CanSim: A novel simulator for training cannulation skills in dialysis care

CanSim：用于训练透析护理插管技能的新型模拟器

• 批准号: 9353425
• 负责人: Ravikiran Singapogu
• 金额: $ 13.66万
• 依托单位: CLEMSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9353425
• 关键词: Affect; African American; Arteriovenous fistula; Attitude; Biological; Biomedical Engineering; Blood; Blood Vessels; Cannulations; Care given by nurses; Caring; Catheters; Caucasians; Cessation of life; Clinic; Clinical; Clinical Research; Clinical Skills; Communities; Computers; Continuity of Patient Care; Control Groups; Controlled Study; Data; Development; Dialysis procedure; Educational Curriculum; Educational process of instructing; End stage renal failure; Environment; Face; Feedback; Fistula; Goals; Health Professional; Hematoma; Hemodialysis; Hospitalization; Human Resources; Incidence; Infection; Instruction; Laparoscopy; Legal patent; Location; Measures; Mechanics; Medical; Medicare; Mentors; Methods; Modeling; Motion; Needles; Nephrology; Nurses; Operative Surgical Procedures; Outcome; Patient Care; Patient Education; Patient-Focused Outcomes; Patients; Phase; Population; Prevalence; Process; Puncture procedure; Recruitment Activity; Research; Research Assistant; Research Methodology; Risk; Scientist; South Carolina; Stenosis; Structure; Technical Expertise; Techniques; Technology; Testing; Thrombosis; Time; Tissues; Training; Translational Research; Universities; base; career development; cyber infrastructure; efficacy testing; experimental study; human subject; improved; novel; professor; prototype; sensor; simulation; skills; skills training; tool; virtual

This K01 details a career development training and research plan for Dr. Joseph Singapogu, Research Assistant Professor at Clemson University. Dr. Singapogu has a background in using simulation technology for training clinical skills. The research plan of this proposal focuses on the development of a novel, state-of-the- art training simulator for training cannulation skills of dialysis clinic personnel (Patient Care Technicians and nurses). Dr. Singapogu's mentoring team consists of key leaders in nephrology, vascular access, cannulation training, computer scientists, bioengineers and statisticians. The goals of his training plan are: (1) Coursework in Clinical and Translational Research methods, (2) Practical clinical exposure along the continuum of care in ESRD, (3) Biologically-based understanding of processes that affect vascular mechanics, and (4) Computational and virtual modeling with cyberinfrastructure training. The survival of a patient with ESRD depends on a functioning vascular access through which blood is drawn for dialysis. Of the currently available three options for vascular accesses, the arteriovenous fistula (AVF) is the most preferred due to better patient outcomes. The Tunneled Dialysis Catheter (TDC) is the least preferred vascular access due to increased likelihood of infections, complications and hospitalizations. Due to the overwhelming evidence for the benefits of AVFs, the national Fistula First Breakthrough Initiative was launched in 2004 with the goal of achieving a 66% fistula rate nationwide. As a result, the rates of incident and prevalent AVFs have continued to rise. Though the widespread creation and use of AVFs are a welcome development, there has arisen the serious challenge of AVF-related complications as a consequence. AVFs need to remain patent and usable for hemodialysis, a condition fraught with vascular complications including non-maturation, thrombosis, stenosis and hematoma formation. Thus, vascular access complications are called the “Achilles heel” of hemodialysis, contributing to about 20% of hospitalizations in ESRD patients. AVF non-use due to any of these conditions, in turn, results in TDC use, which only greatly increases the risk of infection and death. Consequently, the ESRD medical community has collectively called for reduced TDC usage and the need to facilitate prolonged AVF patency. One of the main contributing factors related to AVF complications, prolonged TDC use and lack of AVF use is the lack of cannulation skills. 99% of patients on hemodialysis receive dialysis treatments multiple times a week from Patient Care Technicians (PCTs) and nurses. Through these clinical personnel spend a significant time delivering dialysis treatments, there is currently no standard to test or train PCTs and nurses to safely and effectively cannulate AVFs. In this project, I propose to develop and test a novel simulator for teaching cannulation skills (called the “CanSim”) to PCTs and nurses. I will conduct three experiments to test the central hypothesis that objective feedback provided through novel sensors in a simulator-based test environment will improve cannulation outcomes by enhancing the technical skill of healthcare professionals. This novel study will potentially significantly impact patient care by providing a state-of-the-art simulator for cannulation skills training which, in turn, will have positive impact on patient outcomes and attitudes toward cannulation.

本K01详细介绍了约瑟夫·新加坡博士的职业发展培训和研究计划 克莱姆森大学助理教授。新加坡博士在使用仿真技术方面有一定的背景 培训临床技能。这项提案的研究计划集中在开发一种新颖的、最新的 ART培训模拟器，用于培训透析诊所人员(患者护理技术人员和 护士)。新加坡医生的指导团队由肾病学、血管通路、插管等领域的主要负责人组成 培训、计算机科学家、生物工程师和统计学家。他的训练计划的目标是：(1)课业 临床和转化研究方法，(2)在护理的连续过程中的实际临床暴露 ESRD，(3)对影响血管力学的过程的生物学理解，以及(4) 计算和虚拟建模以及网络基础设施培训。 终末期肾病患者的生存取决于血液通过的功能血管通路 抽签进行透析。在目前可用的三种血管通路中，动静脉瘘 (AVF)是最首选的，因为患者的结果更好。隧道式透析导管(TDC)是最小的 首选血管通路，因为感染、并发症和住院的可能性增加。由于 作为AVF益处的压倒性证据，国家瘘管优先突破倡议是 2004年启动，目标是在全国范围内实现66%的瘘管率。因此，事故率和 流行的Avf持续上升。 虽然AVF的广泛创建和使用是一个受欢迎的发展，但已经出现了 因此，动静脉瘘相关并发症的严重挑战。AVF需要保持专利并可用于 血液透析，一种充满血管并发症的情况，包括未成熟、血栓形成、狭窄 和血肿的形成。因此，血管通路并发症被称为血液透析的“阿喀琉斯之踵”， 约占终末期肾病患者住院总数的20%。AVF因上述任何情况而未使用，在 反过来，使用TDC只会大大增加感染和死亡的风险。因此，ESRD 医学界共同呼吁减少TDC的使用，并有必要促进延长AVF 通畅性。 AVF并发症、TDC使用时间过长和缺乏AVF的主要原因之一 使用方法是缺乏插管技巧。99%的血液透析患者接受多次透析治疗 来自患者护理技术员(PCT)和护士的一周。通过这些临床人员花费了大量的 提供透析治疗的时间，目前还没有标准来测试或培训PCT和护士 安全有效地插管动静脉瘘。在这个项目中，我计划开发和测试一个新的模拟器，用于 向PCT和护士传授插管技巧(称为“CanSim”)。我将进行三个实验来测试 在基于模拟器的测试中，通过新型传感器提供的客观反馈的中心假设 环境将通过提高医疗保健专业人员的技术技能来改善插管结果。 这项新颖的研究将通过为患者提供最先进的模拟器来潜在地显著影响患者护理 插管技能培训，这反过来将对患者的结局和态度产生积极影响 插管。