AHRQ-Funded Study Looks at Benefits of Universal Glove and Gown Use in ICUs

Electronic Newsletter, Issue 398

AHRQ's Electronic Newsletter summarizes Agency research and programmatic activities.

October 23, 2013


Today's Headlines

  1. AHRQ-Funded Study Looks at Benefits of Universal Glove and Gown Use in ICUs.
  2. Chronic Use of Opioids Before and After Bariatric Surgery Documented in AHRQ-Funded Study.
  3. New AHRQ Protocol Helps Hospitals Reduce MRSA and Bloodstream Infections.
  4. AHRQ and PCORI Partner on Uterine Fibroid Project.
  5. Family Medicine Journal Issue Focuses on Practice-Based Research Networks.
  6. New CHIPRA Evaluation Highlight Focuses on Elevating Children on State Policy Agendas.
  7. AHRQ in the professional literature.

1. AHRQ-Funded Study Looks at Benefits of Universal Glove and Gown Use in ICUs

AHRQ has funded one of the first cluster randomized trials to assess the potential benefits of universal glove and gown use in preventing the transmission of antibiotic-resistant bacteria. The trial was conducted in medical and surgical intensive care units (ICUs) in 20 hospitals across the country, and results were published in the Journal of the American Medical Association (JAMA). Researchers found that universal glove and gown use, when compared with usual care, did not result in a significant reduction in the primary outcome of combined methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) acquisition. For secondary outcomes, there was a statistically significant reduction in the acquisition of MRSA and no reduction in VRE acquisition. The authors indicate the need for more research before definitive conclusions are reached. Other findings include no significant increase in adverse events and increased handwashing by caregivers in the intervention group. Full study results can be found in "Universal Glove and Gown Use and Acquisition of Antibiotic-Resistant Bacteria in the ICU: A Randomized Trial," published in the October 4 online issue of JAMA. Select to access the abstract on PubMed®.

2. Chronic Use of Opioids Before and After Bariatric Surgery Documented in AHRQ-Funded Study

A recent study involving opioid use among bariatric surgery patients found that several patients who were chronic opioid users before surgery increased their use of the medications after the procedure. Researchers at Kaiser Permanente Colorado in Denver anticipated that weight loss after the surgery would result in reduced pain and opioid use among patients with chronic pain. Instead, their study of 11,917 adults found that 77 percent of patients who were chronic users before the surgery continued using opioids after surgery. Relative to the year before surgery, chronic users increased their intake of opioids by 13 percent the first year after the procedure and by 18 percent within 3 years. The study was one of several ongoing projects conducted by a distributed research network that is among AHRQ's 11 investments in electronic data infrastructure across the nation. The results can be found in the article, "Chronic Use of Opioid Medications Before and After Bariatric Surgery," published in the October 2 issue of the Journal of the American Medical Association. Select to access the abstract on PubMed®.

3. New AHRQ Protocol Helps Hospitals Reduce MRSA and Bloodstream Infections

A new protocol released by AHRQ provides instructions for implementing universal decolonization in hospital intensive care units (ICUs) that treat adult patients. "Universal ICU Decolonization Toolkit: An Enhanced Protocol" is based on materials successfully used in the REDUCE MRSA Trial, results of which were published in the May 29 issue of the New England Journal of Medicine. The trial found that universal decolonization is the most effective intervention when compared with routine care or targeted decolonization, reducing MRSA clinical cultures by 37 percent and all-cause bloodstream infections by 44 percent.

The protocol provides:

  • Decision-making tools and a rationale to help hospital leaders understand the effectiveness of ICU decolonization with mupirocin and chlorhexidine gluconate and decide if this strategy represents the best course of action for their facility.
  • Instructions on how to garner institutional support from key stakeholders to support the adoption of a universal ICU decolonization strategy within ICUs.
  • Tools to assess adherence to the decolonization protocol and reinforce training.

The protocol also describes the role of unit-based physician and nursing champions who oversee decolonization intervention and provide training and materials for front-line staff. Select to access the protocol.

4. AHRQ and PCORI Partner on Uterine Fibroid Project

AHRQ and the Patient-Centered Outcomes Research Institute (PCORI) have issued a Request for Applications (RFA) for a research project on the effectiveness of different treatments for uterine fibroids. In a first-time partnership with AHRQ, PCORI will commit up to $20 million to develop a national registry of women who have been treated for uterine fibroids and to fund studies on the comparative effectiveness of medical and surgical therapies, and to better understand patient preference in informing treatment decisions using data from the registry. The RFA calls for development of a large, multi-center, practice-based registry that must include women from diverse backgrounds, including those who traditionally have been less involved in health research. Letters of intent may be submitted to AHRQ by November 15 and applications are due by December 16. Select to access the RFA.

5. Family Medicine Journal Issue Focuses on Practice-Based Research Networks

The September-October issue of the Journal of the American Board of Family Medicine (JABFM) focuses on how practice-based research networks (PBRNs) are answering pressing patient and provider questions regarding disease prevention, clinician satisfaction, contemporary practice challenges, and strategies for integrating research in primary care. AHRQ supports the PBRNs, whose purpose is to answer primary care-based health care questions and translate research findings into practice. Select to access the JABFM issue.

6. New CHIPRA Evaluation Highlight Focuses on Elevating Children on State Policy Agendas

AHRQ has released its 4th Evaluation Highlight from the national evaluation of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program. The latest highlight, "How the CHIPRA Quality Demonstration Elevated Children on State Health Policy," gives concrete examples of activities in five states–Maine, Maryland, Massachusetts, Vermont, and Oregon–and explains how these states used their CHIPRA quality demonstration grants to advance children's health care on their states' health policy agendas. This highlight also describes how states have aligned their efforts with and used their CHIPRA quality demonstration project experiences to directly inform broader federal and state health reform initiatives. Select to access the Evaluation Highlight.

7. AHRQ in the Professional Literature

Hsu E, Lin D, Evans SJ, et al. Doing well by doing good: assessing the cost savings of an intervention to reduce central line-associated bloodstream infections in a Hawaii hospital. Am J Med Qual 2013 May 7. Select to access the abstract on PubMed®.

Tubbs-Cooley HL, Cimiotti JP, Silber JH, et al. An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions. BMJ Qual Saf 2013 May 7. Select to access the abstract on PubMed®.

Konetzka RT, Polsky D, Werner RM. Shipping out instead of shaping up: rehospitalization from nursing homes as an unintended effect of public reporting. J Health Econ 2013 Mar; 32(2):341-52. Select to access the abstract on PubMed®.

Whipple EC, Dixon BE, McGowan JJ. Linking health information technology to patient safety and quality outcomes: a bibliometric analysis and review. Inform Health Soc Care 2013 Jan; 38(1):1-14. Select to access the abstract on PubMed®.

Arterburn DE, Bogart A, Sherwood NE, et al. A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obes Surg 2013 Jan; 23(1):93-102. Select to access the abstract on PubMed®.

Saha S, Korthuis PT, Cohn JA, Wolff JL, Marsteller JA, Frick KD, et al. Primary care provider cultural competence and racial disparities in HIV care and outcomes. J Gen Intern Med 2013 May; 28(5):622-9. Select to access the abstract on PubMed®.

Victoroff MS, Drury BM, Campagna EJ, Morrato EH. Impact of electronic health records on malpractice claims in a sample of physician offices in Colorado: a retrospective cohort study. J Gen Intern Med 2013 May; 28(5):637-44. Select to access the abstract on PubMed®.

Beaubrun AC, Brookhart MA, Sleath B, et al. Trends and variations in intravenous vitamin D use among hemodialysis patients in the United States. Ren Fail 2013; 35(1):1-8. Select to access the abstract on PubMed®.


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Current as of October 2013
Internet Citation: AHRQ-Funded Study Looks at Benefits of Universal Glove and Gown Use in ICUs: Electronic Newsletter, Issue 398. October 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/398.html