Camera System Development for Pressure Injury Screening in Veterans with SCI

用于 SCI 退伍军人压力损伤筛查的摄像系统开发

• 批准号: 10631918
• 负责人: CHRISTINE M OLNEY
• 金额: --
• 依托单位: MINNEAPOLIS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-01-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10631918
• 关键词: Area; Beds; Behavior; Care given by nurses; Cessation of life; Clinic; Clinical Trials; Communication; Development; Devices; Early Diagnosis; Early Intervention; Engineering; Esthesia; Feedback; Future; Goals; Health Care Costs; Health Personnel; Healthcare; Home; Home environment; Hospital Costs; Hospitalization; Hour; Image; Infection; Injury; Interruption; Intervention; Lead; Location; Methods; Muscle Tonus; Nursing Research; Operative Surgical Procedures; Outcome; Pathway interactions; Persons; Posture; Prevention; Process; Protocols documentation; Provider; Rehabilitation therapy; Research; Risk; Risk Factors; Secure; Self-Help Devices; Severities; Skin; Specialist; Spinal cord injury; System; Systems Development; Technology; Testing; Time; Training; Trochanters; Veterans; Vision; Visit; Work; base; coccyx; cost; decubitus ulcer; healing; high risk; home test; improved; injury prevention; limb loss; pressure; prevent; sacrum; satisfaction; screening; systems research; tool; trial comparing; usability; wound; wound care

Veterans with spinal cord injury (VwSCI) are at high risk for pressure injury (PI). Risk factors for PI in VwSCI include lack of sensation below the level of injury, relative immobility, and poor gluteal muscle tone. The average added healthcare cost for a person with SCI with a pressure injury is estimated to be $70,000, and hospitalization may be required for weeks to months to heal the pressure injury. Furthermore, incurring a pressure injury can result in severe infection, limb loss, or even death. Preventative behavior to incurring a pressure injury is taught to the VwSCI during rehabilitation. Behaviors such as pressure reliefs every 15 minutes, turning every two hours when lying in bed, and conducting regular skin assessments are recommended for PI prevention. Most VwSCI are taught to use a mirror on a long handle for viewing at-risk seated areas (e.g., sacrum, ischial tuberosities, coccyx area, and trochanters) at least twice a day for evidence of skin changes. If the mirror user discovers a change in the skin, he/she is encouraged to completely offload that area. Many VwSCI live great distances from the VA SCI clinic thus healthcare providers could better advise Veterans to the appropriate pathway if they could view an image of the at-risk skin. The long term goal of this work is to help VwSCI prevent the progression and severity of an early detected pressure injury. The short term goals are to 1) provide VwSCI a more efficient and efficacious tool [In-Sight camera system] to examine their at-risk skin areas; and to 2) provide a secure and efficient communication process with their health care provider or skin specialist regarding areas of concern. The first aim of the project will involve N=18 VwSCI (level C7 and below). During a first visit, Veterans will describe their current use of the long-handled mirror to conduct skin screening and will demonstrate their ability to see key locations with the mirror. They will also fill out the Assistive Device section of the QUEST 2.0 to provide their satisfaction with the long-handled mirror. The In-Sight camera system will be presented to the Veterans and they will be trained on how to use the system by the research nurse. The Veterans will then demonstrate their ability to see key locations with the camera system. Subjects will fill out the Assistive Device section of the QUEST 2.0 for the camera system and will provide feedback on how to improve the system. This feedback will be used by our engineering team to refine the camera system. During a second visit, the refined camera system will be retested by the same N=18 VwSCI using the same protocol. QUEST 2.0 device subscale scores will assist in quantifying improvements to the device during the refinement. The second aim will use the refined camera system in at-home testing of N=6 VwSCI (level C7 and below). During a first visit to the Veteran's home, the Veteran will conduct the same testing with the long-handled mirror as described for Aim 1. The research nurse will train the Veteran on how to use the In-Sight camera system and the Veteran will use the system at home for 3 months. Veterans will send images weekly (using MyHealtheVet) to a wound care nurse at the Minneapolis VA SCI/D Center or more often if they find areas of concern. The research nurse will call Veterans weekly to determine if they are having any issues with the system and to provide feedback regarding the image quality (based on discussions with the wound care nurse). At the end of the study, the research nurse will return to the Veteran's home and the Veteran will demonstrate their use of the camera system and fill out the Assistive Device section of the QUEST 2.0. We expect to show that the camera system is preferred to the long-handled mirror and to establish the feasibility for a future clinical trial comparing different skin screening technologies.

脊髓损伤（VwSCI）的退伍军人是压力损伤（PI）的高风险。VwSCI中PI的风险因素 包括在受伤水平以下缺乏感觉、相对不动和臀肌张力差。的 一个SCI患者因压力性损伤而增加的平均医疗费用估计为70，000美元， 可能需要住院治疗数周至数月以治愈压伤。此外，如果A 压力损伤可能导致严重感染、肢体丧失甚至死亡。避免行为招致 在康复过程中对VwSCI进行压力损伤训练。每15分钟释放一次压力等行为 分钟，躺在床上时每两小时翻身一次，并定期进行皮肤评估， 建议预防PI。大多数VwSCI都被教导使用长柄上的镜子进行危险观察 就座区域（例如，骶骨、坐骨结节、尾骨区和转子），每天至少两次， 皮肤的变化。如果镜像用户发现皮肤发生变化，则鼓励他/她完全卸载 那个地区。许多VwSCI的生活距离VA SCI诊所很远，因此医疗保健提供者可以更好地 建议退伍军人通过适当的途径，如果他们可以查看危险皮肤的图像。长期目标 这项工作的目的是帮助VwSCI预防早期发现的压力损伤的进展和严重程度。的 短期目标是：1）为VwSCI提供一种更有效的工具[In-Sight摄像机系统]， 检查他们的危险皮肤区域;以及2）提供安全有效的沟通过程， 健康护理提供者或皮肤专家关于关注的区域。 该项目的第一个目标将涉及N=18 VwSCI（C7级及以下）。在第一次访问期间，退伍军人将 描述他们目前使用长柄镜进行皮肤筛查，并将展示他们的能力 用镜子看到关键位置他们还将填写QUEST 2.0的辅助设备部分， 让他们对长柄镜子感到满意。In-Sight相机系统将在 研究护士将对退伍军人和他们进行如何使用该系统的培训。退伍军人将 展示他们使用摄像机系统查看关键位置的能力。受试者将填写辅助器械 QUEST 2.0的第一部分，并将提供有关如何改进系统的反馈。这 我们的工程团队将使用反馈来改进摄像机系统。在第二次访问中， 摄像机系统将由相同的N=18 VwSCI使用相同的方案重新测试。QUEST 2.0设备 子量表评分将有助于量化细化期间器械的改进。 第二个目标是在N=6 VwSCI（C7级及以下）的家庭测试中使用改进的摄像系统。 在第一次访问退伍军人的家，退伍军人将进行相同的测试与长柄 如目标1所述的镜子。研究护士将培训退伍军人如何使用In-Sight摄像头 系统和退伍军人将在家中使用该系统3个月。退伍军人将每周发送图像（使用 MyHealtheVet）向明尼阿波利斯VA SCI/D中心的伤口护理护士提供，如果他们发现 关心研究护士将每周打电话给退伍军人，以确定他们是否有任何问题， 并提供关于图像质量的反馈（基于与伤口护理人员的讨论 护士）。研究结束时，研究护士将返回退伍军人的家中，退伍军人将 演示他们如何使用摄像机系统，并填写QUEST 2.0的辅助设备部分。我们 期望能证明该摄像系统优于长柄镜，并建立可行性 用于未来的临床试验，比较不同的皮肤筛查技术。