Improving Patient Safety and Disease Management While on Contact Isolation

描述（由申请人提供）：本K08提案旨在提供教学课程和研究指导，以加强Daniel Morgan成为医院流行病学和质量改进的独立研究员的努力。他是马里兰大学传染病医师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，从而提高整体质量。在这个职业奖项中，在成果研究人员的指导下，Eli Perencevich， Anthony Harris和Lisa Dixon以及一个专家顾问团队，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，不良事件和精神病学筛查的专业知识。对已知有抗生素耐药菌定植的患者进行接触隔离，可防止这些微生物传播给其他患者，并限制医院获得性感染。目前，急症医院约25%的住院病人使用这种药物。这些患者在医学上很复杂，患有多种疾病，经常接触医疗机构。接触隔离的患者不太可能见到卫生保健工作者，护理过程质量指标较低，更容易抑郁，患者满意度较低。因此，为了保护其他患者，被隔离的患者可能受到伤害。该项目旨在限制这种危害。采用马里兰大学医学中心经过验证的临床数据存储库，对不良事件、疾病管理、精神病学筛查和患者满意度进行历史队列和前瞻性队列分析，提出了一种方法严谨的方法来量化患者隔离状态与不良结果之间的影响和关系。利用这些研究的数据，摩根博士将开发并在一个新的队列中验证一种新的、易于应用的预测规则，以识别那些处于不良事件高风险的孤立患者。在该奖项结束时，他将准备调查干预措施，以减少不良事件，并可能改善高达10-15%的住院患者的整体护理，这些患者在接触隔离期间出现不良后果。

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.