Multicomponent intervention to improve delirium and sleep-wake rhythms in older ICU patients

项目摘要 候选人：Biren Kamdar，医学博士，MBA，MHS是医学和重症监护室（ICU）的副教授 医生的职业目标是在ICU环境中对谵妄和睡眠进行新的发现， 特别是在不断扩大的老年重症患者群体中。拥有强大的研究背景， 包括先前领导NIH支持的ICU睡眠促进工作，Kamdar博士的职业目标是获得 独立设计、实施、评估和维持多地点干预措施所需的技能， 证明老年ICU患者的谵妄和睡眠-觉醒节律。研究项目：ICU中的老年患者 易患谵妄和睡眠-觉醒节律失调，使他们处于不利的外- 是在重症监护室出院后由于老年人占ICU患者的大多数， ICU幸存者的比例，需要基于ICU的干预措施，以关注这一特别的vul- 可再生人口在强大的导师和跨学科利益相关者团队的支持下， K76提案涉及在两个学术ICU中实施和测试多组分干预。到 减少老年ICU患者的谵妄和改善夜间睡眠质量，父母的建议对组成， Kamdar博士先前以夜间为重点的努力与白天的干预措施。为了加强干预， 作为补充，Kamdar博士的团队开发了一个基于视频的数字“ICU谵妄剧本”，其中包括 为床边提供者提供关于夜间和日间干预措施的说明。延长本 Kamdar博士的团队与以多样性为重点的专家合作，开发了一个"ICU谵妄游戏- 西班牙语版”。这项多样性、公平性、包容性和无障碍性（DEIA）补充计划的支持将 帮助扩展母公司K76奖项，以包括成果数据收集（例如，动描记术和谵妄）， ly讲西班牙语的病人，并加强指导活动，为博士. Kamdar的不同群体的学员，在- 包括那些代表性不足和弱势背景的人。职业发展：Kamdar博士 职业发展计划包括指导活动，以发展（a）睡眠-觉醒节律和delir， 老年人和老龄化;（B）先进的活动记录方法;（c）干预发展;（d）实施科学 恩塞。母公司K76奖为Kamdar博士的独立研究生涯提供了基础 和领导大型多站点ICU干预。Kamdar博士在过去13年中指导了约50名学员。 年，包括来自生物医学研究背景不足的个人，以及本科生 他们缺乏直接获得临床机会和研究指导的机会。该DEIA补充将支持 博士Kamdar通过为学员提供津贴和增加以DEIA为重点的研究支持， 端口，以指导团队向更多样化的ICU人群提供干预措施。

PROJECT SUMMARY Candidate: Biren Kamdar, MD, MBA, MHS is an Associate Professor of Medicine and intensive care unit (ICU) physician with a career goal of making novel discoveries regarding delirium and sleep in the ICU setting, par- ticularly in the ever-expanding population of older critically ill patients. Bringing a strong research background, including prior leadership of an NIH-supported ICU sleep promoting effort, Dr. Kamdar’s career goal is to gain the skills necessary to independently design, implement, evaluate and sustain multi-site interventions to im- prove delirium and sleep-wake rhythms in older ICU patients. Research Project: Older patients in the ICU are predisposed to delirium and misaligned sleep-wake rhythms, placing them at high risk for adverse out- comes following ICU discharge. As older adults comprise the majority of ICU patients and a rapidly expanding proportion of the ICU survivor population, ICU-based interventions are needed to focus on this particularly vul- nerable population. With the support of a strong mentorship and interdisciplinary stakeholder team, the parent K76 proposal involves implementation and testing of a multicomponent intervention in two academic ICUs. To reduce delirium and improve nighttime sleep quality in older ICU patients, the parent proposal pairs compo- nents of Dr. Kamdar’s prior nighttime-focused efforts with daytime interventions. To enhance intervention im- plementation, Dr. Kamdar’s team developed a video-based digital “ICU Delirium Playbook,” which includes instructions for bedside providers regarding delivery of nighttime and daytime interventions. To extend this effort further, Dr. Kamdar’s team partnered with diversity-focused experts to develop an “ICU Delirium Play- book: Spanish Edition.” Support from this Diversity, Equity, Inclusion and Accessibility (DEIA) supplement will help extend the parent K76 award to include outcomes data collection (e.g., actigraphy and delirium) in primari- ly Spanish-speaking patients, and bolster mentoring activities for Dr. Kamdar’s diverse group of trainees, in- cluding those from underrepresented and disadvantaged backgrounds. Career Development: Dr. Kamdar’s career development plan includes mentored activities to develop expertise in (a) sleep-wake rhythms and delir- ium and aging; (b) advanced actigraphy methods; (c) intervention development; and (d) implementation sci- ence. The parent K76 award has provided Dr. Kamdar with a foundation for an independent research career and leadership of large multi-site ICU interventions. Dr. Kamdar has mentored ~50 trainees over the past 13 years, including individuals from backgrounds underrepresented in biomedical research, and undergraduates who lack direct access to clinical opportunities and research mentorship. This DEIA supplement will support Dr. Kamdar’s mentoring efforts by providing stipends for trainees and by adding DEIA-focused research sup- port to guide the team in delivering interventions to more diverse ICU populations.