Utilizing Innovative Technology To Improve Compliance With Patient Elevation Guidelines – The Impact Of Angulus On Adherence To The Evidence-Based VAP-Prevention Bundle

利用创新技术提高患者抬高指南的合规性 — Angulus 对遵守循证 VAP 预防捆绑包的影响

• 批准号: 9139729
• 负责人: MICHELLE Ng GONG
• 金额: $ 22.49万
• 依托单位: ANGULUS CORPORATION
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-02 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9139729
• 关键词: Adherence; Attention; Beds; Centers for Disease Control and Prevention (U.S.); Clinical; Computer software; Contracts; Cost Savings; Critical Care; Critical Illness; Cross-Over Studies; Cross-Over Trials; Data; Data Aggregation; Data Display; Devices; Effectiveness; Evaluation; Event; Feedback; Focus Groups; Funding; Goals; Grant; Guidelines; Head; Hospitals; Improve Access; Incidence; Intensive Care Units; Length; Measurement; Measures; Medical; Medical center; Methods; Mission; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Nosocomial Infections; Nurses; Outcome; Outpatients; Pain; Patient Monitoring; Patient-Focused Outcomes; Patients; Phase; Positioning Attribute; Posture; Practice Guidelines; Prevention; Provider; Public Health; Publishing; Randomized; Scourge; Signal Transduction; Site; Staging; Sternum; System; Technology; Testing; Time; Translating; Ventilator; Wireless Technology; Work; commercialization; cost; design; digital; efficacy trial; empowered; evidence base; experience; hospital bed; improved; innovative technologies; mortality; novel; product development; prototype; public health relevance; satisfaction; sensor; standard of care; tool; trend; usability; ventilator-associated pneumonia

 DESCRIPTION (provided by applicant): Each year in the U.S. over 250,000 ventilated patients in the intensive care unit contract Ventilator-associated pneumonia (VAP), a hospital-acquired infection which has captured the attention of numerous stakeholders in the critical care domain. VAP has a 30% mortality rate1,2 and results in an extended ICU stay of 4.3 days1,2,3,4, on average. Hospitals incur an additional $40,000 in incremental costs3 per patient, and a national average of Reducing the incidence of Ventilator-associated pneumonia (VAP) and $10 Billion is spent on VAP annually3,16. related ventilator-associated events (VAE) is of prime importance to clinicians, hospital stakeholders, accrediting agencies and ultimately patients. However, despite evidence that maintaining ventilated patients at an elevation between 30-45 degrees is correlated with significantly improved VAP outcomes3,6,10,12, there is currently a dearth of effective methods for accurately and efficiently measuring a patient's elevation in real time. Existing tools for measuring patient elevation are archaic, inflexible and unreliable. Without accurate, reliable and available data on a patient's elevation, evaluating and improving compliance with head of bed guidelines is challenging to say the least. A mechanism that accurately measures a patient's elevation and signals that information to nurses is highly desired, and can dramatically improve compliance with best-practice patient-elevation guidelines, which in turn would reduce the incidence of VAP, shorten ICU stays and translate into tremendous cost savings and improved clinical outcomes for hospitals. Angulus was developed to fill this gap in critical care technology. It is a novel sensor, which accurately measures patient elevation in real time - irrespective of a patient's idiosyncratic orientation - and transmits on-demand minute-to-minute data and aggregate trends to a corresponding display device via Bluetooth. Angulus is composed of two components - a wireless sensor which is affixed to the patient's sternum, and a corresponding software interface, which displays the patient elevation angle. Utilization of Angulus will empower critical care treatment teams to more efficiently monitor patients' elevation, and improve compliance to HOB guidelines. In this Phase I proposal we will collaborate with Albert Einstein/ Montefiore Medical center to: 1) conduct initil end-user focus groups, 2) validate the accuracy of Angulus as a patient elevation measurement tool, 3) implement a randomized cross over trial to measure the impact of Angulus on improving compliance with patient elevation guidelines, and 4) collect end-user satisfaction and usability scores and integrate critical functionality with an agile and iterative product development approach. By empowering critical care teams with intelligible, accessible and accurate on demand data about a patient's elevation angle in real time, Angulus will improve compliance with patient elevation guidelines. This work will have a tremendous impact on resolving a burdensome problem associated with increased patient morbidity and astronomical costs. This proposal is very highly aligned with the overall mission of NHLBI.

 描述（由申请人提供）：美国重症监护病房每年有超过 250,000 名呼吸机相关肺炎 (VAP) 患者，这是一种医院获得性感染，引起了重症监护领域众多利益相关者的关注。死亡率为 30%1,2，导致 ICU 住院时间平均延长 4.3 天1,2,3,4。每位患者的增量成本 3 为 40,000 美元，全国平均每年花费 100 亿美元用于降低呼吸机相关性肺炎 (VAP) 的发生率3,16，这对于叛乱分子和医院来说至关重要。然而，尽管有证据表明将通气患者保持在 30-45 度之间的高度与显着改善 VAP 相关。结果3,6,10,12，目前缺乏准确、高效地实时测量患者海拔的有效方法，现有的测量患者海拔的工具陈旧、不灵活且不可靠，没有准确、可靠和可用的数据。至少可以说，准确测量患者海拔并向护士发出信息的信号是非常需要的，并且可以显着提高对最佳实践的依从性。 Angulus 的开发旨在填补重症监护技术的这一空白，从而减少 VAP 的发生率、缩短 ICU 住院时间并改善医院的临床效果。实时准确测量患者海拔 - 无论患者的特殊方向如何 - 并通过蓝牙将按需的每分钟数据和聚合趋势传输到相应的显示设备 - 无线传感器和无线传感器。贴在患者的胸骨上，以及显示患者仰角的相应软件界面，Angulus 的使用将使重症监护治疗团队能够更有效地监测患者的仰角，并提高对 HOB 指南的遵从性。与 Albert Einstein/ Montefiore 医疗中心合作：1) 开展初始最终用户焦点小组，2) 验证 Angulus 作为患者海拔测量工具的准确性，3) 实施随机交叉试验来测量Angulus 对提高患者抬高依从性的影响，以及 4) 收集最终用户满意度和可用性评分，并将关键功能与敏捷和迭代的产品开发方法相集成，为重症监护团队提供有关患者的易懂、可访问和准确的按需数据。 Angulus 能够实时监测患者的仰角，从而提高患者仰角指南的依从性，这项工作将对解决与患者发病率增加和天文成本相关的繁重问题产生巨大影响。 NHLBI 的使命。