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.

项目总结 儿科院内心脏骤停几乎只发生在儿科重症监护病房和 每年影响数以千计的住院儿童。虽然心脏骤停的生存结果 改善后，这些儿童中有一半以上将在出院前死亡，这使得预防成为最好的选择 提高儿科患者安全性的途径。在我们之前的单中心工作中，使用 武士PICU(整合多学科团队的态势意识减少了#年的逮捕人数 PICU捆绑包改善了高危患者的早期识别，增加了共享情况 意识，并支持风险缓解计划，导致IHCA事件减少50% 需要心肺复苏。使用强调共享的创新流程 通过自动化临床决策支持和风险缓解来感知情况，我们将使用 以用户为中心的设计方法，以适应、实施和评估 武士PICU在其他儿科机构的有效性。我们假设身份证明 通过使用我们的自动化临床应用，降低PICU患者住院期间心脏骤停的高危风险 决策支持工具和这种高风险状态在日常安全会议中的整合将导致 提高了对共同情况的认识，随后减少了心脏骤停事件。我们会 利用五中心实用型前瞻性混合I型有效性--实施研究 利用儿科复苏质量协作组的现有基础设施进行评估 以下具体目标：1)调整每个干预地点的武士PICU捆绑包，以适应 通过以用户为中心的设计方法实现本地环境，2)实现武士PICU捆绑包 以混合阶梯楔形方式，评估捆绑包减少CPR的有效性 在PICU里发生的事件。这项拟议的研究具有重要意义，它有可能为 转变心脏骤停预防领域，最终防止与住院相关的死亡 未来数千名儿童心脏骤停将显著改善儿科患者 安全。