The WISER Study

WISER 研究

• 批准号: 9256504
• 负责人: Jochen Profit
• 金额: $ 55.09万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9256504
• 关键词: Absenteeism; Achievement; Address; Adoption; Affect; Attention; Behavior; Behavior Therapy; California; Caregivers; Caring; Child; Climate; Clinical; Cohort Studies; Collaborations; Discipline of Nursing; Education; Effectiveness; Emotional; Ensure; Environment; Equipment and supply inventories; Exercise; Feedback; Happiness; Health; Health Personnel; Health Professional; Healthcare; Healthcare Systems; Individual; Infant; Infection; Intensive Care Units; Interdisciplinary Study; Intervention; Interview; Knowledge; Learning; Measurable; Measures; Mental Depression; Methods; Mission; Modeling; Movement; National Institute of Child Health and Human Development; Neonatal Intensive Care Units; Neonatal Nursing; Nurse Practitioners; Nurses; Online Systems; Outcome; Patients; Perception; Performance; Perinatal; Physicians; Positioning Attribute; Premature Infant; Process; Program Effectiveness; Provider; Psychology; Quality of Care; Randomized Controlled Trials; Research; Research Infrastructure; Research Personnel; Resources; Safety; Sampling; Scientific Advances and Accomplishments; Source; Stress; Stressful Event; Surveys; Technology; Testing; Text; Time; United States; Universities; Vermont; Very Low Birth Weight Infant; Well in self; Work; Workplace; burnout; career life balance; collaborative care; combat; design; evidence base; exhaustion; experience; follow up assessment; follow-up; health care delivery; implementation science; improved; informant; innovation; insight; neonatal patient; patient safety; prevent; primary outcome; programs; public health relevance; resilience; respiratory; scale up; secondary outcome; tertiary care; tool; volunteer; webinar

 DESCRIPTION (provided by applicant): This proposal serves the mission of the NICHD to ensure that all children have the chance to achieve their full potential for healthy and productive lives. Optimizing provider well-being is critical to the delivery of safe and high quality care to he most vulnerable of patients: very preterm babies. Major innovative objectives of this proposal include testing the Web-based Implementation for the Science of Enhancing Resilience (WISER) program's effectiveness in enhancing resilience among Neonatal Intensive Care Unit (NICU) health workers, evaluating its effect on unit safety culture, and examining its effect on clinical outcomes in preterm infants. The WISER program is an established but low-intensity yet engaging intervention, which integrates education and behavior modification to boost provider well-being and resilience in order to create an organizational environment which prevents patient harm. Care for the more than 50,000 very low birth weight (VLBW; < 1500 gm) infants born annually in the United States is challenging and expensive. Quality of care and outcomes vary widely. Increasing technical demands and patient acuity have pushed burnout among health workers to the breaking point. The few tested interventions that improve caregiver resilience lack feasibility for widespread adoption. We must improve health workers' ability to cope with the stress at the workplace in order to create an environment that supports safer, better care. This study is designed to achieve the following aims: 1. Test the effectiveness of WISER in improving NICU health professional resilience; 2. Test the effectiveness of WISER in improving patient safety and organizational outcomes; 3. Test the sustainability of WISER; and 4. Describe the barriers and facilitators of the WISER program. We propose to test the effectiveness of the WISER Program in the NICU setting using a stepped-wedge mixed-methods randomized controlled trial (swRCT) at six tertiary care NICUs. The results of this trial will also provide insights into the causal relations between health worker resilience, the organizational environment, and clinical outcomes among infants born VLBW. This proposal builds on and expands the existing collaborative relationships among the expert interdisciplinary research team. If successful, this proposal will represent a breakthrough for the neonatal patient safety movement and provide a model for scaling up nationally.

 描述（由申请人提供）：本提案符合NICHD的使命，即确保所有儿童都有机会充分发挥其健康和生产的潜力。 生活优化提供者的福祉对于为最脆弱的患者提供安全和高质量的护理至关重要：非常早产儿。该提案的主要创新目标包括测试基于网络的增强复原力科学（WISER）计划在增强新生儿重症监护室（NICU）卫生工作者的复原力方面的有效性，评估其对单位安全文化的影响，并检查其对早产儿临床结局的影响。WISER计划是一项既定但低强度但具有吸引力的干预措施，它将教育和行为矫正整合在一起，以提高提供者的福祉和弹性，从而创造一个防止患者伤害的组织环境。在美国，每年出生的50，000多名极低出生体重（VLBW; < 1500 gm）婴儿的护理具有挑战性且昂贵。护理质量和结果差异很大。不断增长的技术需求和病人的敏锐度已经将卫生工作者的倦怠推到了临界点。少数经过测试的提高照顾者复原力的干预措施缺乏广泛采用的可行性。我们必须提高卫生工作者科普工作场所压力的能力，以创造一个支持更安全、更好护理的环境。本研究旨在实现以下目标：1.测试WISER在提高NICU卫生专业人员复原力方面的有效性; 2.测试WISER在改善患者安全和组织结果方面的有效性; 3.测试WISER的可持续性; 4.描述WISER计划的障碍和促进因素。我们建议在六个三级护理NICU中使用阶梯楔形混合方法随机对照试验（swRCT）来测试WISER计划在NICU环境中的有效性。这项试验的结果也将提供深入了解卫生工作者的韧性，组织环境和VLBW婴儿的临床结果之间的因果关系。这项建议建立在并扩大了专家跨学科研究小组之间的现有合作关系。如果成功，这一提案将代表新生儿患者安全运动的一个突破，并为在全国范围内推广提供一个模式。