Engaging Patients and Families to Improve Care for Mechanically Ventilated Patients

 描述（由申请人提供）：我的长期目标是应用严格的以患者为中心的结局研究方法来提高重症监护室和围手术期环境中患者护理的质量和安全。我曾担任首席或合作研究员， 十多个资助的奖项，以开发，实施和评估比较有效的研究，重点是提高病人护理的质量和安全。尽管有着丰富的经验，但我的研究中没有一项有显著的患者或家庭参与。拟议的职业发展计划将使我获得进行高质量的以患者为中心的结果研究所需的额外技能和经验，并为作为一名独立的以患者为中心的结果研究人员的成功职业生涯奠定基础。我的职业发展计划包括：1）以患者为中心的成果研究的正式课程，2）专注于以患者为中心的成果研究的会议和研讨会，3）参与PCRI资助的研究项目，以及4）由高级研究员和一个合格的咨询委员会进行结构化指导，以便在整个研究过程中响应并涉及患者和家属。拟议研究的目的是与患者和家属合作，通过改善提供者与患者和家属就机械通气的使用、潜在并发症和减少并发症的策略进行沟通，并使家属能够在相关护理中发挥积极作用，来改善对机械通气患者的护理。具体目标是：1）让患者和家庭合作伙伴组成理事会，以确定机械通气的当前知识和关键经验，他们重视的并发症，沟通的关键内容，以及以个人为中心的沟通方法。2)与患者和家庭理事会合作开发“以患者和家庭为中心的呼吸机工具包”，以改善提供者关于机械通气的沟通，并使家庭能够在机械通气患者的护理中发挥积极作用。新的工具包将通过广泛的专业网络广泛传播给ICU的提供者、患者和家庭，并提供一个可能适用于其他可预防伤害领域的框架。这项研究在重症监护领域是新颖的，填补了改善护理和减少机械通气相关并发症的空白。成功完成拟议的研究将通过在重症监护领域产生新知识，与患者和家属合作，以提高对循证建议的依从性，改善对机械通气患者的护理，以及让患者和家属参与ICU护理，推进以患者为中心的结局研究。

 DESCRIPTION (provided by applicant): My long-term goal is to apply rigorous patient-centered outcomes research methodologies to improve the quality and safety of patient care in the intensive care unit and perioperative setting. I have served as principal or co-investigator on more than a dozen funded awards to develop, implement and evaluate comparative effectiveness research focused on improving quality and safety of patient care. Despite this extensive experience, none of my research has had significant patient or family involvement. The proposed career enhancement program will allow me to gain the additional skills and experience required to conduct high quality patient-centered outcomes research and provide a foundation for a successful career as an independent patient-centered outcomes researcher. My career enhancement plan includes: 1) formal coursework in patient-centered outcomes research, 2) conferences and seminars focused on patient-centered outcomes research, 3) participation in PCORI funded research projects, and 4) structured mentoring by a senior investigator and a well-qualified advisory committee for the conduct of research that is responsive to and involves patients and families throughout the research process. The objective of the proposed research is to partner with patients and families to improve care for mechanically ventilated patients by improving provider communication with patients and families regarding the use of mechanical ventilation, potential complications and strategies to reduce them, and empowering families to take an active role in related care. The specific aims are to: 1) Engage a council of patient and family partners to identify current knowledge and key experiences of mechanical ventilation, complications they value, key content to communicate, and individual- centered approaches to communication. 2) Partner with the patient and family council to develop a "patient and family-centered ventilator toolkit" to improve communication of providers regarding mechanical ventilation, and to empower families to take an active role in the care of a mechanically ventilated patient. The new toolkit will be broadly disseminated to providers, patients and families in ICUs through an extensive professional network and provide a framework that may likely be applied in other areas of preventable harm. The proposed research is novel in the critical care field and fills a gap in efforts to improve care and reduce complications associated with mechanical ventilation. Successful completion of the proposed research will advance patient-centered outcomes research by generating new knowledge in the area of critical care, partnering with patients and families to increase adherence with evidence-based recommendations and improve care for mechanically ventilated patients, and engaging patients and families in ICU care.