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Navigating Patients and Families through the Neuro-ICU

引导患者和家属浏览 Neuro-ICU

基本信息

批准号：
10225307
负责人：
Claire Johanna Creutzfeldt
金额：
$ 18.94万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2022-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10225307
关键词：
Acute Acute Brain Injuries Address Admission activity Affect Behavioral Research Biometry Blood Vessels Caring Cessation of life Clinical Research Clinical Trials Design Communication Communication Research Critical Care Critical Illness Data Data Analyses Data Collection Decision Making Development Disease Distress Early treatment Educational Curriculum Electronic Health Record Elements Epidemiology Family Family member Future Goals Health Services Research Hospitalization Hospitals Hypoxic-Ischemic Brain Injury Institute of Medicine (U.S.)Intensive Care Units Intervention Intervention Studies Interview K-Series Research Career Programs Learning Length of Stay Malignant Neoplasms Medical Mentors Morbidity - disease rate Neurologic Neurology Nurses Outcome Outcome Assessment Outcomes Research Pain Palliative Care Patient Care Patient observation Patient-Focused Outcomes Patients Physicians Process Prognosis Prospective cohort study Publishing Qualitative Research Quality of Care Quality of life Randomized Research Research Methodology Scientist Social support Statistical Methods Stroke Surveys Survivors Symptoms Time Training Traumatic Brain Injury Work acceptability and feasibility advanced disease base career development clinical care communication aid coping depressive symptoms design disability efficacy evaluation experience family support feasibility testing high risk improved improved outcome individual patient mortality multi-component intervention neurosurgery novel palliative patient oriented patient population personalized management post-traumatic stress prognostic psychological distress randomized trial satisfaction severe injury standard of care surrogate decision maker therapy design tool virtual

项目摘要

PROJECT SUMMARY/ABSTRACT Every day in hospitals across the world, severe acute brain injury devastates patients and their families and challenges clinicians with a unique set of clinical care issues. As these patients with stroke or traumatic brain injury present with acute and neurologically devastating injury, their outcomes rely on early treatment decisions, and these decisions are virtually all made through discussions with surrogate decision makers and organized by critical care, neurosurgery or neurology clinicians who do not know these patients. Despite the remarkable recent advances in acute neurological care, morbidity and mortality remain high. With palliative care increasingly recognized as specialized medical care for patients with serious illness that focuses on improving communication about goals of care and quality of life, there remains a critical gap in understanding palliative care needs specific to patients with severe acute brain injury and their families. The long- term goal of this career development award is to promote Dr. Creutzfeldt's development into an independent physician-scientist working to understand and improve the quality of care early after severe acute brain injury. Dr. Creutzfeldt will conduct a prospective cohort study employing an established palliative care needs checklist that is in daily use in our neurological intensive care unit (neuro-ICU). The aims of this project are to identify those patients and families at highest risk for poor outcome and at highest need for a palliative care intervention, and to test the feasibility of a multifaceted communication intervention to meet the palliative care needs of this unique patient population and their families. To support her career development, Dr. Creutzfeldt proposes an integrated curriculum consisting of practical experience in designing, conducting and publishing clinical research; coursework in epidemiology, biostatistics and health services research; and intensive mentoring by experts in the fields of palliative care, neurology and critical care. Moreover, she will develop expertise in survey-based outcome assessment, clustered and longitudinal statistical methods, and qualitative data collection and analysis. This proposal has important implications for patients with severe acute brain injury and their families. Understanding the specific palliative care needs and how they affect long-term outcomes will inform the development of palliative care interventions to reduce distress and improve outcomes for these patients and their families.

项目总结/摘要每天在世界各地的医院里，严重的急性脑损伤都会使患者及其家属家庭和挑战临床医生与一组独特的临床护理问题。由于这些患者中风或创伤性脑损伤表现为急性和神经破坏性损伤，结果取决于早期的治疗决定，这些决定几乎都是通过与代理决策者进行讨论，并由重症监护、神经外科或不认识这些患者的神经病学临床医生。尽管最近在这方面取得了显著进展，急性神经系统护理、发病率和死亡率仍然很高。随着姑息治疗越来越多被认为是针对重病患者的专门医疗护理，关于护理目标和生活质量的沟通，在理解方面仍然存在重大差距针对严重急性脑损伤患者及其家属的姑息治疗需求。很长的- 这个职业发展奖的长期目标是促进Creutzfeldt博士的发展成为一个独立的医生-科学家，致力于了解和提高护理质量，严重急性脑损伤Creutzfeldt博士将进行前瞻性队列研究，在我们的神经重症监护室中，已建立的姑息治疗需要检查表（神经ICU）。该项目的目的是确定那些风险最高的患者和家庭，结果不佳，最需要姑息治疗干预，并测试姑息治疗的可行性多方面的沟通干预，以满足这一独特患者的姑息治疗需求人口及其家庭。为了支持她的职业发展，Creutzfeldt博士提出了综合课程，包括设计，执行和出版的实践经验临床研究;流行病学、生物统计学和卫生服务研究课程;以及由姑息治疗、神经病学和重症监护领域的专家提供密集指导。此外，委员会认为，她将发展基于调查的成果评估、集群和纵向评估方面的专业知识，统计方法以及定性数据收集和分析。这一建议具有重要意义对严重急性脑损伤患者及其家属的影响。了解具体的姑息治疗需求以及它们如何影响长期结果将为发展提供信息姑息治疗干预，以减少痛苦，改善这些患者的结果，家人

项目成果

期刊论文数量（22）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Palliative Care and Shared Decision Making in the Neurocritical Care Unit.

DOI：
10.1212/con.0000000000001003
发表时间：
2021-10-01
期刊：
Continuum (Minneapolis, Minn.)
影响因子：
0
作者：
Creutzfeldt, Claire J
通讯作者：
Creutzfeldt, Claire J

A Qualitative Look at End-of-Life Care in the ICU.

对 ICU 临终关怀的定性观察。

DOI：
10.1097/ccm.0000000000002756
发表时间：
2017
期刊：
Critical care medicine
影响因子：
8.8
作者：
Granstein,JustinH;Creutzfeldt,ClaireJ
通讯作者：
Creutzfeldt,ClaireJ

Taking a Chance to Recover: Families Look Back on the Decision to Pursue Tracheostomy After Severe Acute Brain Injury.

DOI：
10.1007/s12028-021-01335-9
发表时间：
2022-04
期刊：
Neurocritical care
影响因子：
3.5
作者：
Lou W;Granstein JH;Wabl R;Singh A;Wahlster S;Creutzfeldt CJ
通讯作者：
Creutzfeldt CJ

A Global Survey of the Effect of COVID-19 on Critical Care Training.

DOI：
10.34197/ats-scholar.2021-0045br
发表时间：
2021-12
期刊：
ATS scholar
影响因子：
1.9
作者：
Wahlster S;Sharma M;Çoruh B;Town JA;Lewis A;Lobo SM;Maia IS;Hartog C;Patel PV;Kross EK;Amorim E;Greer DM;Curtis JR;Creutzfeldt CJ
通讯作者：
Creutzfeldt CJ

Adapting to a New Normal After Severe Acute Brain Injury: An Observational Cohort Using a Sequential Explanatory Design.

DOI：
10.1097/ccm.0000000000004947
发表时间：
2021-08-01
期刊：
Critical care medicine
影响因子：
8.8
作者：
Rutz Voumard R;Kiker WA;Dugger KM;Engelberg RA;Borasio GD;Curtis JR;Jox RJ;Creutzfeldt CJ
通讯作者：
Creutzfeldt CJ