Optimizing the use of noninvasive respiratory support in the Emergency Department

优化急诊科无创呼吸支持的使用

基本信息

批准号：
10591839
负责人：
Neha Neelam Goel
金额：
$ 19.02万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-02-20 至 2028-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10591839
关键词：
Accident and Emergency department Acute Acute respiratory failure Address Adherence COVID-19 pandemic Caring Censuses Clinical Clinical Investigator Clinical Management Consolidated Framework for Implementation Research Critical Care Critical Illness Data Development Development Plans Effectiveness Emergency Care Emergency Department patient Emergency research Ensure Evidence based practice Failure Feedback Focus Groups Funding Future Goals Guidelines Health system Hospitals Intensive Care Units International Interruption Intervention Intubation Lung Mechanical ventilation Medicine Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methodology Methods Monitor Morbidity - disease rate Nose Outcome Oxygen Patient Care Patient-Focused Outcomes Patients Phase Physicians Positioning Attribute Process Process Measure Protocols documentation Provider Quality of Care Recommendation Research Research Personnel Research Project Grants Resources Sample Size Sampling Scientist Shock Statistical Data Interpretation Testing Time Series Analysis Training United States Work Workload acute care acute hypoxemic respiratory failure care delivery career career development clinical application cohort design effectiveness testing effectiveness/implementation study evidence base evidence based guidelines implementation evaluation implementation process implementation science implementation strategy improved mortality mortality risk multidisciplinary pilot test pressure research study respiratory skills standardized care ventilation

项目摘要

PROJECT SUMMARY The goal of Dr. Neha Goel’s K23 project is to enable her to become an independent physician-investigator who conducts research on the implementation of evidence-based care for patients with acute respiratory failure. Building upon her strengths as a pulmonary-critical care physician and her prior training in clinical emergency care research, Dr. Goel will transition into the next phase of her career through a well-defined training plan. The training plan is meticulously designed to enable her to acquire requisite skills in guideline development, implementation science methodology, and advanced statistical analyses. Her career development plan contains focused training through conduct of a mentored research study, relevant didactic coursework, and close mentorship from leaders in the fields of emergency and critical care medicine, and implementation science. Dr. Goel’s ultimate research objective is to improve clinical outcomes for patients with acute respiratory failure through the implementation of a systematically developed, evidence-based, high flow nasal oxygen (HFNO) monitoring protocol for the emergency department (ED). In keeping with this objective, her K23 mentored research project will focus on investigating the implementation of evidence-based protocol on HFNO use and management for The Mount Sinai Hospital ED. HFNO use and management is a timely and important research topic. Since the COVID-19 pandemic began, there has been a rapid increase in HFNO usage. However, guidance on HFNO use and monitoring in the ED setting is lacking, and adverse clinical outcomes occur in the absence of guidance. Dr. Goel’s K23 research project specific aims are to: (Aim 1) develop a pragmatic protocol for HFNO use and management in ED setting for hypoxemic acute respiratory failure using feedback from a national panel of multi-disciplinary experts and current evidence; (Aim 2) select implementation strategies that address the determinants of protocol-concordant HFNO use and management, commensurate with the ED’s capabilities, resources, and needs of its patients; and (Aim 3) examine both the implementation process for the HFNO protocol and the applicable clinical outcomes in a pilot hybrid effectiveness-implementation study. The completed project will include an implementation plan for HFNO management in the ED setting, and will provide estimates of effect and sample sizes for a future R01 implementing and testing the impact of HFNO monitoring protocols across health systems. Using the skills and preliminary data gained throughout this K23 mentored career development project, Dr. Goel will be well positioned to become an independent physician-scientist with R01 funding to implement and test the effectiveness of respiratory care protocols for improving patient and process outcomes across health systems. Larger scale implementation of such interventions can help standardized care delivery, with the ultimate goal of improving patient outcomes for more than a million acutely ill patients presenting to EDs annually in the United States with respiratory complaints.

项目摘要 Neha Goel博士的K23项目的目标是使她成为一个独立的物理评估者对急性呼吸衰竭患者实施基于证据的护理的研究。基于她作为肺部关键护理身体的长处，并在临床紧急情况下进行培训护理研究，Goel博士将通过定义明确的培训计划过渡到职业生涯的下一阶段。精心设计培训计划，以使她能够在指南开发中获得所需的技能，实施科学方法和高级统计分析。她的职业发展计划包含通过进行指导的研究，相关的教学课程和关闭的关注培训急诊和重症监护医学领域的领导者以及实施科学领域的遗产。 Goel博士的最终研究目标是改善急性呼吸衰竭患者的临床结果通过实施系统开发的，基于证据的高流量鼻氧（HFNO）急诊科（ED）的监视协议。为了与这个目标保持一致，她的K23很重要研究项目将着重于调查有关HFNO使用的基于证据的协议的实施西奈山医院的管理层。 HFNO使用和管理是一项及时，重要的研究话题。自从COVID-19大流行开始以来，HFNO的使用量迅速增加。然而，缺乏有关ED环境中HFNO使用和监测的指南，并且不良临床结果发生在缺乏指导。 Goel博士的K23研究项目的特定目的是：（目标1）制定务实的协议在ED设置中使用HFNO的使用和管理用于低氧急性呼吸衰竭，使用来自国家多学科专家和当前证据的国家小组；（目标2）选择实施策略解决协议协议的确定性HFNO使用和管理，与ED相称患者的能力，资源和需求；（AIM 3）检查两个 HFNO方案和适用的临床结果中的临床结果在一项试验效率实施研究中。这已完成的项目将在ED环境中包括HFNO管理的实施计划，并将提供未来R01实施和测试HFNO监测的影响的效果和样本量的估计值和样本量跨卫生系统的协议。使用在整个K23中获得的技能和初步数据很重要职业发展项目，戈尔博士将有能力成为独立的身体科学家 R01资金以实施和测试呼吸护理方案的有效性，以改善患者和跨卫生系统的过程结果。大规模实施此类干预措施可以帮助标准化的护理交付，最终的目标是改善患者的结果超过一百万每年在美国出现呼吸道投诉的病患者。