SAMURAI PICU: Situation Awareness incorporating Multidisciplinary Teams Reduce Arrests In the Pediatric ICU

SAMURAI PICU：结合多学科团队的态势感知减少儿科 ICU 的逮捕

• 批准号: 10769356
• 负责人: Maya L Dewan
• 金额: $ 39.78万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10769356
• 关键词: SAMURAI; PICU; Situation; Awareness; incorporating

PROJECT SUMMARY Pediatric in-hospital cardiac arrest occurs almost exclusively in pediatric intensive care units and affects thousands of hospitalized children each year. While cardiac arrest survival outcomes have improved, more than half of these children will die prior to discharge making prevention the best approach to improve pediatric patient safety. In our single center prior work, the use of the SAMURAI PICU (Situation Awareness incorporating MUltidisciplinary Teams Reduce Arrests In the PICU) bundle improved early identification of high-risk patients, increased shared situation awareness, and supported risk mitigation plans leading to a >50% decrease in IHCA events requiring cardiopulmonary resuscitation. Using an innovative process of emphasizing shared situation awareness through automated clinical decision support and mitigation of risk, we will use a user-centered design approach to adapt, implement, and assess the feasibility and effectiveness of SAMURAI PICU at other pediatric institutions. We hypothesize that identification of PICU patients at high risk for in-hospital cardiac arrest through the use of our automated clinical decision support tool and integration of this high-risk status in daily safety huddles will lead to improved shared situation awareness and subsequent reduction in cardiac arrest events. We will utilize a five-center pragmatic prospective Hybrid Type 1 effectiveness-implementation study leveraging the existing infrastructure of Pediatric Resuscitation Quality Collaborative to evaluate the following specific aims: 1) adapt the SAMURAI PICU bundle at each intervention site to fit local context through a user-centered design approach, 2) implement the SAMURAI PICU bundle in a hybrid stepped wedge fashion and evaluate the effectiveness of the bundle to reduce CPR events in the PICU. This proposed research is significant it has the potential to inform and transform the field of cardiac arrest prevention and ultimately prevent death related to in hospital cardiac arrest for thousands of children in the future significantly improving pediatric patient safety.

项目摘要 小儿心脏骤停几乎完全发生在小儿重症监护病房中 每年影响成千上万的住院儿童。而心脏骤停的生存结果有 改善，这些孩子中有一半以上会在出院之前死亡，使预防最好 改善小儿患者安全的方法。在我们的单一中心工作中，使用 武士picu（融合多学科团队的情况意识减少了逮捕 PICU）捆绑包改进了高风险患者的早期识别，共同情况增加 意识和支持降低风险的计划，导致IHCA事件降低> 50％ 需要心肺复苏。使用强调共享的创新过程 通过自动临床决策支持和减轻风险的情况意识，我们将使用 一种以用户为中心的设计方法，用于适应，实施和评估可行性和 武士picu在其他儿科机构的有效性。我们假设该识别 通过使用我们的自动临床 决策支持工具和这种高风险状态在每日安全障碍中的整合将导致 提高了共同的情况意识，随后心脏骤停事件的降低。我们将 利用五个中心的务实的前瞻性混合1型有效性实施研究 利用小儿复苏质量合作的现有基础设施来评估 以下具体目的：1）在每个干预地点调整武士picu捆绑包以适合 通过以用户为中心的设计方法，2）实现武士picu捆绑 以混合阶梯式楔形的方式评估捆绑包的有效性 PICU中的事件。这项拟议的研究很重要，它有可能告知和 改变预防心脏骤停的领域，并最终阻止与医院相关的死亡 将来成千上万儿童的心脏骤停会显着改善儿科患者 安全。