIs) are a leading cause of death in the United States, despite being largely preventable. HAIs can be significantly reduced through the use of guideline-based infection prevention processes, e.g., aseptic technique during the placement of invasive devices and hand hygiene during patient care. In the emergency department (ED) care setting, millions of invasive devices are placed each year and numerous opportunities for hand hygiene exist. In recent years, HAI prevention in the ED has become more paramount given the growing problem of ED crowding. ED crowding is a major patient safety concern associated with significant mortality and poor care quality. During times of ED crowding, patients' needs are often met with insufficient resources. Patients commonly receive care from understaffed healthcare providers in cramped, unsafe settings, which likely affect guideline-based care. However, no study has examined infection prevention in the context of ED crowding. Guided by Donabedian's framework of healthcare quality, this study aims to determine the relationship between ED crowding and patients' receipt of guideline-based infection prevention processes, i.e., aseptic technique during urinary catheter, peripheral venous catheter, and central venous catheter placement, and hand hygiene during care. The proposed study will be conducted in the ED of an urban, tertiary hospital in northern Manhattan. Direct observations of infection prevention processes will be representative of all shifts and days of the
week. Processes data will be recorded on psychometrically sound checklists, which reflect current evidence- based guidelines. Checklists include those developed by the World Health Organization and adapted from hospital policies. Observers will undergo rigorous testing throughout the course of the study to ensure high levels of inter-rater reliability (kappa >0.9). More than 900 observation periods will be included in analyses. Checklist data will be aggregated during each observation period and an adherence score will be calculated. Adherence scores will be the main variable of interest. ED crowding will be the primary predictor variable and will be measured using a validated, standardized instrument at the start of each observation period. Depending on the distribution and spread of data, a multivariate linear or logistic regression model will be used to analyze the relationship between ED crowding and patients' receipt of guideline-based infection prevention care. The short term goal of this study is to demonstrate the need for improved infection prevention in the ED, with the ultimate goal of facilitating interventions that improve evidence-based practices and prevent HAI. As such, this study is well aligned with the National Institute of Nursing Research's goal of disease prevention. Further, the receipt of this award will attest to NINR's mission to train the future generation of nurse scientists. The applicant is a BSN to PhD student eager to become a nurse scientist and improve care quality in the ED.
描述(申请人提供):医疗保健相关感染(HAI)在美国是主要的死亡原因,尽管基本上是可以预防的。通过使用基于指南的感染预防程序,例如在放置侵入性设备期间的无菌技术和在病人护理期间的手卫生,可以显著减少人类免疫缺陷感染。在急诊科(ED)的护理环境中,每年放置数以百万计的侵入性设备,存在着无数的手部卫生机会。近年来,由于急诊室拥挤的问题日益严重,在急诊室预防HAI变得更加重要。急诊室拥挤是一个主要的患者安全问题,与显著的死亡率和糟糕的护理质量有关。在急症室挤迫的时候,病人的需要往往得不到足够的资源。患者通常在狭窄、不安全的环境中接受人手不足的医疗保健提供者的护理,这可能会影响基于指南的护理。然而,还没有研究在ED拥挤的背景下检查感染预防。在多纳贝迪安的医疗质量框架指导下,本研究旨在确定急诊室拥挤与患者接受基于指南的感染预防过程的关系,即尿管、外周静脉导管和中心静脉导管放置过程中的无菌技术,以及护理过程中的手部卫生。这项拟议的研究将在曼哈顿北部一家城市三级医院的急诊室进行。对感染预防过程的直接观察将代表
星期。过程数据将被记录在心理测量学上合理的清单上,这反映了当前基于证据的指导方针。清单包括由世界卫生组织制定并根据医院政策修改的清单。观察员将在整个研究过程中接受严格的测试,以确保评分员之间的高度可靠性(kappa>;0.9)。分析将包括900多个观测期。将在每个观察期内汇总核对表数据,并计算遵守分数。坚持度分数将是人们感兴趣的主要变量。ED拥挤将是主要的预测变量,并将在每个观察期开始时使用经过验证的标准化仪器进行测量。根据数据的分布和分布,将使用多元线性或Logistic回归模型来分析急诊室拥挤与患者接受以指南为基础的感染预防护理的关系。这项研究的短期目标是论证在ED中改进感染预防的必要性,最终目标是促进干预措施,以改进循证做法和预防HAI。因此,这项研究与国家护理研究所的疾病预防目标非常一致。此外,这一奖项的获得将证明NINR培养未来一代护士科学家的使命。申请者是BSN到博士生,渴望成为一名护士科学家,并提高急诊室的护理质量。
项目成果
期刊论文数量(0)
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Eileen Juliana Carter其他文献
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{{ truncateString('Eileen Juliana Carter', 18)}}的其他基金
The Examination of Infection Prevention and Crowding in the Emergency Department
急诊科感染预防与拥挤情况检查
- 批准号:
8593409 - 财政年份:2013
- 资助金额:
$ 1.67万 - 项目类别: