A Practice-Based Research Network for Improvement Science

描述(由申请人提供)：护士是提供医院护理的最大的健康专业人员群体，但人们对护士在系统环境中如何确保护理安全、有益、以患者为中心、及时、高效和公平知之甚少。医疗保健中的质量改进和患者安全是国家优先事项；然而，质量改进科学没有取得足够的进展，特别是侧重于医院环境中的护理过程。该项目的总体目标是创建一个新的以护理为重点的大型实践研究网络(PBRN-RN)和支持中心，目的是在系统背景下加速跨专业改进科学。拟议的PBRN-RN将通过创建一个改善和科学的基础设施枢纽来填补国家空白。我们为期两年的项目将利用现有的基础设施来建立一个可持续的PBRN-RN，用于急性医疗保健组织内的护理研究。我们的具体目标如下：1.设计一个反映PBRN最佳实践的PBRN-RN(Durako，2006；Green等人，2005)，并利用PBRN-RN协调中心团队、PBRN-RN指导委员会及其成员、UTHSC IIMS和Westat，Inc.之间的协同作用，实现规模经济和共享学习。2.从领先的临床和学术机构招募和聘用关键成员，使其成为有效的国家研究网络的成员，该网络合作产生改进的科学以指导实践。3.启动相关、严格和强大的PBRN-RN研究计划，以改善微系统和系统背景下以及跨多个医院地点的患者护理。4.建立PBRN-RN协调中心资源和结构，以增强临床和学术研究人员PBRN-RN成员跨多个环境进行和传播严格改进研究的能力。5.设计一个以网络为基础的电子技术基础设施，以支持开展改进研究研究，并为收集、储存、处理、使用和交流数据和信息提供效率和准确性。6.评估基本的网络功能，包括治理和政策、工作人员支持、沟通和多站点研究支持的有效性。 公共卫生相关性：医疗保健中的质量改进和患者安全是联邦政府、认证机构、监管机构和患者权益团体高度重视的问题；然而，在了解如何提高有效性和安全性方面进展不足，特别是侧重于医院护理。该项目的总体目标是扩大全国实践为基础的研究网络(PBRN-RN)，并建立一个新的大型协调中心，以促进以医院为基础的护理研究，向我们展示如何使护理安全有效。

DESCRIPTION (provided by applicant): Nurses represent the single largest group of health professionals that delivers hospital care, yet little is known about what nurses do within a system context to ensure that care is safe, beneficial, patient-centered, timely, efficient and equitable. Quality improvement and patient safety in healthcare are national priorities; yet insufficient progress has been made in quality improvement science, particularly focusing on nursing care processes in the hospital setting. The broad goal of this project is to create a new large-scale nursing-focused practice-based research network (PBRN- RN) and support center for the purpose of accelerating interprofessional improvement science in a systems context. The proposed PBRN-RN will fill a national gap by creating an infrastructure hub for improvement and science. Our 2-year project will leverage existing infrastructure to establish a sustainable PBRN-RN for nursing care research within acute healthcare organizations. Our specific aims are as follows: 1. Design a PBRN-RN that reflects best practices in PBRNs (Durako, 2006; Green et al., 2005) and capitalizes on synergies among the PBRN-RN coordinating center team, the PBRN-RN Steering Council and membership, the UTHSC IIMS, and Westat, Inc., to achieve economies of scale and shared learning. 2. Recruit and engage key members from leading clinical and academic settings to be members of an effective national research network that collaborates to generate improvement science to guide practice. 3. Launch a relevant, rigorous, and robust PBRN-RN program of research studies to improve patient care within microsystem and system contexts and across multiple hospital sites. 4. Establish PBRN-RN coordinating center resources and structures that enhance ability of clinical and academic researcher PBRN-RN members to conduct and disseminate rigorous improvement research studies across multiple settings. 5. Design a web based electronic technology infrastructure that supports the conduct of improvement research studies and affords efficiency and accuracy for collecting, storing, processing, using, and communicating data and information. 6. Evaluate the essential network features, including governance and policies, staff support, communication, and effectiveness of multi-site study support. PUBLIC HEALTH RELEVANCE: Quality improvement and patient safety in healthcare are high priorities held by the federal government, accrediting bodies, regulatory agencies, and patient-advocacy groups; yet insufficient progress has been made in knowing how to improve effectiveness and safety, specifically focused on hospital nursing care. The broad goal of this project is to expand a national practice-based research network (the PBRN-RN) and build a new large-scale coordinating center that will accelerate hospital-based nursing studies, showing us how to make care safe and effective.