UTI in Nursing Home Residents: Research Training and Clinical Investigation

疗养院居民的尿路感染：研究培训和临床调查

• 批准号: 8058624
• 负责人: MANISHA JUTHANI-MEHTA
• 金额: $ 15.97万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-15 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8058624
• 关键词: Acute; Adverse drug effect; Americas; Antibiotic Therapy; Antibiotic-resistant organism; Area; Bacteremia; Bacteria; Bacteriuria; Burn injury; Caring; Cessation of life; Chronic Disease; Clinical; Clinical Trials; Clinical Trials Design; Colony-forming units; Communicable Diseases; Consensus; Data; Development; Development Plans; Diagnosis; Discipline of Nursing; Dysuria; Elderly; Environment; Epidemiology; Expenditure; Fatigue; Fever; Flank Pain; Frequencies; Future; Geriatrics; Goals; Gold; Growth; Healthcare; Hematuria; Increased frequency of micturition; Indwelling Catheter; Infection; Infection Control; Infectious Disease Epidemiology; Inflammatory Response; Interview; Investigation; Laboratories; Lead; Leukocytes; Licensed Practical Nurse; Long-Term Care; Longitudinal Studies; Malaise; Medical; Mentors; Mentorship; Methodology; Nurses; Nursing Homes; Odors; Outcome; Pain; Pattern; Personal Satisfaction; Physicians; Psyche structure; Public Health; Pyuria; Registered nurse; Research; Research Design; Research Personnel; Research Training; Risk; Sepsis; Societies; Specimen; Symptoms; Temperature; Time; Training; Universities; Urinalysis; Urinary tract; Urinary tract infection; Urination; Urine; Validation; Vulnerable Populations; adverse outcome; base; career development; clinical epidemiology; cohort; evidence base; functional decline; functional status; health care delivery; improved; meetings; member; mental state; micturition urgency; milliliter; mortality; pathogen; patient oriented; programs; skills; urinary

DESCRIPTION (provided by applicant): Improving health care delivery for older adults requires investigation by both trained geriatricians and subspecialists with a geriatric focus. Infections in older adults are a common public health problem that lead to functional decline, mortality, and healthcare expenditures. Nursing home residents, in particular, are a vulnerable population in whom further investigation is warranted to optimize medical care. Urinary tract infection (UTI) in nursing home residents is an investigatively understudied topic. The primary objective of this application is to train Dr. Juthani-Mehta, the candidate, to be an investigative leader in geriatric infectious diseases and to advance multidisciplanary research in UTI in nursing home residents. The goals of this career development plan are: 1) to establish the candidate as a patient-oriented investigator at the interface of infectious diseases, geriatric medicine, and nursing home practice; 2) to gain additional training and mentorship in chronic disease epidemiology, infectious diseases epidemiology, and longitudinal study design; 3) to obtain skills in clinical trial design, geriatric medicine, and infection control methodology in nursing homes; and 4) to prepare the candidate to conduct multi-center observational and interventional clinical trials in long-term care facilities. The specific aims of the research plan are: 1) to determine the reliability of urinary tract specific (e.g. flank pain or tenderness) and urinary tract non-specific (e.g., change in mental status) clinical features as assessed by nursing home staff in nursing home residents with suspected UTI; and 2) to identify and validate those reliable clinical features in residents with suspected UTI that are associated with laboratory evidence of UTI (i.e., bacteriuria plus pyuria). Supplementary aims are to identify residents with suspected UTI that have adverse outcomes related to UTI, to treatment, or to either. The combination of reliable and validated clinical features, bacteriuria, and pyuria will be the basis for an evidence-based definition of UTI. The candidate is an emerging patient-oriented investigator with unique training in infectious diseases and geriatric clinical epidemiology. Since she has been recognized nationally by the Infectious Diseases Society of America as a Williams Scholar, she is an ideal candidate to be an investigative leader in this field. The renowned mentors she has assembled and the environment at Yale University will allow for outstanding training and the successful completion of the proposed study.

描述（由申请人提供）：改善老年人的医疗保健服务需要培训的老年医生和专科医生的调查，并以老年人为重点。老年人的感染是一个常见的公共卫生问题，导致功能下降，死亡率和医疗保健支出。尤其是养老院居民是一个脆弱的人群，在其中有必要进行进一步的调查以优化医疗服务。疗养院居民中的尿路感染（UTI）是一个调查研究的话题。该应用的主要目的是培训候选人Juthani-Mehta博士，成为老年传染病的调查领导者，并推进疗养院居民UTI的多学科研究。该职业发展计划的目标是：1）在传染病，老年医学和疗养院实践的界面上建立候选人为以患者为导向的研究者； 2）获得慢性疾病流行病学的额外培训和指导，传染病流行病学和纵向研究设计； 3）在疗养院中获得临床试验设计，老年医学和感染控制方法的技能； 4）为候选人做好准备在长期护理设施中进行多中心观察和介入临床试验。研究计划的具体目的是：1）确定特定于尿路的可靠性（例如侧翼疼痛或压痛）和尿路非特异性（例如，心理状况的变化）临床特征，由疗养院工作人员评估，疗养院居民在养老院居民中评估。 2）识别和验证与具有UTI实验室证据相关的居民（即细菌和脓尿）相关的可靠临床特征。补充目的是确定具有与UTI，治疗或任何一种相关的可疑UTI的居民。可靠和经过验证的临床特征，杆菌和脓尿的结合将是基于证据的UTI定义的基础。该候选人是一名新兴的以患者为导向的研究者，在传染病和老年临床流行病学方面进行了独特的培训。由于她在全国范围内被美国传染病学会认可为威廉姆斯学者，因此她是成为该领域的调查领导者的理想候选人。她召集的著名导师和耶鲁大学的环境将允许出色的培训并成功完成拟议的研究。