Improving Pressure Ulcer Care in Nursing Homes

描述（由申请人提供）：NIA职业发展奖（CDA）申请的目的是为申请人提供必要的知识、分析技能和初步数据库，以开发技术，促进干预措施的转移，特别是用于监测压疮（PU）护理过程的质量评估（QA）系统，在养老院（NHs）实施。拟议的CDA将允许申请人接受四个主要领域的培训，每个领域都补充了她现有的知识：1)专家共识方法，这建立在她与国家PU小组和研究开发评估PU工具的经验之上；2)在她的临床和教学经验的基础上，开展与改变提供者行为和实施NHs实践指南相关的卫生服务研究；3)成本效益和成本效益分析，4)运筹学建模，这样可以确定实施QA系统所需的相关成本和人力资源，这两个都扩展了她现有的研究方法知识，并将加强她的统计分析知识。具体来说，这个CDA申请旨在为申请人提供必要的知识和分析技能，以追求她的直接职业目标，即完善和验证QA系统，以监控NHs的PU护理过程。拟议的CDA培训计划包括正式课程和个性化教程，为申请人提供必要的知识和技能，以实现其近期的职业目标。Dr. John F. Schnelle博士是行为心理学家，也是NHs行为和环境干预方面的专家，他将作为申请人的担保人和主要导师，提供焦点小组方法方面的培训，以及NHs干预措施的设计、实施和评估。Charlene Harrington博士是一名护士和NHs人员配置专家，她将在NHs护士人员配置问题和实施QA系统所需的护士人员配置比例方面担任导师。Drs。George Xakellis和Laurence Rubenstein将是她在实施实践指南、NH组织结构和与QA系统实施相关的成本效益分析方面的导师。她将与Claude B. Pepper老年美国独立中心（OAIC）数据管理核心一起开发软件，并与两名顾问一起改进运动监测技术，这两项技术都是NHs系统实施所必需的。玛丽·卡多根医生将为护士专家小组提供指导。兰德公司高级数学家Emmett Keeler博士将提供与干预和运营研究建模技术相关的成本分析培训，以确定系统成本和必要的人力资源。这样的培训将允许申请人追求她的长期职业目标，即发展行为和环境干预措施，以改善机构老年人的生活质量，并确定在NH环境中实施此类干预措施所需的NH员工资源和相关成本。因此，拟议的CDA培训对于申请人在其所选的老年学研究领域发展成为独立科学家的能力至关重要。

DESCRIPTION (provided by applicant): The purpose of the NIA Career Development Award (CDA) application is to provide the applicant with the knowledge, analytical skills, and preliminary database necessary to develop technology that will facilitate the transfer of interventions, specifically a quality assessment (QA) system for monitoring pressure ulcer (PU) care processes, into practice in nursing homes (NHs). The proposed CDA will allow the applicant to receive training in four primary areas, each of which compliments her existing knowledge: 1) expert consensus methodology, which builds on her experience with national PU panels and research developing a tool for assessing PUs; 2) health service research relevant to changing provider behavior and implementing practice guidelines in NHs, which builds on her clinical and teaching experience; 3) cost effectiveness and cost benefit analysis and 4) operations research modeling such that associated costs and staffing resources required for implementing the QA system can be determined, both of which expand her existing knowledge of research methodology and will strengthen her knowledge of statistical analysis. Specifically, this CDA application is designed to provide the applicant with the necessary knowledge and analytical skills to pursue her immediate career goal of refining and validating the QA system for monitoring PU care processes in NHs. The proposed CDA program of training incorporates formal coursework and individualized tutorials to provide the applicant with the requisite knowledge and skills to accomplish her immediate career goals. Dr. John F. Schnelle, PhD, a behavioral psychologist and expert in behavioral and environmental interventions in NHs, will serve as the applicant's sponsor and primary mentor, providing training in focus group methodology as well as designing, implementing, and evaluating interventions in NHs. Dr. Charlene Harrington, a nurse and expert in NH staffing, will serve as a mentor in nurse staffing issues in NHs and nurse staffing ratios needed for implementation of the QA system. Drs. George Xakellis, and Laurence Rubenstein will be her mentors in implementing practice guidelines, NH organizational structure, and cost benefit analysis related to implementation of the QA system. She will work with the Claude B. Pepper Older American Independence Center (OAIC) Data Management Core in developing software, and with two consultants to refine movement monitoring technology both of which are necessary for implementation of the system in NHs. Dr. Mary Cadogan will provide guidance for the nurse expert panel. Dr. Emmett Keeler, a senior mathematician at RAND, will provide training in cost analysis related to the intervention and operations research modeling techniques to determine systems costs and the necessary staff resources. Such training will permit the applicant to pursue her long-term career goal of developing behavioral and environmental interventions that improve the quality of life among institutionalized elders, and determine the NH staff resources and the associated costs necessary to implement such interventions in the NH setting. Thus, the proposed CDA training would be central to the applicant's ability to develop as an independent scientist within her chosen area of gerontologic research.