The candidate's career objective is to develop a nationally and internationally known program in `Infection Prevention in Aging'. The candidate will achieve this objective by conducting patient-oriented research that improves outcomes from infectious diseases and reduces antimicrobial resistance in a vulnerable older population and by training a multidisciplinary group of students, residents, fellows, nurse investigators and junior faculty who wish to conduct patient-oriented and outcomes research in infection prevention. The majority of the candidate's professional life has been dedicated to the conduct of patient-oriented research in infection prevention, establish a steady stream of research funding and organize numerous career-development programs in aging research nationally. Translation of research findings into clinical practice, particularly in nursing homes, is challenging. Frail olde adults who receive care in institutional settings are a particularly high risk of poor outcomes. Training a multidisciplinary group of junior investigators is key to design evidence-based randomized studies to test innovative models and practices that reduce infections and antimicrobial resistance in nursing homes. Thus, the overall aims of this proposal are:
Aim 1 : To enhance the candidate's capacity to effectively mentor a multi-disciplinary group of mentees in patient-oriented research by bridging basic science, clinical and community-based participatory research programs Aim 2: To expand the candidate's clinical research program `Infection Prevention in Aging' in directions that create new and innovative opportunities for her and her mentees The candidate's research brings together expertise in geriatrics and aging research, microbiology and infectious diseases, epidemiology, outcomes research, nursing and others. Her work on reducing infections and antimicrobial resistance in vulnerable populations grows out of work originally funded by NIA, AHRQ, T. Franklin Williams Scholarship (now known as GEMSSTAR) and the Hartford foundation. Three federally funded grants will serve as the platform for this grant proposal: an NIA funded RO1 grant: Targeted Infection Control Program (TIP) to reduce antimicrobial resistance and infections in Nursing Homes, NIA funded concurrent RO1: Pathway from functional disability to antimicrobial resistance in Nursing Homes and an AHRQ award: `AHRQ Safety Program for long-term care: CAUTI'. These federally funded studies have created rich datasets and banked microbes that will be utilized to train mentees in patient-oriented research with extensions to molecular epidemiology and community-based participatory research. Resources supporting the training and development include the MICHR, University of Michigan Pepper Center, UM School of Public Health, UM Patient Safety Enhancement Program (PSEP), and UM Host Microbiome Initiative.
Infections and antimicrobial resistance is common in institutionalized elderly population and often leads to poor outcomes. There is a paucity of trained researchers who can conduct patient-oriented research to inform policy, practice and outcomes in this setting. The overarching goal of this proposal is to train the next generation of multidisciplinary group of researchers who will advance the field of infection prevention in older adults and make healthcare safer. The widespread impact of this research will be in designing effective, efficient, and targeted infection control programs for frail older adults. We expect our results to shift the evolving paradigm of infection control and prevention in long-term care institutions.
|Manu, Erika R; Mody, Lona; McNamara, Sara E et al. (2017) Advance Directives and Care Received by Older Nursing Home Residents. Am J Hosp Palliat Care 34:105-110|
|Meddings, Jennifer; Saint, Sanjay; Krein, Sarah L et al. (2017) Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents. J Hosp Med 12:356-368|
|Hurria, Arti; High, Kevin P; Mody, Lona et al. (2017) Aging, the Medical Subspecialties, and Career Development: Where We Were, Where We Are Going. J Am Geriatr Soc 65:680-687|
|Mody, Lona; Boustani, Malaz; Braun, Ursula K et al. (2017) Evolution of Geriatric Medicine: Midcareer Faculty Continuing the Dialogue. J Am Geriatr Soc 65:1389-1391|
|Armbruster, Chelsie E; Prenovost, Katherine; Mobley, Harry L T et al. (2017) How Often Do Clinically Diagnosed Catheter-Associated Urinary Tract Infections in Nursing Homes Meet Standardized Criteria? J Am Geriatr Soc 65:395-401|
|Eke-Usim, Angela C; Rogers, Mary A M; Gibson, Kristen E et al. (2016) Constitutional Symptoms Trigger Diagnostic Testing Before Antibiotic Prescribing in High-Risk Nursing Home Residents. J Am Geriatr Soc 64:1975-1980|
|Ismail, Miriam D; Luo, Ting; McNamara, Sara et al. (2016) Long-Term Carriage of Ciprofloxacin-Resistant Escherichia coli Isolates in High-Risk Nursing Home Residents. Infect Control Hosp Epidemiol 37:440-7|
|Cao, Jie; Min, Lillian; Lansing, Bonnie et al. (2016) Multidrug-Resistant Organisms on Patients' Hands: A Missed Opportunity. JAMA Intern Med 176:705-6|
|Flanagan, Elaine; Cassone, Marco; Montoya, Ana et al. (2016) Infection Control in Alternative Health Care Settings: An Update. Infect Dis Clin North Am 30:785-804|
|Mody, Lona (2015) Editorial commentary: Preventing aspiration pneumonia in high-risk nursing home residents: role of chlorhexidine-based oral care questioned again. Clin Infect Dis 60:858-9|
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