National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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Search All Research Studies
Topics
- Adverse Events (2)
- Antibiotics (2)
- Antimicrobial Stewardship (2)
- Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (5)
- Children/Adolescents (1)
- Clostridium difficile Infections (1)
- Communication (3)
- Comparative Effectiveness (3)
- Critical Care (2)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- (-) Evidence-Based Practice (22)
- Guidelines (5)
- (-) Healthcare-Associated Infections (HAIs) (22)
- Health Information Technology (HIT) (1)
- Hospitals (3)
- Implementation (1)
- Infectious Diseases (5)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (4)
- Kidney Disease and Health (2)
- Long-Term Care (2)
- Medication (2)
- Nursing (1)
- Nursing Homes (1)
- Organizational Change (1)
- Orthopedics (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (10)
- Pneumonia (1)
- Pressure Ulcers (2)
- Prevention (9)
- Quality Improvement (3)
- Quality of Care (5)
- Registries (1)
- Research Methodologies (1)
- Risk (1)
- Surgery (3)
- Urinary Tract Infection (UTI) (3)
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 22 of 22 Research Studies DisplayedBrajcic BC, Ko CY, Liu JB
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
This paper describes the protocol for an upcoming multicenter randomized surgical trial to evaluate choice of prophylactic antibiotics for pancreaticoduodenectomy. The rationale and methodology of the trial evaluating piperacillin-tazobactam compared to cefoxitin for surgical site infection prevention is described. The study will utilize a clinical registry for data collection.
AHRQ-funded; HS000078.
Citation: Brajcic BC, Ko CY, Liu JB .
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
J Surg Oncol 2021 May;123(6):1387-94. doi: 10.1002/jso.26402..
Keywords: Cancer, Antibiotics, Medication, Prevention, Surgery, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Evidence-Based Practice
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
Chatterjee P, Williams MD, Coppin JD
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
This study examined whether using novel coper-impregnated solid materials on high-touch surfaces in patient rooms lowered bacterial contamination which may lead to health care-associated infections in acute care hospitals. Sixteen rooms were installed with copper-impregnated surfaces and were compared to standard noncopper laminate surfaces in 16 rooms over a 3-day period. Samples were taken 3 times per day. A lower level of microbial contamination was found in copper-impregnated solid surfaces as compared to standard surfaces.
AHRQ-funded; HS025598.
Citation: Chatterjee P, Williams MD, Coppin JD .
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
Open Forum Infect Dis 2020 Aug;7(8). doi: 10.1093/ofid/ofaa238..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Comparative Effectiveness, Prevention, Evidence-Based Practice
Meddings J, Greene MT, Ratz D
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
AHRQ’s Safety Program for ICUs aimed to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in intensive care units with elevated rates. Included hospitals had at least one adult intensive care unit with elevated CLABSI or CAUTI rates. The investigators targeted intensive care units with elevated catheter infection rates but yielded no statistically significant reduction in CLABSI, CAUTI or catheter utilization in the first two of six planned cohorts. Improvements in the interventions based on lessons learned from these initial cohorts are being applied to subsequent cohorts.
AHRQ-funded; 233201500016I.
Citation: Meddings J, Greene MT, Ratz D .
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
BMJ Qual Saf 2020 May;29(5):418-29. doi: 10.1136/bmjqs-2019-009330..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Urinary Tract Infection (UTI), Intensive Care Unit (ICU), Hospitals, Evidence-Based Practice, Patient-Centered Outcomes Research, Inpatient Care, Critical Care
Flores EJ, Jue JJ, Giradi G
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
In this pilot study, findings from the 2016 AHRQ EPC report on Clostridioides difficile infection were translated into a treatment pathway and disseminated via a cloud-based platform and electronic health record (EHR). Results indicated that pathways can be an approach for disseminating AHRQ EPC report findings within health care systems, with reports including guideline and pathway syntheses. Embedding hyperlinks to pathway content within the EHR may be a viable and low-effort solution for promoting awareness of evidence-based resources.
AHRQ-funded.
Citation: Flores EJ, Jue JJ, Giradi G .
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
Jt Comm J Qual Patient Saf 2019 Dec;45(12):822-28. doi: 10.1016/j.jcjq.2019.10.002..
Keywords: Implementation, Evidence-Based Practice, Infectious Diseases, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Paje D, Rogers MAM, Conlon A
Use of peripherally inserted central catheters in patients with advanced chronic kidney disease: a prospective cohort study.
Existing guidelines, including Choosing Wisely recommendations, endorse avoiding placement of peripherally inserted central catheters (PICCs) in patients with chronic kidney disease (CKD). The purpose of this study was to describe the frequency of and characteristics associated with PICC use in hospitalized patients with stage 3b or greater CKD (glomerular filtration rate [GFR] <45 mL/min/1.73 m2).
AHRQ-funded; HS025891.
Citation: Paje D, Rogers MAM, Conlon A .
Use of peripherally inserted central catheters in patients with advanced chronic kidney disease: a prospective cohort study.
Ann Intern Med 2019 Jul 2;171(1):10-18. doi: 10.7326/m18-2937..
Keywords: Kidney Disease and Health, Guidelines, Evidence-Based Practice, Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
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
Bradley SM, Schweon SJ, Mody L
Identifying safe practices for use of the urinary leg bag drainage system in the postacute and long-term care setting: an integrative review.
In the postacute and long-term care setting, the practice of changing the indwelling urinary catheter large sterile drainage bag to a small-size leg drainage bag is intended to maintain a person's mobility, dignity, and comfort. There is scant evidence that assesses the impact of intermittent use of a leg bag on frequency of urinary tract infection since this breaks the closed urinary drainage system. The investigators identified the existence of low-level evidence that leg bags pose no evident, disproportionate risk of infection compared with maintaining a closed system.
AHRQ-funded; 290201000025I.
Citation: Bradley SM, Schweon SJ, Mody L .
Identifying safe practices for use of the urinary leg bag drainage system in the postacute and long-term care setting: an integrative review.
Am J Infect Control 2018 Sep;46(9):973-79. doi: 10.1016/j.ajic.2018.03.029..
Keywords: Care Management, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Long-Term Care, Patient Safety, Urinary Tract Infection (UTI)
Jump RLP, Crnich CJ, Mody L
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review.
AHRQ-funded; HS022465.
Citation: Jump RLP, Crnich CJ, Mody L .
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
J Am Geriatr Soc 2018 Apr;66(4):789-803. doi: 10.1111/jgs.15248.
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Keywords: Elderly, Healthcare-Associated Infections (HAIs), Infectious Diseases, Nursing Homes, Long-Term Care, Antimicrobial Stewardship, Antibiotics, Medication, Evidence-Based Practice, Guidelines
Patel PK, Gupta A, Vaughn VM
Review of strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs.
This systematic review was conducted back in October 2015 within PubMed and Cochrane databases on interventions to reduce central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI). The interventions were categorized by stages applicable to both CAUTI and CLABSI prevention. Stage 0: avoid catheter if possible; Stage 1: ensure aseptic placement; Stage 2: maintain awareness and proper care of catheters in place, and Stage 3: promptly remove unnecessary catheters. They also looked for effective components that the 5 stages were most successful with. The review is designed for hospitalists to use to formulate quality improvement interventions for infection reduction.
AHRQ-funded; HS018334.
Citation: Patel PK, Gupta A, Vaughn VM .
Review of strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs.
J Hosp Med 2018 Feb;13(2):105-16. doi: 10.12788/jhm.2856..
Keywords: Care Management, Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Infectious Diseases, Intensive Care Unit (ICU), Patient Safety, Urinary Tract Infection (UTI)
Metersky ML, Wang Y, Klompas M
Trend in ventilator-associated pneumonia rates between 2005 and 2013.
This study found that, from 2005 through 2013, Medicare Patient Safety Monitoring System (MPSMS) ventilator-associated pneumonia (VAP) rates remained stable and substantial, affecting approximately 10 percent of ventilated patients. Persistently high VAP rates bolster concerns that most interventions purported to reduce VAP are supported by limited evidence.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Metersky ML, Wang Y, Klompas M .
Trend in ventilator-associated pneumonia rates between 2005 and 2013.
JAMA 2016 Dec 13;316(22):2427-29. doi: 10.1001/jama.2016.16226.
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Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Evidence-Based Practice
Padula WV, Gibbons RD, Valuck RJ
Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers?
The objective of this study was to evaluate the longitudinal impact of CMS policy and quality improvement adoption on hospital-acquired pressure ulcers (HAPU) rates. It concluded that HAPU rates were significantly lower after changes in CMS reimbursement. Reductions are associated with hospital-wide implementation of evidence-based practices for HAPU prevention.
AHRQ-funded; HS023710.
Citation: Padula WV, Gibbons RD, Valuck RJ .
Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers?
Med Care 2016 May;54(5):512-8. doi: 10.1097/mlr.0000000000000516..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Pressure Ulcers, Quality Improvement
Alvarez E, Uslan DZ, Malloy T
It is time to revise our approach to registering antimicrobial agents for health care settings.
This paper discusses antimicrobial surfaces, such as copper alloy, for the prevention of healthcare-associated infections. The authors address the current process for registering antimicrobial products, flaws in the registration requirements, and the need for evidence-based approaches to reduce healthcare-associated infections.
AHRQ-funded; HS021188.
Citation: Alvarez E, Uslan DZ, Malloy T .
It is time to revise our approach to registering antimicrobial agents for health care settings.
Am J Infect Control 2016 Feb;44(2):228-32. doi: 10.1016/j.ajic.2015.09.015.
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Keywords: Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Prevention, Evidence-Based Practice, Registries
Rangachari P, Madaio M, Rethemeyer RK
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
The authors investigated the challenge of consistent implementation of evidence-based infection prevention practices at the unit level. Their results showed that the interventions cumulatively had a significant desired impact on central catheter use and helped validate the theoretical literature and identify evidence-based management strategies for practice change at the unit level. Further, periodic top-down communications have the potential to modify interprofessional knowledge exchanges and enable practice change at the unit level, leading to significantly improved outcomes and reduced costs.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
Health Care Manage Rev 2015 Oct-Dec;40(4):324-36. doi: 10.1097/hmr.0000000000000038.
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Keywords: Communication, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Children/Adolescents, Prevention
Padula WV, Valuck RJ, Makic MB
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced, the overall reduction of pressure ulcers (PUs). It found that several internal factors influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns and data sharing among peer institutions.
AHRQ-funded; HS023710.
Citation: Padula WV, Valuck RJ, Makic MB .
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
J Wound Ostomy Continence Nurs 2015 Jul-Aug;42(4):327-30. doi: 10.1097/won.0000000000000145..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Prevention
Chenoweth CE, Hines SC, Hall KK
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
The purpose of this study was to observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. The researchers found considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68 percent (range, 45 percent–92 percent) across all facilities.
AHRQ-authored; AHRQ-funded; 290200600022I.
Citation: Chenoweth CE, Hines SC, Hall KK .
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
Infect Control Hosp Epidemiol 2015 Jul;36(7):802-6. doi: 10.1017/ice.2015.55..
Keywords: Kidney Disease and Health, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Prevention
Vogel JA, Haukoos JS, Erickson CL
Is long-axis view superior to short-axis view in ultrasound-guided central venous catheterization?
The authors evaluated whether using long-axis or short-axis view during ultrasound-guided internal jugular and subclavian central venous catheterization results in fewer skin breaks, decreased time to cannulation, and fewer posterior wall penetrations. They found the long-axis view for the internal jugular more efficient than the short-axis view with fewer redirections; the long-axis view for subclavian central venous catheterization more efficient with decreased time to cannulation and fewer redirections; the long-axis approach to subclavian central venous catheterization associated with fewer posterior wall penetrations; and the long-axis view for subclavian central venous catheterization and avoiding posterior wall penetrations resulting in fewer central venous catheter-related complications.
AHRQ-funded; HS017526.
Citation: Vogel JA, Haukoos JS, Erickson CL .
Is long-axis view superior to short-axis view in ultrasound-guided central venous catheterization?
Crit Care Med 2015 Apr;43(4):832-9. doi: 10.1097/ccm.0000000000000823.
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Keywords: Adverse Events, Comparative Effectiveness, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research
Rangachari P, Madaio M, Rethemeyer RK
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
There are gaps in understanding the mechanisms by which top-down communications enable practice change. The authors sought to address these gaps in order to help identify evidence-based management strategies for successful practice change at the unit level. They found that both intensive care units studied experienced substantially improved outcomes and indicated a statistically significant increase in proactive communications. Early in the study, champions emerged within each unit to initiate process improvements. The authors concluded that the study helped to identify evidence-based management strategies for successful practice change at the unit level.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
Health Care Manage Rev 2015 Jan-Mar;40(1):65-78. doi: 10.1097/hmr.0000000000000001.
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Keywords: Intensive Care Unit (ICU), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Critical Care, Communication, Evidence-Based Practice, Organizational Change, Prevention, Patient Safety
Kronick R
AHRQ Author: Kronick R
Patient safety: the Agency for Healthcare Research and Quality’s ongoing commitment.
The author, director of the Agency for Healthcare Research and Quality, highlights AHRQ’s role in producing evidence to make care safer and fostering the use of that evidence. In particular, he discusses the following goals: preventing healthcare-acquired infections; reducing harm associated with obstetrical care in labor and delivery; improving safety and reducing medical liability; and, accelerating patient safety improvement in nursing homes.
AHRQ-authored
Citation: Kronick R .
Patient safety: the Agency for Healthcare Research and Quality’s ongoing commitment.
J Nurs Care Qual. 2014 Jul-Sep;29(3):195-9. doi: 10.1097/NCQ.0000000000000065..
Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Patient Safety
Rangachari P, Madaio M, Rethemeyer RK
Role of communication content and frequency in enabling evidence-based practices.
The study sought to promote central line bundle (CLB) implementation in a medical ICU and a pediatric ICU through periodic quality improvement (QI) interventions over a 52-week period. It found that proactive communications increased by 68 percent in the MICU and 61 percent in the PICU. During the same timeframe, both units increased CLB adherence to 100 percent. Both units also demonstrated statistically significant declines in catheter days.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Role of communication content and frequency in enabling evidence-based practices.
Qual Manag Health Care 2014 Jan-Mar;23(1):43-58. doi: 10.1097/qmh.0000000000000017..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Communication, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Quality of Care, Quality Improvement
Zimring C, Denham ME, Jacob JT
http://journals.sagepub.com/doi/10.1177/193758671300701S09
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
The objective of this report was to summarize the findings and provide recommendations based on the multidisciplinary literature review and industry scan, focusing on the links between the built environment and healthcare-associated infections. It concluded that there are currently few data that demonstrate a reduction in infection rates. There is a need for multidisciplinary collaboration and increased efforts to standardize the evaluation of environmental studies.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Denham ME, Jacob JT .
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
HERD 2013 Oct;7(1 suppl):127-39..
Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Hospitals
Zimring C, Jacob JT, Denham ME
http://journals.sagepub.com/doi/pdf/10.1177/193758671300701S04
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
This paper describes the conceptual framework and methodology used to conduct a comprehensive literature review of current evidence evaluating the role of the built environment in the transmission of healthcare-associated infections. The methodology involves a chain of transmission interventions model that is a multidisciplinary conceptualization of the interaction between pathogens and the built environment. This model facilitated a systematic literature review of a very large amount of data.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Jacob JT, Denham ME .
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
HERD 2013 Oct;7(1 suppl):18-30.
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Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Research Methodologies