Using Implementation Science and Informatics to Develop and Pilot Test Antibiotic Stewardship Clinical Decision Support

利用实施科学和信息学来开发和试点测试抗生素管理临床决策支持

基本信息

批准号：
10350624
负责人：
Michael Joseph Durkin
金额：
$ 12.67万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-02-15 至 2026-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10350624
关键词：
Adherence Adoption Adverse drug event Allergic Reaction Antibiotic Resistance Antibiotics Car Phone Centers for Disease Control and Prevention (U.S.)Chicago Clinic Clinical Clostridium difficile Communities Computer software Data Decision Making Dental Dental Clinics Dental General Practice Dental Records Dental Schools Dental Students Dentistry Dentists Development Dissemination and Implementation Drug resistance Effectiveness Electronic Health Record Endodontics Event Faculty Federal Government Feedback Focus Groups Funding Future Goals Grant Health Care Costs Illinois Infection Informatics Intervention Intervention Studies Knowledge Life Logic Maintenance Measures Methods Mouth Diseases Multi-Drug Resistance National Institute of Dental and Craniofacial Research Online Systems Oral health Organism Outpatients Paper Patient Care Patients Policies Provider Public Health Publications Questionnaires Reach Effectiveness Adoption Implementation and Maintenance Research Resources Risk Science Series Site Societies Strategic Planning Surveys System Technology Testing Time United States Universities base clinical decision support clinical implementation college combat cost dental infection design diarrheal disease dissemination research effectiveness evaluation evidence base implementation evaluation implementation framework implementation science improved innovation novel patient safety pilot test practice-based research network primary outcome programs response satisfaction secondary outcome support tools theories therapy design tool treatment optimization urgent care volunteer web site

项目摘要

Project Summary/Abstract Dentists are responsible for approximately 10% of outpatient antibiotic prescriptions in the United States. Many of these antibiotic prescriptions are unnecessary and place patients at risk of adverse drug events, including allergic reactions and infections with drug resistant organisms. However, improving antibiotic prescribing practices in dental settings is challenging. Dental clinics often lack the resources to design and implement policies to evaluate dental antibiotic prescribing practices and design interventions to improve prescribing practices. My long-term goal is to oversee the development of electronic clinical decision support tools (CDST) to facilitate optimal antibiotic prescribing among dentists. I envision creating, pilot testing, and disseminating CDSTs that can be embedded within electronic health record systems, including electronic dental record systems, to improve adherence to science-based practices while making the lives of clinicians easier. This specific proposal aims to design and implement a novel web-based application “app” that can be accessed by dentists on mobile phones or websites. Our first aim is to design the CDST based on focus group feedback from dental students, residents, and faculty at the University of Illinois College of Dentistry (UIC- COD). Our second aim is to pilot test the app using clinical vignettes and validated technology survey questions. The third aim is to evaluate the effectiveness and implementation of our CDST within UIC-COD using a dissemination and implementation research framework. We will propose to measure changes in antibiotic knowledge and confidence in antibiotic decision making before and after implementation of the CDST using paired surveys. We will also use surveys to measure provider satisfaction with the CDST. We will track CDST usage (implementation metrics) using Google analytics. After completion of this project, we plan to test our CDST in community dentists via the National Institute for Dental and Craniofacial Research Dental Practice Based Research Network and apply for grant funding to embed this CDST into electronic dental record systems.

项目概要/摘要在美国，约 10% 的门诊抗生素处方由牙医负责。这些抗生素处方中的一部分是不必要的，并使患者面临药物不良事件的风险，包括过敏反应和耐药微生物感染然而，改善抗生素处方。牙科诊所的实践往往缺乏设计和实施的资源。评估牙科抗生素处方实践和设计干预措施以改进处方的政策做法。我的长期目标是监督电子临床决策支持工具（CDST）的开发，以我设想创建、试点测试和传播抗生素处方，以促进牙医的最佳抗生素处方。可嵌入电子健康记录系统（包括电子牙科记录）中的 CDST 系统，以提高对基于科学的实践的遵守，同时使牧师的生活更轻松。该具体提案旨在设计和实现一种新颖的基于网络的应用程序“app”，该应用程序可以牙医可以通过手机或网站访问我们的首要目标是基于焦点小组设计 CDST。来自伊利诺伊大学牙科学院 (UIC- 我们的第二个目标是使用临床小插图和经过验证的技术调查对该应用程序进行试点测试。第三个目标是评估 UIC-COD 内 CDST 的有效性和实施情况。我们将建议使用传播和实施研究框架来衡量变化。 CDST 实施前后的抗生素知识和抗生素决策信心我们还将使用配对调查来衡量提供商对 CDST 的满意度。使用 Google Analytics 的 CDST 使用情况（实施指标）完成此项目后，我们计划进行测试。我们通过国家牙科和颅面研究牙科诊所对社区牙医进行 CDST 基于研究网络并申请拨款资金将此 CDST 嵌入电子牙科记录中系统。