National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Blood Clots (2)
- Care Management (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Clostridium difficile Infections (1)
- Critical Care (1)
- Digestive Disease and Health (1)
- Evidence-Based Practice (1)
- Falls (2)
- Healthcare-Associated Infections (HAIs) (6)
- Healthcare Costs (1)
- Home Healthcare (1)
- Hospitals (2)
- Infectious Diseases (3)
- Inpatient Care (3)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (1)
- Medication (2)
- Medication: Safety (1)
- Newborns/Infants (1)
- Nursing (2)
- Orthopedics (1)
- (-) Patient Safety (14)
- (-) Prevention (14)
- Provider (4)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Nurse (1)
- Public Health (1)
- Quality Improvement (4)
- Quality of Care (4)
- Risk (1)
- Shared Decision Making (1)
- Skin Conditions (1)
- Surgery (2)
- Teams (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 14 of 14 Research Studies DisplayedStoops C, Stone S, Evans E
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
The purpose of this study was to test if acute kidney injury (AKI) is preventable in patients in the neonatal intensive care unit and if infants at high-risk of nephrotoxic medication-induced AKI can be identified using a systematic surveillance program previously used in the pediatric non-intensive care unit setting. The authors concluded that a systematic surveillance program to identify high-risk infants can prevent nephrotoxic-induced AKI and has the potential to prevent short and long-term consequences of AKI in critically ill infants.
AHRQ-funded; HS023763.
Citation: Stoops C, Stone S, Evans E .
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
J Pediatr 2019 Dec;215:223-28.e6. doi: 10.1016/j.jpeds.2019.08.046..
Keywords: Newborns/Infants, Medication, Medication: Safety, Patient Safety, Kidney Disease and Health, Intensive Care Unit (ICU), Critical Care, Quality Improvement, Quality of Care, Prevention, Adverse Drug Events (ADE), Adverse Events
Krein SL, Kuhn L, Ratz D
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
The authors identified the prevalence of and factors associated with having a designated nurse peripherally inserted central catheter (PICC) team among U.S. acute care hospitals. They found that nurse PICC teams inserted PICCs in more than 60% of U.S. hospitals during the study period. Moreover, certain practices to prevent central line-associated bloodstream infection, including maximum sterile barrier precautions, chlorhexidine gluconate for insertion site antisepsis, and facility-wide insertion checklists were regularly used by a higher percentage of hospitals with nurse PICC teams compared with those without. They concluded that nurse PICC teams play an integral role in PICC use at many hospitals and that use of such teams may promote key practices to prevent complications.
AHRQ-funded; HS022835.
Citation: Krein SL, Kuhn L, Ratz D .
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
J Patient Saf 2019 Dec;15(4):293-95. doi: 10.1097/pts.0000000000000246..
Keywords: Nursing, Teams, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Inpatient Care, Hospitals, Patient Safety, Prevention, Provider: Nurse, Provider
Kreutzer L, Yang AD, Sansone C
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
This study analyzed barriers for administration of VTE chemoprophylaxis to hospitalized patients from nurses. Researchers conducted 14 focus group interviews with nurses from five inpatient units to assess their perceptions of barriers to administration of VTE chemoprophylaxis. Barriers included nurses’ misconceptions that patients did not require chemoprophylaxis, their uncertainty when counseling patients on the importance of chemoprophylaxis, and a lack of comparative data regarding specific refusal rates.
AHRQ-funded; HS024516.
Citation: Kreutzer L, Yang AD, Sansone C .
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
J Hosp Med 2019 Nov 1;14(10):668-72. doi: 10.12788/jhm.3290..
Keywords: Blood Clots, Patient Safety, Prevention, Inpatient Care, Care Management, Nursing
Leeds IL, DiBrito SR, Canner JK
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
This goal of this study was to assess the cost-effectiveness of extended prophylaxis in patients with Crohn's disease after abdominal surgery. A decision tree model was used to assess cost-effectiveness and cost-per-case averted with extended-duration venous thromboembolism prophylaxis following abdominal surgery. Results showed that extended prophylaxis in patients with Crohn's disease postoperatively is not cost-effective when the cumulative incidence of posthospital thrombosis remains less than 4.9%. These findings are driven by the low absolute risk of thrombosis in this population and the considerable cost of universal treatment.
AHRQ-funded; HS024547.
Citation: Leeds IL, DiBrito SR, Canner JK .
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
Dis Colon Rectum 2019 Nov;62(11):1371-80. doi: 10.1097/dcr.0000000000001461..
Keywords: Prevention, Digestive Disease and Health, Surgery, Healthcare Costs, Adverse Events, Patient Safety, Blood Clots, Shared Decision Making, Medication
Jones KJ, Skinner A, Venema D
Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals.
Researchers evaluated the implementation and outcomes of evidence-based fall-risk-reduction processes when those processes are implemented using a multiteam system (MTS) structure. They found that multiteam systems that effectively coordinate fall-risk-reduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls.
AHRQ-funded; HS024630; HS021429.
Citation: Jones KJ, Skinner A, Venema D .
Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals.
Health Serv Res 2019 Oct;54(5):994-1006. doi: 10.1111/1475-6773.13186..
Keywords: Falls, Hospitals, Inpatient Care, Quality of Care, Quality Improvement, Patient Safety, Prevention, Risk
Klock M, Kang H, Gon Y
Scoring patient fall reports using quality rubric and machine learning.
Employing AHRQ’s rubric for assessing the quality of fall reports, the authors compared three different machine-learning models and identified the most effective method for scoring fall reports. They intend that their study results will be applicable in healthcare facilities to score reports during reporting for reporters to improve report quality. Their ultimate goal is to increase learning from fall reports for better prevention of patient falls.
AHRQ-funded; HS022895.
Citation: Klock M, Kang H, Gon Y .
Scoring patient fall reports using quality rubric and machine learning.
Stud Health Technol Inform 2019 Aug 21;264:639-43. doi: 10.3233/shti190301..
Keywords: Falls, Patient Safety, Prevention, Quality of Care, Quality Improvement
Kates AE, Zimbric ML, Mitchell K
The impact of chlorhexidine gluconate on the skin microbiota of children and adults: a pilot study.
The authors examined the effect of chlorhexidine gluconate bathing on the skin microbiota of adult and pediatric patients. They observed no differences in pediatric patients, but multiple genera of bacteria were observed to be significantly less abundant in adults. They recommended further research to determine long-term impact.
AHRQ-funded; HS024039.
Citation: Kates AE, Zimbric ML, Mitchell K .
The impact of chlorhexidine gluconate on the skin microbiota of children and adults: a pilot study.
Am J Infect Control 2019 Aug;47(8):1014-16. doi: 10.1016/j.ajic.2019.01.024..
Keywords: Children/Adolescents, Skin Conditions, Healthcare-Associated Infections (HAIs), Prevention, Patient Safety
Musuuza JS, Hundt AS, Carayon P
Implementation of a Clostridioides difficile prevention bundle: understanding common, unique, and conflicting work system barriers and facilitators for subprocess design.
This study assessed the factors that should be considered when designing subprocesses of a Clostridioides difficile (C. difficile) prevention bundle. Three focus groups were conducted with environmental services staff, physicians and nurses to assess their perspectives on the prevention bundle and barriers to implementation. Common barriers included inconsistencies in knowledge and practice of CD management procedures; increased workload; poor setup of aspects of the physical environment; and inconsistencies in CD documentation. There were also unique barriers in different hospital environments. The authors recommend a systems engineering approach to help holistically identify factors that influence successful implementation of subprocesses of the CD infection prevention bundle.
AHRQ-funded; HS023791.
Citation: Musuuza JS, Hundt AS, Carayon P .
Implementation of a Clostridioides difficile prevention bundle: understanding common, unique, and conflicting work system barriers and facilitators for subprocess design.
Infect Control Hosp Epidemiol 2019 Aug;40(8):880-88. doi: 10.1017/ice.2019.150..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Musuuza JS, Guru PK, O'Horo JC
The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis.
This review and meta-analysis examined the effect of chlorhexidine gluconate (CHG) bathing on reducing hospital-acquired bloodstream infections (HABSIs) and also assessed fidelity to the implementation of this intervention. The literature research included randomized controlled trials, cluster randomized trials, and quasi-experimental studies that evaluated the effect of CHG bathing versus a non-CHG comparator; studies involving pediatric patients, pre-surgical CHG use, and those without a non-CHG comparison arm were excluded. Outcomes were HABSIs, patient-centered outcomes, and implementation fidelity assessed through five elements: adherence, exposure or dose, quality of delivery, participant responsiveness, and program differentiation. The findings indicate that patient bathing with CHG significantly reduced the incidence of HABSIs in both ICU and non-ICU settings. Many studies, however, did not report fidelity to intervention or patient-centered outcomes.
AHRQ-funded; HS024039.
Citation: Musuuza JS, Guru PK, O'Horo JC .
The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis.
BMC Infect Dis 2019 May 14;19(1):416. doi: 10.1186/s12879-019-4002-7..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention
Calderwood MS, Yokoe DS, Murphy MV
Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty.
The authors assessed the effect of a multistate quality improvement campaign to promote the adoption of evidence-based surgical site infection (SSI) prevention practices. Rates of SSI among Medicare beneficiaries undergoing hip and knee arthroplasty during pre-intervention and post-intervention in five states included in a multistate trial of the Project JOINTS campaign and five matched comparison states were analyzed. The authors found a larger reduction of SSI rates following hip and knee arthroplasty in intervention states than in the matched control states.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Yokoe DS, Murphy MV .
Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty.
BMJ Qual Saf 2019 May;28(5):374-81. doi: 10.1136/bmjqs-2018-007982..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Orthopedics, Quality Improvement, Quality of Care, Evidence-Based Practice, Prevention, Patient Safety
Woodard JA, Leekha S, Jackson SS
Beyond entry and exit: Hand hygiene at the bedside.
This study assessed compliance with, knowledge of, and attitudes toward the World Health Organization (WHO) 5 moments for hand hygiene (HH) using a modified WHO HH observation form and a survey that assessed health care personnel (HCP) knowledge, opinions, and barriers to HH. Of the 218 HCPs who completed the survey, less than one-third were familiar with the WHO 5 moments and only 21& of that group could recall the 5 moments. 302 HH opportunities in 104 unique HCP-patient interactions were observed, but with infrequent compliance. The researchers conclude that lack of recognition of opportunities at the bedside and for glove use may contribute to low compliance.
AHRQ-funded; HS024108.
Citation: Woodard JA, Leekha S, Jackson SS .
Beyond entry and exit: Hand hygiene at the bedside.
Am J Infect Control 2019 May;47(5):487-91. doi: 10.1016/j.ajic.2018.10.026..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention, Provider, Public Health
Baloh J, Thom KA, Perencevich E
Hand hygiene before donning nonsterile gloves: healthcareworkers' beliefs and practices.
The purpose of this study was to examine the practices and beliefs of health care workers related to the use of nonsterile gloves and associated hand hygiene (HH) before gloving. Gloving and HH practices of health care workers at three large academic hospitals were observed as they entered patient rooms, and interviews were conducted with providers, nurses, and nursing assistants to elicit their beliefs and perceptions of these hygiene practices. While interviewed health care workers reported 100% HH compliance before gloving, observed HH compliance was only 42% and observed gloving before entering contact precaution rooms was 78%. Most health care workers described glove use more often than was necessary, and generally used gloves for their own safety, and sanitized their hands before gloving for patient safety. The authors conclude that HH and glove use are intertwined in clinical practice and should be considered jointly to improve infection prevention improvement efforts.
AHRQ-funded; HS024108.
Citation: Baloh J, Thom KA, Perencevich E .
Hand hygiene before donning nonsterile gloves: healthcareworkers' beliefs and practices.
Am J Infect Control 2019 May;47(5):492-97. doi: 10.1016/j.ajic.2018.11.015..
Keywords: Provider: Clinician, Provider, Provider: Health Personnel, Patient Safety, Prevention
Keller SC, Cosgrove SE, Kohut M
Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy.
This study looked at hazards that patients undergoing outpatient parenteral antimicrobial therapy (OPAT) have to avoid while undergoing the treatment at home with a venous catheter. A qualitative study was conducted with patients discharged from 2 academic medical centers in Baltimore, Maryland. Hazards identified included bathing, pets, temperature extremes, household clutter, food and soil exposures and travel. Patients that were interviewed developed strategies to avoid these hazards.
AHRQ-funded; HS025782.
Citation: Keller SC, Cosgrove SE, Kohut M .
Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy.
Am J Infect Control 2019 Apr;47(4):425-30. doi: 10.1016/j.ajic.2018.09.020..
Keywords: Home Healthcare, Infectious Diseases, Patient Safety, Prevention
Werzen A, Thom KA, Robinson GL
Comparing brief, covert, directly observed hand hygiene compliance monitoring to standard methods: a multicenter cohort study.
The purpose of this study was to examine and compare the effect of covert observers versus brief observation periods on hand hygiene compliance. The authors conclude that compliance rates were greater when reported by infection prevention programs than when reported by covert observers over brief observation periods.
AHRQ-funded; HS024108.
Citation: Werzen A, Thom KA, Robinson GL .
Comparing brief, covert, directly observed hand hygiene compliance monitoring to standard methods: a multicenter cohort study.
Am J Infect Control 2019 Mar;47(3):346-48. doi: 10.1016/j.ajic.2018.08.015..
Keywords: Patient Safety, Prevention, Provider