A Practice-Based Research Network for Improvement Science

描述（由申请人提供）：护士代表了提供医院护理的最大卫生专业人员群体，但很少有人知道护士在系统背景下做了什么，以确保护理安全、有益、以患者为中心、及时、高效和公平。提高保健质量和病人安全是国家的优先事项；然而，在质量改进科学方面进展不足，特别是在医院环境中的护理过程方面。该项目的总体目标是创建一个新的大规模以护理为重点的基于实践的研究网络（PBRN- RN）和支持中心，以加速系统背景下的跨专业改进科学。拟议的PBRN-RN将通过创建一个改善和科学的基础设施中心来填补国家空白。我们为期两年的项目将利用现有的基础设施，为急症医疗机构的护理研究建立一个可持续的PBRN-RN。我们的具体目标如下：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指导委员会和成员、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环境中招募和吸引关键成员，成为有效的国家研究网络的成员，合作产生改进的科学来指导实践。3. 启动相关的、严格的、健全的PBRN-RN研究项目，以改善微系统和系统环境下以及跨多个医院站点的患者护理。4. 建立PBRN-RN协调中心资源和结构，提高临床和学术研究人员PBRN-RN成员在多个环境中开展和传播严格的改进研究的能力。5. 设计一个基于网络的电子技术基础设施，以支持改进研究的进行，并为收集、存储、处理、使用和交流数据和信息提供效率和准确性。6. 评估基本的网络特征，包括治理和政策、员工支持、沟通和多站点研究支持的有效性。

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.