Pressure ulcer prevention and treatment media

压疮预防和治疗介质

• 批准号: 7228019
• 负责人: Richard Charles Goldsworthy
• 金额: $ 32.99万
• 依托单位: ACADEMIC EDGE, INC.
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-07-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7228019
• 关键词: Achievement; Address; Adherence; Affect; Agreement; Attitude; Awareness; Belief; Books; Caring; Compatible; Decubitus ulcer; Discipline of Nursing; Educational Materials; Effectiveness; Ensure; Environment; Family; Feedback; Focus Groups; Growth; Health; Health Personnel; Healthcare; Healthcare Systems; Home Care Services; Home Health Aides; Home environment; Human; Human Resources; Incidence; Individual; Internet; Knowledge; Letters; Licensing; Long-Term Care; Monitor; Morbidity - disease rate; Numbers; Nurses; Nurses' Aides; Nursing Students; Occupations; Online Systems; Paper; Patients; Performance; Phase; Portal Pressure; Practice Management; Prevalence; Prevention; Psychological reinforcement; Public Health; Published Comment; Publishing; Rate; Recommendation; Reporting; Resources; Risk; Risk Factors; Savings; Site; Staging; Standards of Weights and Measures; Supervision; Training; Validation; Work; base; comparison group; design; health organization; model design/development; success; theories; tool; trend; usability

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.

描述（由申请人提供）：压疮是长期医疗保健中的一个重大问题。长期和扩展护理环境中患病率的估计值约为8％，并且在过去十年中显得稳定。估计有30％的新入学者进入家庭护理，有发生压力溃疡的风险。然而，有力地认为，在遵循适当的预防性实践标准时，无论患者的风险概况如何，都可以预防压力溃疡。虽然将零减少到零可能是不现实的，尤其是由于机构，系统和个人因素的特殊因素，美国卫生保健系统的特殊因素，但仍可降低长期和家庭服务的当前发病率，这是可行的，并且通过减少患者sequelae and Coelae and Coor-tise and save save and save and Homebound Care是可行的。遵守标准预防，治疗和管理实践的依从性是一个合理且有价值的目标。学术Edge，Inc。（AEI）正在开发一套教育材料和支持资源，以解决压力溃疡的预防和治疗。这些都是通过网络以及其他媒体交付的。材料将具有互动性，准确，有效且可扩展。媒体和现场将在预防和治疗方面解决压力溃疡，并将针对家庭保健助手（HHA），护士和其他监督人员，在较小但同样重要的程度上，患者及其家人。在第1阶段，AEI通过识别出色的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 - 象征 - 专家（SME）评论评估这些文档，证明了这项工作的可行性，并通过制作涵盖内容的一部分视频并进行该视频的视频试验。第2阶段将开发两个交互式课程，压力溃疡信息的网站以及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）监视压力溃疡的迹象，（2）采取积极的步骤来识别，监控和减轻风险因素，（3）使用当前的标准练习来管理与其他人相互作用的人，以及与其他人相互作用的人，以及与那些互动的人进行压力，并为他们互动的风险互动。这些将使用基于理论的设计和开发模型来开发，并将使用焦点小组和咨询小组评论不断评估。核心内容和课程还将在两组现场试验中进行评估：针对每门课程的初始小规模组合（n = 20）验证试验，以确保每个课程中的一切正常，以及一组较大的总结试验（n = 440，家庭保健人员； n = 120名护理学生），以评估努力的有效性。压疮是长期护理中的一个重大问题。在过去的十年中，接受长期家庭护理的个人数量迅速增加。家庭健康助手是美国增长最快的职业，预计在2004 - 2014年期间的增长率为56％，同期增加了约35万个工作岗位。尽管大多数家庭健康助手似乎都愿意采取措施减少压力溃疡的发生率，但目前没有对压力溃疡的标准化，友好和有效的培训，及其预防HHA场。几乎没有培训的实际培训通常针对更高级的从业人员，并通过书籍和其他基于纸质的媒体来做到这一点。在多种媒体中开发的个人和小组培训的一组互动课程，工具和资源，应受到家庭健康组织的良好对待，可以适用于更广泛的应用程序，例如在更广泛的应用程序中，例如在商业前的护理培训中，并且将对这种重要的，可预防的，公共保健对公众产生积极影响。