A Smart Simulator for Metrics-based Cannulation Skills Training for Hemodialysis

用于基于指标的血液透析插管技能培训的智能模拟器

• 批准号: 10830667
• 负责人: Lydia Petersen
• 金额: $ 31.21万
• 依托单位: SOJOURN MEDTECH LLC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2024-09-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10830667
• 关键词: American; Anatomy; Anxiety; Arteriovenous fistula; Assessment tool; Blood Vessels; Cannulations; Care given by nurses; Caring; Catheters; Client satisfaction; Clinic; Clinical; Complex; Complication; Computer software; Country; Credentialing; Data; Dependence; Detection; Devices; Dialysis procedure; Education; End stage renal failure; Engineering; Excision; Exposure to; Feedback; Fistula; Guidelines; Hemodialysis; Hemorrhage; Human Resources; Industry; Infiltration; Injury; Learning; Link; Maintenance; Measures; Mechanics; Medical Care Costs; Minor; Modeling; Morbidity - disease rate; Needles; Outcome; Patient Care; Patient-Focused Outcomes; Patients; Perforation; Phase; Procedures; Process; Psychological Transfer; Research; Risk; Small Business Innovation Research Grant; Small Business Technology Transfer Research; Source; South Carolina; Standardization; Structure; Techniques; Technology; Testing; Time; Training; aging population; arm; clinically relevant; comorbidity; design; experience; improved; models and simulation; mortality; neglect; pilot test; prototype; sensor; skills; skills training; tool; ultrasound; usability

Project Summary About 750,000 Americans and approx. 4.5 million patients worldwide have End-Stage Renal Disease (ESRD)1– 3. Aging population as well as rise in ESRD-related comorbidities are key factors in the anticipated rate of increase in patients with ESRD4. One of the primary causes for this high morbidity and mortality are the complications associated with maintaining a functioning vascular access5–7. An important and potentially avoidable complication is injury to the arteriovenous fistula (AVF) at the time of cannulation, which is performed in the dialysis clinics three times per week for patients on hemodialysis8. During cannulation needles can be inserted in such a way that the fistula or graft vessel wall is perforated causing an “infiltration”11, potentially resulting in a patient not being able to dialyze or even losing the vascular access. As such, the current state of cannulation has been dubbed the “Achilles Heel” of vascular access in ESKD. Due to high industry turnover, lack of proficiency assessment tools, and, most importantly, a lack of effective training tools, expertise and proficiency varies among workers performing cannulation. Many training tools exist, such as “low-tech mannikins (e.g. “fake arms”), ultrasound-compatible models (e.g. Blue Phantom Vascular Access), and “high- tech” simulators. The problems with available tools include: 1) no currently available effective trainers that are specific hemodialysis cannulation, 2) lack of realism in current simulators diminishes their educational value, and 3) absence of metrics for skill assessment and training. Sojourn MedTech is developing the CanSim simulator, a smart, personalized, and dialysis-specific trainer for learning cannulation skills that are critical for dialysis nurses and patient care technicians (PCTs). The need for this hardware and software integrated device arises from the large number of routine cannulation injuries (and resultant complications) that occur daily in clinics across the country. CanSim will not only substantially improve patient outcomes, it will also enable a more confident dialysis workforce as well as positively impact patient experience. CanSim technology is based on more than seven years of extensive research on the original prototype(s) of the device15–17, with data from >80 novice and experienced cannulators. Results for various studies have resulted in validated metrics for quantifying cannulation skill18–21 using simulation models and motivate the design and testing of the commercial CanSim devices— the objective of this STTR Phase 1 proposal. The primary features of the CanSim are as follows: 1. Dialysis-specific, 2. Realistic and low-maintenance design, and 3. Metrics-based personalized feedback. During Phase I, we will complete the following aims: 1) We will engineer and refine key components of our hardware (and associated firmware) to be integrated into the first CanSim commercial products and 2) We will create and test a model for assessing quality of a user’s cannulation attempts on the simulator via objective metrics. Results will provide the basis for a full assessment of the CamSim commercial product in Phase II.

项目概要 大约 750,000 名美国人和全球大约 450 万名患者患有终末期肾病 (ESRD)1– 3. 人口老龄化以及 ESRD 相关合并症的增加是影响预期死亡率的关键因素 ESRD 患者的增加是造成这种高发病率和死亡率的主要原因之一。 与维持功能性血管通路相关的并发症5-7。 可避免的并发症是插管时动静脉瘘 (AVF) 损伤 对于血液透析患者，每周 3 次去透析诊所8。 以瘘管或移植血管壁穿孔的方式插入，导致“渗透”11，可能 导致患者无法透析甚至失去血管通路。 由于行业流动率高，插管被称为 ESKD 血管通路的“致命弱点”。 缺乏能力评估工具，最重要的是缺乏有效的培训工具、专业知识和 进行插管的工人的熟练程度各不相同，存在许多培训工具，例如“低技术含量”。 人体模型（例如“假手臂”）、超声兼容模型（例如蓝色幻影血管通路）和“高 可用工具的问题包括：1）目前没有有效的培训师。 特定的血液透析插管，2) 当前模拟器缺乏真实感，降低了其教育价值， 3) 缺乏技能评估和培训指标。Sojourn MedTech 正在开发 CanSim。 模拟器，一个智能、个性化和透析专用的培训器，用于学习对透析至关重要的插管技能 透析护士和患者护理技术人员 (PCT) 需要这种硬件和软件集成。 该装置源于大量发生的常规插管损伤（以及由此产生的并发症） CanSim 每天都会在全国各地的诊所中使用，不仅会显着改善患者的治疗效果，而且还将大大改善患者的治疗效果。 使透析人员更加自信，并对患者体验产生积极影响。 技术基于对原始原型七年多的广泛研究 设备 15-17，来自超过 80 个新手和经验丰富的插管器的数据已得出各种研究结果。 使用仿真模型量化插管技能的经过验证的指标18-21并激励设计和 测试商业 CanSim 设备——STTR 第一阶段提案的目标。 CanSim 的特点如下： 1. 透析专用， 2. 现实且低维护的设计，以及 3. 基于指标的个性化反馈 在第一阶段，我们将完成以下目标： 1) 我们将 设计和完善我们的硬件（以及相关固件）的关键组件，以集成到第一个 CanSim 商业产品和 2) 我们将创建并测试一个模型来评估用户的质量 通过客观指标在模拟器上进行插管尝试的结果将为全面评估提供基础。 CamSim商业产品第二阶段的成果。