UTI in Nursing Home Residents: Research Training and Clinical Investigation

疗养院居民的尿路感染：研究培训和临床调查

• 批准号: 7813790
• 负责人: MANISHA JUTHANI-MEHTA
• 金额: $ 15.97万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-15 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7813790
• 关键词: Acute; Adverse drug effect; Americas; Antibiotic Therapy; Antibiotic-resistant organism; Area; Bacteremia; Bacteria; Bacteriuria; Burn injury; Caring; Cessation of life; Chronic Disease; Clinical; Clinical Trials; Clinical Trials Design; Colony-forming units; Communicable Diseases; Consensus; Data; Development; Development Plans; Diagnosis; Discipline of Nursing; Dysuria; Elderly; Environment; Epidemiology; Expenditure; Fatigue; Fever; Flank Pain; Frequencies; Future; Geriatrics; Goals; Gold; Growth; Healthcare; Hematuria; Increased frequency of micturition; Indwelling Catheter; Infection; Infection Control; Infectious Disease Epidemiology; Inflammatory Response; Interview; Investigation; Laboratories; Lead; Left; Leukocytes; Licensed Practical Nurse; Long-Term Care; Longitudinal Studies; Malaise; Medical; Mentors; Mentorship; Methodology; Nurses; Nursing Homes; Odors; Outcome; Pain; Pattern; Personal Satisfaction; Physicians; Psyche structure; Public Health; Pyuria; Registered nurse; Research; Research Design; Research Personnel; Research Training; Risk; Sepsis; Societies; Specimen; Symptoms; Temperature; Time; Training; Universities; Urinalysis; Urinary Incontinence; Urinary tract; Urinary tract infection; Urination; Urine; Validation; Vulnerable Populations; adverse outcome; base; career development; clinical epidemiology; cohort; evidence base; functional decline; functional status; health care delivery; improved; meetings; member; mental state; milliliter; mortality; pathogen; patient oriented; programs; skills

DESCRIPTION (provided by applicant): Improving health care delivery for older adults requires investigation by both trained geriatricians and subspecialists with a geriatric focus. Infections in older adults are a common public health problem that lead to functional decline, mortality, and healthcare expenditures. Nursing home residents, in particular, are a vulnerable population in whom further investigation is warranted to optimize medical care. Urinary tract infection (UTI) in nursing home residents is an investigatively understudied topic. The primary objective of this application is to train Dr. Juthani-Mehta, the candidate, to be an investigative leader in geriatric infectious diseases and to advance multidisciplanary research in UTI in nursing home residents. The goals of this career development plan are: 1) to establish the candidate as a patient-oriented investigator at the interface of infectious diseases, geriatric medicine, and nursing home practice; 2) to gain additional training and mentorship in chronic disease epidemiology, infectious diseases epidemiology, and longitudinal study design; 3) to obtain skills in clinical trial design, geriatric medicine, and infection control methodology in nursing homes; and 4) to prepare the candidate to conduct multi-center observational and interventional clinical trials in long-term care facilities. The specific aims of the research plan are: 1) to determine the reliability of urinary tract specific (e.g. flank pain or tenderness) and urinary tract non-specific (e.g., change in mental status) clinical features as assessed by nursing home staff in nursing home residents with suspected UTI; and 2) to identify and validate those reliable clinical features in residents with suspected UTI that are associated with laboratory evidence of UTI (i.e., bacteriuria plus pyuria). Supplementary aims are to identify residents with suspected UTI that have adverse outcomes related to UTI, to treatment, or to either. The combination of reliable and validated clinical features, bacteriuria, and pyuria will be the basis for an evidence-based definition of UTI. The candidate is an emerging patient-oriented investigator with unique training in infectious diseases and geriatric clinical epidemiology. Since she has been recognized nationally by the Infectious Diseases Society of America as a Williams Scholar, she is an ideal candidate to be an investigative leader in this field. The renowned mentors she has assembled and the environment at Yale University will allow for outstanding training and the successful completion of the proposed study.

描述（由申请人提供）：改善老年人的医疗保健服务需要经过培训的老年病学家和以老年病为重点的专科医生进行调查。老年人感染是一个常见的公共卫生问题，导致功能下降，死亡率和医疗保健支出。养老院居民，特别是，是一个脆弱的人群，其中有必要进一步调查，以优化医疗服务。护理之家居民的尿路感染（UTI）是一个调查研究不足的话题。该申请的主要目标是培养候选人Juthani-Mehta博士成为老年传染病的调查领导者，并在养老院居民中推进UTI的多学科研究。该职业发展计划的目标是：1）在传染病，老年医学和疗养院实践的界面上将候选人确立为以患者为导向的研究者; 2）在慢性病流行病学，传染病流行病学和纵向研究设计方面获得额外的培训和指导; 3）获得临床试验设计，老年医学和养老院感染控制方法的技能;和4）准备候选人在长期护理机构进行多中心观察性和干预性临床试验。研究计划的具体目的是：1）确定尿路特异性（例如，胁腹疼痛或压痛）和尿路非特异性（例如，精神状态的变化）临床特征;和2）鉴定和验证与UTI的实验室证据相关的疑似UTI的居民中的那些可靠的临床特征（即，菌尿加脓尿）。补充的目的是确定居民怀疑UTI有不良后果相关的UTI，治疗，或两者之一。结合可靠和有效的临床特征，菌尿和脓尿将是UTI循证定义的基础。候选人是一个新兴的以病人为导向的调查，在传染病和老年临床流行病学独特的培训。由于她已被美国传染病学会认可为威廉姆斯学者，她是一个理想的候选人是在这一领域的调查领导者。著名的导师，她已经聚集在耶鲁大学的环境将允许出色的培训和拟议的研究的成功完成。