Standardizing Antibiotic Prescribing for Children Hospitalized with Infections using Novel Metrics and Electronic Clinical Decision Support Tools
使用新指标和电子临床决策支持工具标准化住院感染儿童的抗生素处方
基本信息
- 批准号:10705784
- 负责人:
- 金额:$ 14.83万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-30 至 2027-09-29
- 项目状态:未结题
- 来源:
- 关键词:
项目摘要
PROJECT SUMMARY/ABSTRACT
Antibiotics are one of the most prescribed classes of medications for children, yet 30-50% of all antibiotics are
inappropriately prescribed or completely unnecessary. Despite the availability of nationally endorsed treatment
guidelines and the expansion of antimicrobial stewardship programs, deviation from evidence-based practices
occurs adding to prescribing variability. Individual provider characteristics including knowledge deficits are
known to contribute to variability in antibiotic selection. However, other factors, including usability of available
prescribing resources, local culture, social pressures, and the work environment likely also contribute to this
variation, but have received less attention. Developing a rich understanding of sources of antibiotic prescribing
variability among front-line providers can inform usability and workflow integration to maximize uptake of
prescribing interventions. As mobile electronic clinical decision support (eCDS) tools have the potential to
reach broad audiences and to integrate the end-users (i.e., front-line prescribers) and user environment (i.e.,
busy inpatient ward) they may serve as powerful tools in the dissemination of evidence-based antibiotic
practices. Dr. Markham, a pediatric hospitalist physician and the candidate for this Career Development Award,
together with a strong interdisciplinary mentorship team has created a 5-year career development plan which
includes structured mentoring, completion of training in human factors science and the application of qualitative
methods within systems analyses, implementation science, and clinical informatics. This unique combination of
training activities in combination with Dr. Markham’s clinical expertise will place Dr. Markham at the forefront of
eCDS tool implementation in pediatrics. Acquisition of these skills will establish a pathway for Dr. Markham to
become a leader in addressing the quality and safety of pediatric hospitalizations through the development and
implementation of novel eCDS tools and interventions targeting other high-priority diagnoses affecting children.
Dr. Markham's training activities will be complemented by an innovative project that will facilitate practical
application of these new skills. The goals of the project are to: (1) measure and understand inter- and intra-
hospital antibiotic prescribing variability for children hospitalized with common infections; (2) utilize usability
testing and psychometric analysis to evaluate the impact of an eCDS tool to deliver evidence-based antibiotic
recommendations within simulated scenarios; and (3) perform a pilot implementation study to explore barriers
and facilitators to widescale deployment of a usability informed antibiotic eCDS tool. Findings from this study
will be used to prioritize infections in need of standardization of treatment, to track antibiotic standardization
improvement over time, and to inform future implementation studies examining the impact of eCDS tools on
standardization of antibiotic use and patient outcomes. The ultimate goal of this proposal is to provide Dr.
Markham with the skills to effectively enhance healthcare systems by improving the accuracy and efficiency
with which healthcare professionals can provide high-quality, evidence-based care to children.
项目总结/摘要
抗生素是儿童最常用的处方药之一,但30-50%的抗生素是
不适当的规定或完全不必要的。尽管有国家认可的治疗方法
指南和抗菌药物管理计划的扩展,偏离循证实践
增加了处方的可变性。个别供应商的特点,包括知识赤字,
已知导致抗生素选择的变异性。然而,其他因素,包括可用性
规定资源、当地文化、社会压力和工作环境也可能导致这一点
变化,但受到的关注较少。对抗生素处方来源的丰富理解
一线供应商之间的可变性可以通知可用性和工作流程集成,以最大限度地提高
处方干预。由于移动的电子临床决策支持(eCDS)工具具有潜力,
接触广泛的受众并整合最终用户(即,一线开处方者)和用户环境(即,
忙碌的住院病房),它们可能成为传播循证抗生素的有力工具
实践Markham博士是一名儿科住院医师,也是这一职业发展奖的候选人,
与强大的跨学科导师团队一起制定了一个5年职业发展计划,
包括结构化的指导,完成人因科学的培训和定性分析的应用。
系统分析、实施科学和临床信息学中的方法。这种独特的组合,
培训活动与Markham博士的临床专业知识相结合,将使Markham博士处于以下领域的最前沿:
eCDS工具在儿科的应用。获得这些技能将为马卡姆博士建立一条途径,
通过发展和加强医疗保健服务,
实施新的eCDS工具和针对影响儿童的其他高度优先诊断的干预措施。
博士万锦的培训活动将得到一个创新项目的补充,
运用这些新技能。该项目的目标是:(1)测量和了解内部和内部的,
医院抗生素处方变异性为住院儿童常见感染;(2)利用可用性
测试和心理测量分析,以评估eCDS工具对提供循证抗生素的影响
在模拟情景中提出建议;以及(3)进行试点实施研究,以探索障碍
和促进者,以大规模部署可用性知情的抗生素eCDS工具。从这个研究结果
将用于确定需要标准化治疗的感染的优先顺序,跟踪抗生素标准化
随着时间的推移不断改进,并为未来的实施研究提供信息,研究eCDS工具对
抗生素使用标准化和患者结局。该提案的最终目标是提供博士。
Markham拥有通过提高准确性和效率来有效增强医疗保健系统的技能
医疗保健专业人员可以为儿童提供高质量的循证护理。
项目成果
期刊论文数量(4)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Bridging the gap of work-as-imagined versus work-as-done through use of multiuser immersive virtual reality simulation.
通过使用多用户沉浸式虚拟现实模拟,缩小想象中的工作与完成的工作之间的差距。
- DOI:10.1002/jhm.13281
- 发表时间:2024
- 期刊:
- 影响因子:2.6
- 作者:Platt,Michael;Chan,YRaymond;Markham,JessicaL
- 通讯作者:Markham,JessicaL
Phlebotomy-free days in children hospitalized with common infections and their association with clinical outcomes.
因常见感染住院的儿童的无静脉放血天数及其与临床结果的关系。
- DOI:10.1002/jhm.13282
- 发表时间:2024
- 期刊:
- 影响因子:2.6
- 作者:Collins,MeganE;Hall,Matt;Shah,SamirS;Molloy,MatthewJ;Aronson,PaulL;Cotter,JillianM;Steiner,MichaelJ;McCoy,Elisha;Tchou,MichaelJ;Stephens,JohnR;Markham,JessicaL
- 通讯作者:Markham,JessicaL
Essential Concepts for Reducing Bias in Observational Studies.
减少观察研究中偏差的基本概念。
- DOI:10.1542/hpeds.2023-007116
- 发表时间:2023
- 期刊:
- 影响因子:0
- 作者:Markham,JessicaL;Richardson,Troy;Stephens,JohnR;Gay,JamesC;Hall,Matt
- 通讯作者:Hall,Matt
Changing patterns of routine laboratory testing over time at children's hospitals.
随着时间的推移,儿童医院的常规实验室检测模式正在发生变化。
- DOI:10.1002/jhm.13372
- 发表时间:2024
- 期刊:
- 影响因子:2.6
- 作者:Tchou,MichaelJ;Hall,Matt;Markham,JessicaL;Stephens,JohnR;Steiner,MichaelJ;McCoy,Elisha;Aronson,PaulL;Shah,SamirS;Molloy,MatthewJ;Cotter,JillianM
- 通讯作者:Cotter,JillianM
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Jessica Lynn Markham其他文献
Jessica Lynn Markham的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Jessica Lynn Markham', 18)}}的其他基金
Standardizing Antibiotic Prescribing for Children Hospitalized with Infections using Novel Metrics and Electronic Clinical Decision Support Tools
使用新指标和电子临床决策支持工具标准化住院感染儿童的抗生素处方
- 批准号:
10591108 - 财政年份:2022
- 资助金额:
$ 14.83万 - 项目类别:
相似国自然基金
水环境中新兴污染物类抗生素效应(Like-Antibiotic Effects,L-AE)作用机制研究
- 批准号:21477024
- 批准年份:2014
- 资助金额:86.0 万元
- 项目类别:面上项目
相似海外基金
New, easy to use, low-cost technologies based on DNA origami biosensing to achieve distributed screening for AMR and improved antibiotic prescribing
基于 DNA 折纸生物传感的易于使用、低成本的新型技术,可实现 AMR 的分布式筛查并改进抗生素处方
- 批准号:
MR/Y034481/1 - 财政年份:2024
- 资助金额:
$ 14.83万 - 项目类别:
Research Grant
Canadian antibiotic prescribing feedback initiative: Building a national framework to combat antimicrobial resistance in primary care (CANBuild-AMR)
加拿大抗生素处方反馈倡议:建立国家框架以应对初级保健中的抗菌药物耐药性 (CANBuild-AMR)
- 批准号:
487020 - 财政年份:2023
- 资助金额:
$ 14.83万 - 项目类别:
Operating Grants
Informatics Approaches to Understand and Reduce Inappropriate Antibiotic Prescribing by Dentists
了解和减少牙医不适当抗生素处方的信息学方法
- 批准号:
10736908 - 财政年份:2023
- 资助金额:
$ 14.83万 - 项目类别:
Antibiotic Prescribing Implementation Laboratory (APrIL)
抗生素处方实施实验室 (APrIL)
- 批准号:
481561 - 财政年份:2023
- 资助金额:
$ 14.83万 - 项目类别:
Operating Grants
Development, Validation and Real-World Application of Comprehensive Metrics to Improve Hospitals' Antibiotic Prescribing
改善医院抗生素处方的综合指标的开发、验证和实际应用
- 批准号:
10636459 - 财政年份:2023
- 资助金额:
$ 14.83万 - 项目类别:
Implementing Telemedicine to Improve Appropriate Antibiotic Prescribing for Acute Respiratory Tract Infections
实施远程医疗以改善急性呼吸道感染的适当抗生素处方
- 批准号:
10419727 - 财政年份:2022
- 资助金额:
$ 14.83万 - 项目类别:
Implementing Telemedicine to Improve Appropriate Antibiotic Prescribing for Acute Respiratory Tract Infections
实施远程医疗以改善急性呼吸道感染的适当抗生素处方
- 批准号:
10624848 - 财政年份:2022
- 资助金额:
$ 14.83万 - 项目类别:
Standardizing Antibiotic Prescribing for Children Hospitalized with Infections using Novel Metrics and Electronic Clinical Decision Support Tools
使用新指标和电子临床决策支持工具标准化住院感染儿童的抗生素处方
- 批准号:
10591108 - 财政年份:2022
- 资助金额:
$ 14.83万 - 项目类别:
Active Monitoring" Versus "Wait and See": Tackling Action Bias in Antibiotic Prescribing Through Strategic Decision Framing.
主动监测”与“观望”:通过战略决策框架解决抗生素处方中的行动偏差。
- 批准号:
2738694 - 财政年份:2022
- 资助金额:
$ 14.83万 - 项目类别:
Studentship
Incidence and risk factors of inappropriate antibiotic prescribing and related adverse health outcomes among Ontario long-term care residents and marginalized older community-dwelling adults with COVID-19 (I-CARE)
安大略省长期护理居民和边缘化老年社区居民感染 COVID-19 时抗生素处方不当及相关不良健康结果的发生率和风险因素 (I-CARE)
- 批准号:
459264 - 财政年份:2021
- 资助金额:
$ 14.83万 - 项目类别:
Operating Grants