National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (1)
- Elderly (3)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (2)
- Hospitalization (1)
- Injuries and Wounds (1)
- Long-Term Care (6)
- Medicare (1)
- Medication (1)
- Medication: Safety (1)
- (-) Nursing Homes (11)
- Outcomes (1)
- Patient Experience (1)
- Patient Safety (1)
- Policy (1)
- Pressure Ulcers (1)
- Prevention (2)
- Provider Performance (2)
- Quality Improvement (3)
- Quality Measures (3)
- Quality of Care (4)
- Quality of Life (1)
- Rehabilitation (1)
- Shared Decision Making (1)
- Urinary Tract Infection (UTI) (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 11 of 11 Research Studies DisplayedClark SE, Bautista L, Neeb K
Post-acute sequelae of SARS-CoV-2 (PASC) in nursing home residents: a retrospective cohort study.
This retrospective cohort study was conducted at two nursing homes in Michigan to explore post-acute sequelae of SARS-CoV-2 (PASC) among residents. Minimum Data Set was used to examine trajectories of functional dependence and cognitive function. The results suggested that nursing-home residents experienced a significant functional decline persisting for nine months following acute infection. The authors concluded that further research is needed to determine whether increased rehabilitation services after COVID-19 may help mitigate this decline.
AHRQ-funded; 1HS025451.
Citation: Clark SE, Bautista L, Neeb K .
Post-acute sequelae of SARS-CoV-2 (PASC) in nursing home residents: a retrospective cohort study.
J Am Geriatr Soc 2024 Feb; 72(2):551-58. doi: 10.1111/jgs.18678.
Keywords: COVID-19, Nursing Homes
Powell KR, Farmer M, Liu J
A survey of technology abandonment in US nursing homes.
This study examined abandonment of health information technology (HIT) by US nursing homes (NHs) and its association with organizational characteristics among a national sample of US NHs. This longitudinal, retrospective analysis used data from 2 sources: the HIT Maturity Survey and Staging model and public data from the Care Compare database. The authors used a random sample of 299 NHs representing each US state that completed the HIT maturity survey in 2 consecutive years: year 1 (Y1) was June 2019-August 2020 and year 2 (Y2) was June 2020-August 2021. The primary dependent variable was technology abandonment, operationalized by using total HIT maturity score, HIT maturity stage, and subscale scores within each dimension/domain; and independent variables were NH organizational characteristics including bed size, type of ownership, urbanicity, Centers for Medicare & Medicaid Services Five-Star Overall Rating and Staffing Rating. Results were that over the 2-year period HIT abandonment occurred in 28% of NHs compared with 44% that experienced growth in HIT systems. Capabilities in resident care was abandoned most frequently. They found that large NHs (bed size greater than 120) were more likely to experience technology abandonment in administrative activities. They concluded that technology abandonment can increase strain on scarce resources and may impact administrators' ability to oversee clinical operations, especially in large NHs.
AHRQ-funded; HS022497.
Citation: Powell KR, Farmer M, Liu J .
A survey of technology abandonment in US nursing homes.
J Am Med Dir Assoc 2024 Jan; 25(1):6-11. doi: 10.1016/j.jamda.2023.09.002..
Keywords: Nursing Homes, Health Information Technology (HIT), Long-Term Care
Jones KM, Krein SL, Mantey J
Characterizing infection prevention programs and urinary tract infection prevention practices in nursing homes: a mixed-methods study.
This study assessed nursing home (NH) infection prevention and control (IPC) resources and practices related to catheter and non-catheter-associated urinary tract infection (CAUTI and UTI). This mixed-methods study was conducted from April 2018 through November 2019 using quantitative surveys and semistructured qualitative interviews. Surveys were completed by 51 NH infection preventionists (IPs), and interviews were conducted with 13 participants from 7 NHs. The participating IPs had limited experience and/or additional roles, and in 36.7% of NHs, IPs had no specific IPC training, with a high turnover rate often mentioned during interviews. Most NHs were aware of their CAUTI and UTI rates and reported using prevention practices, such as hydration (85.7%) or nurse-initiated catheter discontinuation (65.3%). Interviewees expressed concerns about overuse of urine testing and antibiotics. Transfer sheets were used by 84% to communicate about infection, but the information received was described as suboptimal.
AHRQ-funded; HS25451.
Citation: Jones KM, Krein SL, Mantey J .
Characterizing infection prevention programs and urinary tract infection prevention practices in nursing homes: a mixed-methods study.
Infect Control Hosp Epidemiol 2024 Jan; 45(1):40-47. doi: 10.1017/ice.2023.127..
Keywords: Urinary Tract Infection (UTI), Nursing Homes, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Prevention
Mukamel DB, Harrington C
Resident satisfaction surveys and clinical quality of care in nursing homes: two sides of the same coin?
The authors of this article believe that quality of nursing homes is a complex, multidimensional construct. Unlike acute care hospitals, where patients are typically treated for one specific condition and stay for a short period of time, the length of stays in nursing homes varies widely. They argue that neither the individual assessment of clinical quality nor evaluation of hotel services are sufficient.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Harrington C .
Resident satisfaction surveys and clinical quality of care in nursing homes: two sides of the same coin?
Aging Health 2013 Dec;9(6):607-9. doi: 10.2217/ahe.13.63..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Long-Term Care, Nursing Homes, Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Moga DC, Carnahan RM, Lund BC
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
This study evaluated the risks and benefits of drugs to reduce urinary incontinence that were used by elderly VA nursing home residents. It found that the use of these drugs, known as bladder antimuscarinics, resulted in improved continence rates and better social engagement but also led to a higher risk of fractures in new users.
AHRQ-funded; HS016094
Citation: Moga DC, Carnahan RM, Lund BC .
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
J Am Med Dir Assoc. 2013 Oct;14(10):749-60. doi: 10.1016/j.jamda.2013.03.008..
Keywords: Elderly, Medication, Medication: Safety, Nursing Homes, Long-Term Care, Injuries and Wounds, Patient Safety
Sheppard KD, Brown CJ, Hearld KR
Symptom burden predicts nursing home admissions among older adults.
Using a sample of community-dwelling Medicare beneficiaries in Alabama who were contacted by telephone every 6 months during an eight and a half-year study, researchers found that symptom burden is an independent risk factor for NH admission. The study suggests that symptom assessment and management may reduce NH utilization.
AHRQ-funded; HS013852
Citation: Sheppard KD, Brown CJ, Hearld KR .
Symptom burden predicts nursing home admissions among older adults.
J Pain Symptom Manage. 2013 Oct;46(4):591-7. doi: 10.1016/j.jpainsymman.2012.10...
Keywords: Medicare, Long-Term Care, Elderly, Nursing Homes, Healthcare Costs
Spector WD, Limcangco R, Williams C
AHRQ Author: Spector WD
Potentially avoidable hospitalizations for elderly long-stay residents in nursing homes.
The authors sought to determine the relationship between clinical risk factors, facility characteristics and State policy variables, and both avoidable and unavoidable hospitalizations. Using data from the Nursing Home Stay file, 2006-2008, they found that three fifths of hospitalizations were potentially avoidable and most were for infections, injuries, and congestive heart failure. Clinical risk factors included renal disease, diabetes, and a high number of medications. Staffing, quality, and reimbursement affected avoidable, but not unavoidable, hospitalizations.
AHRQ-authored.
Citation: Spector WD, Limcangco R, Williams C .
Potentially avoidable hospitalizations for elderly long-stay residents in nursing homes.
Med Care 2013 Aug;51(8):673-81. doi: 10.1097/MLR.0b013e3182984bff.
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Keywords: Elderly, Hospitalization, Long-Term Care, Nursing Homes, Policy
Wagner LM, McDonald SM, Castle NG
Impact of voluntary accreditation on short-stay rehabilitative measures in U.S. nursing homes.
The purpose of this paper was to examine accreditation from nursing homes accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) and whether this is associated with improved rehabilitation care. Findings indicated that CARF-accredited nursing homes demonstrate better quality with regard to the short-stay quality measures and that approaches beyond traditional regulation and governmental inspections are necessary to improve the quality of care in nursing homes.
AHRQ-funded; HS013983.
Citation: Wagner LM, McDonald SM, Castle NG .
Impact of voluntary accreditation on short-stay rehabilitative measures in U.S. nursing homes.
Rehabil Nurs 2013 Jul-Aug;38(4):167-77. doi: 10.1002/rnj.94.
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Keywords: Quality of Care, Nursing Homes, Quality Measures, Rehabilitation
Werner RM, Konetzka RT, Kim MM
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
The researchers tested the extent to which improvements in outcomes of care are explained by changes in nursing home processes. Of the 5 outcome measures examined, they found that only improvements in the percentage of nursing home residents in moderate or severe pain were associated with changes in nursing home processes of care. They concluded that understanding the mechanism behind improvements in nursing home outcomes may be key to successfully achieving broad quality improvements across nursing homes.
AHRQ-funded; HS021861.
Citation: Werner RM, Konetzka RT, Kim MM .
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
Med Care 2013 Jul;51(7):582-8. doi: 10.1097/MLR.0b013e31828dbae4.
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Keywords: Nursing Homes, Long-Term Care, Quality Improvement, Quality Measures, Quality of Care, Provider Performance, Outcomes
Pesis-Katz I, Phelps CE, Temkin-Greener H
AHRQ Author: Spector WD
Making difficult decisions: the role of quality of care in choosing a nursing home.
The authors investigated how quality of care affects nursing home choice. They examined choices in California, Ohio, New York, and Texas, in 2001. They found that, in all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality; choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size.
AHRQ-authored.
Citation: Pesis-Katz I, Phelps CE, Temkin-Greener H .
Making difficult decisions: the role of quality of care in choosing a nursing home.
Am J Public Health 2013 May;103(5):e31-7. doi: 10.2105/ajph.2013.301243.
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Keywords: Shared Decision Making, Quality of Care, Nursing Homes, Provider Performance, Quality of Life
Sharkey S, Hudak S, Horn SD
AHRQ Author: Spector W
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
The researchers determined those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level. They found that after at least 9 months of implementation effort, 36% of the nursing homes achieved level III of the On-Time QI-HIT program. They concluded that the learning from On-Time QI offers several lessons associated with facility factors that contribute to high level of implementation of a QI-HIT program in a nursing home.
AHRQ-authored; AHRQ-funded; 29020050020.
Citation: Sharkey S, Hudak S, Horn SD .
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
Adv Skin Wound Care 2013 Feb;26(2):83-92; quiz p.93-4. doi: 10.1097/01.ASW.0000426718.59326.bb.
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Keywords: Health Information Technology (HIT), Nursing Homes, Pressure Ulcers, Prevention, Quality Improvement