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Diabetic Foot and Pressure Ulcer Databank

糖尿病足和压疮数据库

基本信息

批准号：
7871089
负责人：
HAROLD BREM
金额：
$ 16.53万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-01 至 2010-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7871089
关键词：
Accountability Amputation Ankle Area Bioinformatics Biometry Blood Vessels Care given by nurses Caring Chemistry Chronic Clinical Cohort Studies Collaborations Collection Communicable Diseases Communication Complex Computerized Medical Record Computers Confidentiality of Patient Information Data Data Collection Databases Debridement Decision Making Decubitus ulcer Diabetic Foot Diabetic Foot Ulcer Diagnosis Digit structure Discipline of Nursing Documentation Electronics Ensure Environment Epidemiology Geographic Locations Goals Graph Healed Health Insurance Portability and Accountability Act Health Personnel Health Professional Healthcare Healthcare Systems Hematology Hospital Nursing Hospitals Incidence Informatics Information Systems Inpatients Institutes Institution Internet Intervention Ischemia Knowledge Laboratories Length Limb structure Literature Location Measures Medical Medical History Medical Records Medicine Methods Microbiology Morbidity - disease rate Nursing Homes Nursing Schools Nutritionist Operative Surgical Procedures Orthopedic Nursing Osteomyelitis Outcome Outpatients Pathologist Pathology Report Patient Care Patient Monitoring Patients Peer Review Pharmaceutical Preparations Primary Care Physician Procedures Protocols documentation Provider Publications Radiology Specialty Recording of previous events Research Research Personnel Resolution Resources Secure Site Solutions Specialist Staging Stratification Surgeon System Talents Technology Testing Therapeutic Time Treatment Protocols Ulcer United States United States National Library of Medicine Update Width Work Workload Wound Healing base bone clinical care digital effective therapy glycemic control healing improved indexing medical schools mortality programs prospective radiologist statistics tertiary care tool wound

项目摘要

DESCRIPTION: Patients with chronic wounds are cared for by a variety of clinicians during the course of their treatment. Many of these patients seek treatment in different settings including hospitals, nursing homes, and out patient wound centers. Few clinicians have expertise in managing chronic wounds, which is why the wound resolution rate is so low, and the morbidity and mortality so high. A wound related informatics system that is secure and universally accessible by healthcare professionals, regardless of their geographic location, could potentially improve clinical decision making in the management of wounds and, consequently, decrease the morbidity and mortality in more than 3 million patients suffering from pressure ulcers and diabetic foot ulcers. The purpose of this study is to develop and evaluate a HIPAA compliant Wound Electronic Medical Record (WEMR) to determine if it can reduce the progression of early stage pressure ulcers (l-lll) to stage IV, and decrease the rate of amputations associated with diabetic foot ulcers. A longer term goal of this program is to evaluate the utility of the WEMR on an entire healthcare system (including hospitals, nursing homes, and wound centers). The research hypotheses of this study are: 1) the WEMR will significantly decrease the number of pressure ulcers that progress to stage IV and 2) the WEMR will significantly decrease the number of amputations associated with diabetic foot ulcers. To accomplish these hypotheses, we have developed the WEMR, which comprises of a photograph of the wound, a real-time graph of the wound's healing rate as measured by area, vascular testing, chemistry, hematology, microbiology laboratory values, current wound treatments, glycemic control, ambulatory status, and radiology and pathology reports. The WEMR has been beta-tested in 1600 consecutive patients in a tertiary care hospital and out patient unit. The preliminary data suggests: 1) that when pressure ulcers are diagnosed before they progress to bone and an appropriate treatment protocol is instituted, they heal; 2) diabetic foot ulcers, in the absence of ischemia and osteomyelitis, heal when they are treated appropriately, thereby averting amputations. The data from beta testing suggests that having all relevant patient information electronically available in one easily accessible record significantly facilitates coordination of clinical care among multiple health care providers, both on the hospital premises and from remote locations. To more definitively test our hypothesis that using the WEMR accelerates wound healing, we propose a multi-site prospective cohort study in 4 institutions: NYU, Cornell, and Southside Hospital as control sites and Columbia as the experimental site. Given that this is a nonrandomized study, the analysis will adjust for patient differences across sites using stratification by propensity scores. We have brought together a team of experts in the fields of wound healing, nursing, medicine, surgery, epidemiology and biostatistics to collaborate on this multi-site study. The proposed study offers a unique opportunity to systematically evaluate a hospital wide electronic medical record system and measure its effects on decreasing the incidence of stage IV pressure ulcers and decreasing amputations associated with diabetic foot ulcers as compared to other centers not using this informatics system.

描述: