HOMeVent4Kids: Home-based Optimization of Mechanical Ventilation for Children

HOMeVent4Kids：基于家庭的儿童机械通气优化

基本信息

批准号：
10055070
负责人：
Carolyn C. Foster
金额：
$ 16.85万
依托单位：
LURIE CHILDREN'S HOSPITAL OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-05 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10055070
关键词：
Accident and Emergency department Active Learning Acute Affect Award Birth Breathing Bronchopulmonary Dysplasia Carbon Dioxide Caregiver Burden Caregivers Caring Categories Child Child Care Child Health Chronic lung disease Clinical Clinical Data Clinical Investigator Clinical Management Data Data Element Dependence Development Plans Discipline of Nursing Educational workshop Emergency department visit Enrollment Environment Equilibrium Extended Family Family Family Caregiver Family health status Fatigue Fostering Foundations Frequencies Funding Gestational Age Goals Growth Health Health Benefit Health Care Costs Health Services Health system Healthcare Height Home environment Hospital Departments Hospitalization Institution Intervention Learning Life Logistics Lung Measurable Measurement Measures Mechanical ventilation Medical Medical Technology Medicine Mental Health Mentors Mentorship Methods Modeling Monitor Nurses Outcome Outcome Measure Oxygen Parents Patient Outcomes Assessments Patients Pediatric Hospitals Physical Function Physicians Physiological Population Private Duty Nursing Process Provider Psyche structure Publishing Pulmonary Hypertension Research Research Infrastructure Research Personnel Research Training Resources Risk Safety Science Self Efficacy Services Severity of illness Social Environment Surveys System Testing Time Tracheostomy procedure Training United States National Institutes of Health Universities Ventilator Weaning Weight Work base care burden care giving burden career career development clinical care cost dashboard design evidence base experience health care delivery health care service utilization home mechanical ventilation hospital services improved innovation mortality risk patient population pediatrician perinatal period physical conditioning premature pressure programs prospective respiratory sex skills therapy design usability ventilation

项目摘要

PROJECT SUMMARY/ABSTRACT Candidate: Carolyn Foster, MD, MSHS is a pediatrician and junior clinical investigator focused on improving the evidence-based for the care of children with chronic lung disease (CLD) of prematurity who require invasive home mechanical ventilation (HMV). Dr. Foster’s long-term career goal is to become an independent physician-investigator who works in cross-disciplinary teams to design and evaluate evidence-based health care delivery interventions for children with medical technology dependence who require in-home services. Research Context/Objective: Children with CLD of prematurity are a growing, costly group of patients with high health care resource use and significant family caregiver burden. No empirically based parameters exist to guide how this population is discontinued from invasive HMV, leading to lack of appropriate, timely discontinuation of HMV. Therefore, the objective of this award is for Dr. Foster to learn how to assess the multifaceted factors that contribute to HMV duration, and to pilot test the integration of these factors into clinical management of children with CLD of prematurity, to safely shorten duration of HMV use. Specific Aims: 1) Determine which patient level factors are associated with HMV duration; 2) Determine which family caregiver and health service factors are associated with weaning of HMV support; 3) Develop and pilot the feasibility, acceptability, and usability of integrating patient, family, and health service data elements into a clinical management dashboard design to optimize HMV use in children with CLD of prematurity. Research Plan: Dr. Foster will retrospectively analyze existing patients’ clinical data to evaluate the association of patient medical factors (e.g., ventilator settings, oxygen use, weight, end-tidal CO2,) with HMV duration (Aim 1); prospectively collect patient reported outcome (PRO) measures (i.e., validated surveys) to elucidate which caregiver and system factors are associated with weaning of HMV support among current HMV patients (Aim 2); and use a stakeholder-engaged Learning Health System approach to develop and pilot the feasibility, acceptability, and usability (implementation) of a clinical HMV dashboard (Aim 3). Career Development Plan/Environment: Through a combination of local and national didactic activities, experiential learning, workshops, seminars, and professional activities, Dr. Foster will acquire expertise in evaluating longitudinal health outcomes and health care utilization; patient-reported outcome (PRO) health measurement science; and intervention design and pilot testing. Dr. Foster will strengthen her professional skills needed for an independent physician-investigator career through close mentorship by an experienced, complementary team of NIH-funded team mentors, advisors, and collaborators. Northwestern University and Lurie Children’s Hospital will provide outstanding research infrastructures to enable a successful award and are strongly committed to Dr. Foster’s transition to research independence.

项目概要/摘要候选人：Carolyn Foster，医学博士、MSHS 是一名儿科医生和初级临床研究员，专注于改善患有慢性肺病 (CLD) 的早产儿的循证护理 Foster 博士的长期职业目标是成为一名独立的有创家庭机械通气 (HMV) 患者。在跨学科团队中设计和评估循证健康的医师研究员为需要家庭服务的具有医疗技术依赖的儿童提供护理干预。研究背景/目标：患有早产慢性肺病 (CLD) 的儿童是一个不断增长且成本高昂的患者群体医疗保健资源使用率高，家庭护理人员负担重，不存在基于经验的参数。指导该人群如何停止接触侵入性 HMV，从而导致缺乏适当、及时的治疗因此，该奖项的目的是让福斯特博士学习如何评估 HMV。影响 HMV 持续时间的多方面因素，并初步测试将这些因素整合到临床中早产儿 CLD 儿童的管理，以安全地缩短 HMV 使用时间。具体目标： 1) 确定哪些患者水平因素与 HMV 持续时间相关；2) 确定哪些因素家庭照顾者和健康服务因素与 HMV 支持的断绝相关 3) 开发和试点；将患者、家庭和健康服务数据元素整合到一个数据中的可行性、可接受性和可用性临床管理仪表板设计可优化早产儿 CLD 儿童的 HMV 使用。研究计划：Foster博士将回顾性分析现有患者的临床数据，以评估患者医疗因素（例如呼吸机设置、氧气使用、体重、呼气末二氧化碳）与 HMV 的关联持续时间（目标 1）；前瞻性收集患者报告的结果 (PRO) 措施（即经过验证的调查）阐明哪些护理人员和系统因素与目前 HMV 支持的断绝相关 HMV 患者（目标 2）；并使用利益相关者参与的学习健康系统方法来开发和试点临床 HMV 仪表板的可行性、可接受性和可用性（实施）（目标 3）。职业发展计划/环境：通过结合地方和国家的教学活动，体验式学习、讲习班、研讨会和专业活动，福斯特博士将获得以下方面的专业知识评估纵向健康结果和医疗保健利用情况；福斯特博士将加强她的专业知识；测量科学；干预设计和试点测试。通过经验丰富的、由 NIH 资助的团队导师、顾问和合作者组成的互补团队。卢里儿童医院将提供出色的研究基础设施，以确保获奖和成功坚定地致力于福斯特博士向独立研究的过渡。