Geriatric Emergency care Applied Research network 2.0 - Advancing Dementia Care (GEAR 2.0 ADC)

项目摘要： 老年阿尔茨海默病和相关痴呆症(ADRD)的紧急护理是次要的 尽管急诊科(ED)的使用率高于匹配对照组。痴呆症患者 (PWD)在急诊科识别不佳，更有可能有可避免的急诊科就诊，被送往医院， 在ED环境中挣扎，并经历许多其他挑战。尽管在全国范围内呼吁 针对阿尔茨海默氏症的计划及其最新进展，已经进行了有限的研究来优化 残障人士的急救护理。 要推进残疾人的急救，首先需要划定与以下方面相关的研究空白 确定接受紧急护理的残疾患者，并为他们提供最佳护理，然后建立和 测试解决差距的策略。为了有效和高效地识别和解决这些差距，目标是 这项建议的其中一个建议是启动老年急救应用研究网络2.0-Advance 痴呆症护理(Gear 2.0 ADC)。具体地说，该网络将合作并利用现有的ADRD和 通过跨学科的、以紧急护理为重点的网络、基金会、利益相关者和组织 由领先的调查人员和顾问组成的团队，他们已经改变了老年人的紧急护理 通过由美国国立卫生研究院资助的严格研究，为成人和残疾患者的护理提供帮助。 在本提案的第一阶段，将使用利益相关者参与方法，该方法已经 此前，调查人员成功地实施了这一方案。他们将确定ED的研究优先事项 患者和照顾者使用四个领域的共识过程：1.急诊实践2.急诊护理过渡3. 检测，以及4.沟通和决策。Gear 2.0-ADC基础设施及其网络 将建立包括GEDC、ADRC和Gear 2.0的核心：1.行政；2.研究；3. 数据/信息学；以及4.传播和实施。提案的第二阶段将征求、审查、 选择并资助将导致未来解决紧急情况研究差距的全面提案的研究 在第一阶段确定了对残疾患者及其照顾者的关怀。将有超过110万美元用于试点研究 奖项。这项提案将创建一个平台，Gear 2.0 ADC和未来的调查人员将在此平台上生成 大规模融资机会的初步数据，包括多中心项目提案。这种“引爆” 研究管道将促进进一步的跨学科研究和科学，并为 可持续的研究网络基础设施，以支持证据基础的开发，以优化 残障人士的急救护理。

PROJECT ABSTRACT: Emergency care of older adults with Alzheimer's Disease and related dementias (ADRD) is suboptimal despite greater rates of emergency department (ED) use than for matched controls. Persons with dementia (PwD) are poorly identified in the ED, are more likely to have an avoidable ED visit, be admitted to the hospital, struggle in the ED environment, and experience numerous other challenges. Despite calls in the National Plans to Address Alzheimer's Disease and their updates, limited research has been performed to optimize the emergency care of PwD. To advance the emergency care of PwD first requires delineation of the research gaps related to identifying PwD receiving emergency care and providing them optimal care, followed by establishing and testing strategies to resolve the gaps. To effectively and efficiently identify and address these gaps, the goal of this proposal is to launch the Geriatric Emergency Care Applied Research Network 2.0 - Advancing Dementia Care (GEAR 2.0 ADC). Specifically, this network would partner and leverage existing ADRD and emergency care focused networks, foundations, stakeholders, and organizations through a transdisciplinary team of leading investigators and consultants who have already transformed the emergency care of older adults and the care of PwD through rigorous NIH-funded research. During the first phase of this proposal, a stakeholder engagement approach will be used that has been previously and successfully implemented by investigators. They will determine research priorities for ED patients and caregivers using a consensus process in four domains: 1. ED practices 2. ED care transitions 3. Detection, and 4. Communication and decision making. The GEAR 2.0 - ADC infrastructure and its network will be established that includes the GEDC, ADRCs, and GEAR 2.0 Cores: 1. Administrative; 2. Research; 3. Data/Informatics; and 4. Dissemination & Implementation. The second phase of the proposal will solicit, review, select and fund research that will lead to future full-scale proposals addressing research gaps in emergency care for PwD and their caregivers identified during the first phase. There will be over $1.1M in pilot study awards. This proposal will create a platform from which GEAR 2.0 ADC and future investigators will generate preliminary data for large-scale funding opportunities, including multicenter project proposals. This “priming” of the research pipeline will promote further transdisciplinary studies and science and lay the groundwork for a sustainable research network infrastructure to support development of an evidence base to optimize the emergency care of PwD.