Improving Patient Safety and Disease Management While on Contact Isolation

描述(申请人提供)：这份K08提案旨在提供教学课程和研究指导，以加强丹尼尔·摩根成为医院流行病学和质量改进方面的独立研究员的努力。他是马里兰大学传染病内科医生和流行病学和预防医学讲师。他的长期目标是开展和传播有关医院获得性感染和干预措施的研究，以提高整体质量。在这个职业奖项中，在结果研究人员Eli Perencevich博士、Anthony Harris博士和Lisa Dixon博士以及一个顾问专家团队的指导下，他建议完成临床研究硕士学位，并通过他的研究目标，获得衡量护理质量、不良事件和精神筛查的专业知识。对已知带有抗药性细菌的患者进行接触隔离是为了防止这些微生物传播给其他患者，并限制医院获得的感染。目前，约有25%的急性护理医院的住院患者使用该系统。这些患者的医疗情况复杂，患有多种疾病，并经常接触医疗机构。接触隔离的患者看医护人员的可能性较小，护理质量流程衡量标准较低，更有可能变得抑郁，患者满意率较低。因此，隔离的患者可能会受到伤害，以保护其他患者。该项目旨在限制这种危害。为解决不良事件、疾病管理、精神筛查和患者满意度，提出了一种方法上严格的方法，以量化患者隔离状态和不良结果之间的影响和关系，使用马里兰大学医学中心经过验证的临床数据库来处理不良事件、疾病管理、精神筛查和患者满意度。利用这些研究的数据，摩根博士将在一个新的队列中开发并验证一种新的、易于应用的预测规则，以识别那些具有发生不良事件的高风险的孤立患者。在该奖项结束时，他将准备调查干预措施，以减少不良事件，并潜在地改善对高达10%-15%的在接触隔离期间经历不良后果的住院患者的整体护理。

DESCRIPTION (provided by applicant): This K08 proposal is designed to provide the didactic coursework and research mentoring to enhance Daniel Morgan's efforts to become an independent researcher in hospital epidemiology and quality improvement. He is an infectious diseases physician and Instructor of Epidemiology and Preventive Medicine at the University of Maryland. His long-term goal is to conduct and disseminate research on hospital-acquired infections and interventions that lead to overall quality improvement. In this career award, under the mentoring of outcomes researchers, Drs. Eli Perencevich, Anthony Harris and Lisa Dixon and an expert team of advisors, he proposes completing a Masters in Clinical Research and through his research aims, gaining expertise in measuring quality-of-care, adverse events and psychiatric screening. Contact isolation of patients who are known to be colonized with antibiotic-resistant bacteria is used to prevent transmission of these microorganisms to other patients and limit hospital-acquired infections. It is currently used for approximately 25% of inpatients in acute-care hospitals. These patients are medically complex with multiple illnesses and frequent exposure to healthcare facilities. Patients on contact isolation are less likely to see healthcare workers, have lower quality-of-care process measures, are more likely to become depressed and have low rates of patient satisfaction. Thus, isolated patients are potentially harmed to protect other patients. This project is designed to limit such harm. A methodologically rigorous approach is proposed to quantify the impact and relationship between isolation status of patients and adverse outcomes using a validated clinical data repository of the University of Maryland Medical Center for a historical cohort and a prospective cohort to address adverse events, management of disease, psychiatric screening and patient satisfaction. Using the data from these studies Dr. Morgan will develop and, in a new cohort, validate a novel, easily applied prediction rule to identify those isolated patients at high-risk of developing adverse events. At the end of this award he will be prepared to investigate interventions to decrease adverse events and potentially improve the overall care of the up to 10-15% of hospitalized patients who experience adverse outcomes while on contact isolation.