Pediatric patient safety learning laboratory to re-engineer continuous physiologic monitoring systems

儿科患者安全学习实验室重新设计连续生理监测系统

• 批准号: 10225288
• 负责人: Christopher Peter Bonafide
• 金额: $ 57.8万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10225288
• 关键词: Pediatric; patient; safety; learning; laboratory

PROJECT SUMMARY/ABSTRACT The broad objective of this proposal is to establish a pediatric Patient Safety Learning Laboratory (PSLL) at Children’s Hospital of Philadelphia (CHOP). Working in a transdisciplinary fashion, CHOP PSLL investigators will collaboratively apply innovative scientific approaches that integrate their respective disciplines to achieve the goal of analyzing and re-engineering hospital and home physiologic monitoring systems to maximize alarm informativeness. Current systems used to continuously monitor children’s vital signs in hospital ward and home settings generate alarms intended to warn caretakers— nurses in the hospital and parents at home— of conditions that warrant their immediate attention. However, both systems suffer from low informativeness and thus pose patient safety risks such as alarm fatigue that are relevant to critical illness detection, diagnosis, and treatment. This PSLL brings together expertise from CHOP, University of Pennsylvania, and the ECRI Institute in diverse areas including patient safety, pediatric hospital medicine, neonatology, nursing, systems engineering, human factors, design, medical device development, electronic health record clinical decision support, cognitive informatics, simulation, and biostatistics. The project’s Specific Aims are (1) Re-engineer the system of monitoring hospitalized children on acute care wards, with a focus on reducing non-informative alarms and accelerating nurse responses to critical events, and (2) Re-engineer the system of monitoring infants with bronchopulmonary dysplasia at home, with a focus on reducing non-informative hypoxemia alarms and improving clinicians’ access to usable longitudinal pulse oximetry data to inform supplemental oxygen treatment. Each Aim will proceed through a stepwise process of problem analysis, design, development, implementation, and evaluation. This project will use a framework based on the Systems Engineering Initiative for Patient Safety (SEIPS) model and Dual Process Theory, and will apply innovative methods such as forensic accident investigation, video alarm analysis, and in situ simulation to analyze and evaluate monitoring systems. The end products will be redesigned systems for physiologic monitoring in hospitals and homes and a sustainable pediatric Patient Safety Learning Laboratory at one of the top children’s hospitals in the nation.

项目概要/摘要 该提案的总体目标是在以下地点建立儿科患者安全学习实验室 (PSLL)： 费城儿童医院 (CHOP)。 CHOP PSLL 研究人员以跨学科的方式开展工作 将协作应用整合各自学科的创新科学方法来实现 分析和重新设计医院和家庭生理监测系统以最大限度地提高警报的目标 信息性。当前用于持续监测医院病房和家中儿童生命体征的系统 设置生成警报，旨在警告看护者（医院的护士和家里的父母） 需要立即引起注意的情况。然而，这两个系统都存在信息量低且 从而带来患者安全风险，例如与危重疾病检测、诊断和治疗相关的警报疲劳。 治疗。该 PSLL 汇集了 CHOP、宾夕法尼亚大学和 ECRI 研究所的专业知识 涉及不同领域，包括患者安全、儿科医院医学、新生儿学、护理、系统 工程、人为因素、设计、医疗设备开发、电子健康记录临床决策 支持、认知信息学、模拟和生物统计学。该项目的具体目标是 (1) 重新设计 监测急症护理病房住院儿童的系统，重点是减少非信息性 警报并加速护士对紧急事件的响应，以及 (2) 重新设计监测系统 在家治疗患有支气管肺发育不良的婴儿，重点是减少非信息性低氧血症警报 提高临床医生获取可用纵向脉搏血氧饱和度数据的能力，以告知补充氧气 治疗。每个目标都将经历问题分析、设计、开发、 实施、评估。该项目将使用基于系统工程倡议的框架 患者安全（SEIPS）模型和双过程理论，并将应用法医等创新方法 事故调查、视频报警分析和现场模拟来分析和评估监控系统。 最终产品将是重新设计的系统，用于医院和家庭的生理监测以及 位于全国顶级儿童医院之一的可持续儿科患者安全学习实验室。

项目成果

Analysis: Protocol for a New Method to Measure Physiologic Monitor Alarm Responsiveness.

分析：测量生理监测警报响应性新方法的协议。

• DOI: 10.2345/0899-8205-54.6.389
• 发表时间: 2020
• 期刊: Biomedical instrumentation & technology
• 作者: Luo,Brooke;McLoone,Melissa;Rasooly,IritR;Craig,Sansanee;Muthu,Naveen;Won,James;Ruppel,Halley;Bonafide,ChristopherP
• 通讯作者: Bonafide,ChristopherP

Animal influenza epidemiology.

• DOI: 10.1016/j.vaccine.2008.07.064
• 发表时间: 2008-09-12
• 期刊: Vaccine
• 影响因子: 5.5
• 作者: Ducatez MF;Webster RG;Webby RJ
• 通讯作者: Webby RJ

Observing sources of system resilience using in situ alarm simulations.

使用现场警报模拟观察系统弹性的来源。

• DOI: 10.1002/jhm.13217
• 发表时间: 2023
• 期刊: Journal of hospital medicine
• 影响因子: 2.6
• 作者: McLoone,Melissa;McNamara,Meghan;Jennings,MeganA;Stinson,HannahR;Luo,BrookeT;Ferro,Daria;Albanowski,Kimberly;Ruppel,Halley;Won,James;Bonafide,ChristopherP;Rasooly,IritR
• 通讯作者: Rasooly,IritR

Characteristics of Emergency Room and Hospital Encounters Resulting From Consumer Home Monitors.

消费者家用监视器导致急诊室和医院遭遇的特征。

• DOI: 10.1542/hpeds.2021-006438
• 发表时间: 2022
• 期刊: Hospital pediatrics
• 作者: Craig,Sansanee;Rasooly,IritR;Kern-Goldberger,AndrewS;Luo,Brooke;Mai,MarkV;Beus,JonathanM;Faulkenberry,JGrey;Brent,Canita;Herchline,Daniel;Muthu,Naveen;Bonafide,ChristopherP
• 通讯作者: Bonafide,ChristopherP

Structural basis of severe acute respiratory syndrome coronavirus ADP-ribose-1''-phosphate dephosphorylation by a conserved domain of nsP3.

• DOI: 10.1016/j.str.2005.07.022
• 发表时间: 2005-11
• 期刊: Structure (London, England : 1993)
• 作者: Saikatendu KS;Joseph JS;Subramanian V;Clayton T;Griffith M;Moy K;Velasquez J;Neuman BW;Buchmeier MJ;Stevens RC;Kuhn P
• 通讯作者: Kuhn P