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A Sleep Promotion Toolkit for Hospitalized Patients

住院患者睡眠促进工具包

基本信息

批准号：
9514309
负责人：
Lichuan Ye
金额：
$ 6.96万
依托单位：
NORTHEASTERN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-30 至 2018-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9514309
关键词：
Sleep Promotion Toolkit Hospitalized Patients

项目摘要

DESCRIPTION (provided by applicant): Inpatient sleep disturbance has been linked to clinically relevant and detrimental outcomes such as delirium and falls; both are known risk factors for morbidity, mortality, prolonged hospital stays, and increased healthcare costs. Based on our preliminary work of inpatient sleep and incorporating the design of other successful health information technology (IT) interventions developed by our team members, we have developed a prototype of a sleep promotion tool kit (SLEEPkit). Using the SLEEPkit, patients start the assessment of sleep and sleep disturbing factors during the previous night. The SLEEPkit software identifies a core set of evidence-based interventions directly linked to the patient-specific sleep disturbing factors. The assessment data and the associated tailored interventions are then processed by the SLEEPkit software to generate a single care plan for sleep and personalized educational content for all care providers, patients, and family members. The SLEEPkit will be integrated into an existing web-based patient portal and easily accessed from mobile devices (e.g., iPad) at the bedside by patients and their care partners. Responding to the AHRQ PA-14-001, the goal of this R21 project is to inform the development of the SLEEPkit by conducting iterative refinement, implementation, and pilot evaluation guided by the RE-AIM framework. The RE- AIM framework emphasizes the Reach, Effectiveness, Adoption, Implementation, and Maintenance of a health IT intervention in the actual clinical setting. Specifically, we will 1) iteratively refine a patient-centered SLEEPkit and integrate it as an enhancement into an existing web-based patient portal; 2) To implement the SLEEPkit on an oncology patient-care unit where the web-based patient portal is currently in place; and 3) To pilot test the effectiveness of the SLEEPkit on patient's self-perceived overall sleep quality during hospitalization. Based on the primary outcome of interest, self-perceived sleep quality measured by the PROMIS Sleep Disturbance, we plan to enroll a total of 120 patients for this pilot study. Findings of this project will inform further development and refinement of the SLEEPkit, which aims not only to improve inpatient sleep but also to be well integrated to clinical and patient workflow. The pilot evaluation will also inform the effect size of study outcomes for a future randomized controlled trial to evaluate the SLEEPkit application. Consistent with the AHRQ mission, this will lay the groundwork for making inpatient sleep promotion effective and feasible, which will ultimately change current clinical practice related to patient sleep, hence leading to meaningful improvement in patient health, outcomes, quality of care, and cost.

描述（由申请人提供）：住院患者睡眠障碍与临床相关的有害结果有关，例如谵妄和跌倒；两者都是已知的发病率、死亡率、住院时间延长和医疗费用增加的危险因素。基于我们对住院患者睡眠的初步工作，并结合我们团队成员开发的其他成功的健康信息技术 (IT) 干预措施的设计，我们开发了睡眠促进工具包 (SLEEPkit) 的原型。使用 SLEEPkit，患者开始评估前一天晚上的睡眠和睡眠干扰因素。 SLEEPkit 软件确定了一组与患者特定睡眠干扰因素直接相关的核心循证干预措施。然后，评估数据和相关的定制干预措施由 SLEEPkit 软件处理，为所有护理提供者、患者和家庭成员生成单一的睡眠护理计划和个性化教育内容。 SLEEPkit 将集成到现有的基于网络的患者门户中，患者及其护理伙伴可以在床边通过移动设备（例如 iPad）轻松访问。为了响应 AHRQ PA-14-001，该 R21 项目的目标是通过在 RE-AIM 框架的指导下进行迭代细化、实施和试点评估，为 SLEEPkit 的开发提供信息。 RE-AIM 框架强调健康 IT 干预在实际临床环境中的范围、有效性、采用、实施和维护。具体来说，我们将 1) 迭代地完善以患者为中心的 SLEEPkit 并将其作为增强功能集成到现有的基于网络的患者门户中； 2) 在肿瘤患者护理单位实施 SLEEPkit，该单位目前已建立基于网络的患者门户； 3) 试点测试 SLEEPkit 对患者住院期间自我感知整体睡眠质量的有效性。根据感兴趣的主要结果，即通过 PROMIS 睡眠障碍测量的自我感知睡眠质量，我们计划总共招募 120 名患者参加这项试点研究。该项目的研究结果将为 SLEEPkit 的进一步开发和完善提供信息，其目的不仅是改善住院患者的睡眠，而且还能够很好地融入临床和患者工作流程。试点评估还将为未来评估 SLEEPkit 应用的随机对照试验提供研究结果的影响大小。与 AHRQ 的使命一致，这将为住院患者睡眠促进有效且可行奠定基础，最终将改变当前与以下相关的临床实践：患者睡眠，从而显着改善患者健康、结果、护理质量和成本。