Pressure ulcer prevention and treatment media

描述（由申请人提供）：压疮是长期医疗保健中的一个重要问题。在长期和扩展护理环境中的患病率估计约为8%，在过去十年中似乎保持稳定。据估计，30%的新进入家庭护理的人有患压疮的风险。然而，它已有力地认为，无论病人的布雷登风险概况，当遵循适当的预防标准的做法，压力溃疡在很大程度上是可以预防的。虽然减少到零可能是不现实的，特别是在短期内，由于美国卫生保健系统特有的机构，系统和个人因素，但从目前的发病率降低长期和家庭护理是可行的，并将通过减少患者后遗症和共病产生人力和财政节省。加强对标准预防、治疗和管理做法的遵守是一个合理和有价值的目标。The Academic Edge，Inc. (AEI)正在开发一套教育材料和支持资源，以解决压疮的预防和治疗。这些将通过网络以及其他媒体提供。这些材料将是互动的，准确的，有效的，可扩展的。媒体和网站将从预防和治疗两个方面解决压疮问题，并将针对家庭健康助理（HHA），护士和其他监督人员，以及在较小但同样重要的程度上，患者及其家属。在第1阶段，AEI通过识别突出的HHA信念，生成核心内容和设计文档，通过最终用户焦点小组和主题专家（SME）审查评估这些文档，以及通过制作涵盖部分内容的视频并对该视频进行现场试验，证明了努力的可行性。第二阶段将开发两个互动课程、一个压疮信息门户网站、工作辅助工具和其他绩效支持工具，以提高四个关键目标的绩效：（1）监测压疮的迹象，（2）采取积极措施来识别、监测和减轻风险因素，（3）使用当前的标准实践来管理压疮，以及（4）监督与有压疮形成风险的人互动的其他人。这些将使用以理论为基础的设计和开发模式进行开发，并将使用焦点小组和咨询小组审查不断进行评价。核心内容和课程也将在两组现场试验中进行评估：每个课程的初始小规模形成性（n=20）验证试验，确保每个课程中的一切都正常工作，以及一组较大的总结性试验（n=440，家庭医疗保健人员; n=120护理学生），评估工作的有效性。压疮是长期护理中的一个重要问题。在过去的十年里，接受长期在家护理的人数迅速增加。家庭健康助理是美国增长最快的职业，预计2004-2014年期间的增长率为56%，同期增加约35万个工作岗位。虽然大多数家庭健康助理似乎愿意采取措施，以减少压疮的发生率，目前还没有标准化的，友好的，有效的培训压疮和他们的预防HHA领域。现有的少量培训一般针对较高级的从业人员，并通过书籍和其他纸质媒体进行。一个现成的，以证据为基础的，和理论驱动的一套互动课程，工具，和资源的个人和小组培训，在多种媒体开发，应该是非常受欢迎的家庭健康组织，可以适应用于更广泛的应用，如职前护理培训，并将积极影响这一重要的，大多是可预防的，公共卫生问题。

DESCRIPTION (provided by applicant): Pressure ulcers are a significant problem in long-term health care. Estimates of prevalence in the long-term and extended care environments cluster around 8% and appear stable over the past decade. An estimated 30% of new entrants to homebound care are at risk for developing pressure ulcers. Yet it has been forcefully argued that pressure ulcers are largely preventable regardless of a patient's Braden Risk profile when proper precautionary standards of practice are followed. While reduction to zero may be unrealistic, especially in the near-term as a result of institutional, systemic, and individual factors endemic to the U.S. health care system, nonetheless a reduction from the present rates of incidence in long-term and homebound care is feasible and would yield human and financial savings through diminution of patient sequelae and co-morbidity. Improvement in adherence to standard prevention, treatment, and management practices is a reasonable and worthwhile objective. The Academic Edge, Inc. (AEI) is developing a suite of educational materials and support resources to address prevention and treatment of pressure ulcers. These are to be delivered via web as well as other media. The materials will be interactive, accurate, effective, and extensible. The media and site will address pressure ulcers in terms of both prevention and treatment and will target home health aides (HHA), nurses and other supervisory personnel, and, to a lesser, but no less important extent, patients and their families. In Phase 1, AEI demonstrated the feasibility of the effort by identifying salient HHA beliefs, generating core content and design documents, evaluating those documents through end-user focus groups and subject-matter-expert (SME) reviews, and by producing a video covering a portion of the content and conducting a field trial of that video. Phase 2 will develop two interactive courses, a web portal of pressure ulcer information, and job aids and other performance support tools to increase performance of four key objectives: (1) monitoring for signs of pressure ulcers, (2) taking active steps to identify, monitor, and mitigate risk factors, (3) managing pressure ulcers using current standard practices, and (4) supervising others who interact with those at risk for pressure ulcer formation. These will be developed using a theory-based design and development model and will be evaluated continuously using focus groups and advisory panel reviews. The core content and courses will also be evaluated in two sets of field trials: an initial small scale formative (n=20) validation trial for each course that ensures everything is working correctly in each course and a set of larger summative trials (n=440, home health care personnel; n=120 nursing students) that evaluate the effectiveness of the effort. Pressure ulcers are a significant problem in long-term care. The number of individuals receiving long- term homebound care has increased rapidly in the last decade. Home health aides represent the fastest growing occupation in the U.S., with a projected growth rate of 56% over the 2004-2014 period, adding some 350,000 jobs in that same period. Although most home health aides appear to be willing to take steps to reduce the incidence of pressure ulcers, there presently exists no standardized, friendly, and effective training on pressure ulcers and their prevention for the HHA field. What little training does exist generally targets more advanced practitioners and does so through books and other paper-based media. A readily available, evidence-based, and theory driven set of interactive courses, tools, and resources for individual and small group training, developed in multiple media, should be extremely well-received by home health organizations, can be adapted to be used in broader applications, such as pre-professional nursing training, and will positively affect this important, and mostly preventable, public health concern.