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 (5)
- Antibiotics (2)
- Antimicrobial Stewardship (1)
- Arthritis (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (5)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Community-Acquired Infections (1)
- Comparative Effectiveness (3)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Critical Care (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (2)
- (-) Healthcare-Associated Infections (HAIs) (17)
- Health Information Technology (HIT) (1)
- Hospital Discharge (1)
- Hospitals (1)
- Infectious Diseases (1)
- Injuries and Wounds (3)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (2)
- Long-Term Care (1)
- Medication (1)
- Mortality (1)
- Nutrition (1)
- Obesity (1)
- Outcomes (2)
- Patient-Centered Healthcare (1)
- (-) Patient-Centered Outcomes Research (17)
- Patient Safety (6)
- Patient Self-Management (1)
- Pneumonia (2)
- Prevention (4)
- Quality Improvement (1)
- Respiratory Conditions (1)
- Risk (1)
- Shared Decision Making (1)
- Stroke (1)
- Surgery (4)
- Telehealth (1)
- Urinary Tract Infection (UTI) (4)
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 17 of 17 Research Studies DisplayedMeddings 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
Burgermaster M, Murray M, Saiman L
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
This study investigated the outcomes of children and a subsample of infants in pediatric long-term care facilities are need enteral nutrition (EN). Those patients who need EN had a higher risk of acute pediatric infection (ARI) and a lower odds of discharge than those who did not. Infants had a particular higher risk of comorbidities and infections when they were fed using percutaneous feeding tubes.
AHRQ-funded; HS021470.
Citation: Burgermaster M, Murray M, Saiman L .
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
Nutr Clin Pract 2018 Dec;33(6):865-71. doi: 10.1002/ncp.10017..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Nutrition, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions, Long-Term Care
Bardossy AC, Williams T, Jones K
Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: the tale of two teaching hospitals.
This study compared 2 teaching hospitals’ intervention programs for preventing catheter-associated urinary tract infections (CAUTI). The comparisons were done in their adult intensive care units.
AHRQ-funded; 290201000025I; 29032001T.
Citation: Bardossy AC, Williams T, Jones K .
Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: the tale of two teaching hospitals.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1494-96. doi: 10.1017/ice.2018.251..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Patient Safety, Urinary Tract Infection (UTI)
Wahl TS, Patel FC, Goss LE
The obese colorectal surgery patient: surgical site infection and outcomes.
The purpose of this study was to understand the association between BMI and 30-day postoperative outcomes, including surgical site infection, among patients undergoing colorectal surgery. The study found that patients with increasing BMI showed an incremental and independent risk for adverse 30-day postoperative outcomes, especially surgical site infections.
AHRQ-funded; HS013852
Citation: Wahl TS, Patel FC, Goss LE .
The obese colorectal surgery patient: surgical site infection and outcomes.
Dis Colon Rectum 2018 Aug;61(8):938-45. doi: 10.1097/dcr.0000000000001085..
Keywords: Adverse Events, Healthcare-Associated Infections (HAIs), Obesity, Patient-Centered Outcomes Research, Surgery
Haessler S, Lagu T, Lindenauer PK
Treatment trends and outcomes in healthcare-associated pneumonia.
This retrospective cohort study assessed changes in hospital rates of concordant antibiotic use over time and their correlation with outcomes related to management of healthcare-associated pneumonia (HCAP). The study concluded that only 1 in 5 patients with risk factors for HCAP received treatment that was fully in accordance with guidelines, and many received community-acquired pneumonia (CAP) therapy instead.
AHRQ-funded; HS018723.
Citation: Haessler S, Lagu T, Lindenauer PK .
Treatment trends and outcomes in healthcare-associated pneumonia.
J Hosp Med 2017 Nov;12(11):886-91. doi: 10.12788/jhm.2877..
Keywords: Antibiotics, Elderly, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Pneumonia
Sears ED, Momoh AO, Chung KC
A national study of the impact of delayed flap timing for treatment of patients with deep sternal wound infection.
This study aimed to evaluate the impact of delayed flap closure on mortality and resource use for treatment of deep sternal wound infection. The timing of flap closure was delayed more than 7 days after diagnosis in 39 percent of patients. The study concluded that delay in flap closure was associated with greater mortality and resource use.
AHRQ-funded; HS023313.
Citation: Sears ED, Momoh AO, Chung KC .
A national study of the impact of delayed flap timing for treatment of patients with deep sternal wound infection.
Plast Reconstr Surg 2017 Aug;140(2):390-400. doi: 10.1097/prs.0000000000003514.
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Keywords: Injuries and Wounds, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Patient-Centered Outcomes Research
Obremskey WT, Schmidt AH, O'Toole RV
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
The POvIV study is a prospective, multicenter, randomized trial to compare oral (PO) with intravenous (IV) antibiotic therapy in patients with postoperative wound infections after extremity fractures. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.
AHRQ-funded; HS000029.
Citation: Obremskey WT, Schmidt AH, O'Toole RV .
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
J Orthop Trauma 2017 Apr;31 Suppl 1:S32-s38. doi: 10.1097/bot.0000000000000802.
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Keywords: Antibiotics, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Medication, Patient Safety, Adverse Events, Prevention, Patient-Centered Outcomes Research, Outcomes
Fakih MG, Gould CV, Trautner BW
Beyond infection: device utilization ratio as a performance measure for urinary catheter harm.
As multiple definitions for measuring catheter-associated urinary tract infections exist, the authors advocate use of the device utilization ratio (DUR) as an additional performance measure for potential urinary catheter harm. The DUR is currently captured as part of National Healthcare Safety Network reporting, and the data are readily obtainable from electronic medical records. This method also provides a more direct reflection of improvement efforts focused on reducing inappropriate urinary catheter use.
AHRQ-funded; 290201000025I.
Citation: Fakih MG, Gould CV, Trautner BW .
Beyond infection: device utilization ratio as a performance measure for urinary catheter harm.
Infect Control Hosp Epidemiol 2016 Mar;37(3):327-33. doi: 10.1017/ice.2015.287.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Prevention, Patient-Centered Outcomes Research
Yun H, Xie F, Delzell E
Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.
The researchers compare the subsequent risk of hospitalized infections associated with specific biologic agents among RA patients previously hospitalized for infection while receiving anti-tumor necrosis factor (anti-TNF) therapy. They found that among rheumatoid arthritis patients who experienced a hospitalized infection while on anti-TNF therapy, abatacept and etanercept were associated with the lowest risk of a subsequent infection compared to other biologic therapies.
AHRQ-funded; HS021694; HS023009; HS018517.
Citation: Yun H, Xie F, Delzell E .
Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.
Ann Rheum Dis 2015 Jun;74(6):1065-71. doi: 10.1136/annrheumdis-2013-204011..
Keywords: Arthritis, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Patient Safety
Rothberg MB, Zilberberg MD, Pekow PS
Association of guideline-based antimicrobial therapy and outcomes in healthcare-associated pneumonia.
The study objective was to examine the association between guideline-based therapy (GBT) and outcomes for patients with healthcare associated pneumonia (HCAP). It found that among patients who met HCAP criteria, GBT was not associated with lower adjusted mortality, length of stay or costs in any analyses.
AHRQ-funded; HS018723.
Citation: Rothberg MB, Zilberberg MD, Pekow PS .
Association of guideline-based antimicrobial therapy and outcomes in healthcare-associated pneumonia.
J Antimicrob Chemother 2015 May;70(5):1573-9. doi: 10.1093/jac/dku533..
Keywords: Patient-Centered Outcomes Research, Healthcare-Associated Infections (HAIs), Antimicrobial Stewardship, Comparative Effectiveness
Scheck McAlearney A, Hefner J, Robbins J
AHRQ Author: Harrison MI
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
This study identified factors that may explain hospital-level differences in outcomes of programs to prevent central line–associated bloodstream infections. A main theme that differentiated higher- from lower-performing hospitals was a distinctive framing of the goal of “getting to zero” infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition.
AHRQ-authored; AHRQ-funded; 290200600022.
Citation: Scheck McAlearney A, Hefner J, Robbins J .
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
Infect Control Hosp Epidemiol 2015 May;36(5):557-63. doi: 10.1017/ice.2015.27..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, 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
Friedant AJ, Gouse BM, Boehme AK
A simple prediction score for developing a hospital-acquired infection after acute ischemic stroke.
The authors sought to develop a simple scoring system for any hospital-acquired infection (HAI). Ranging from 0 to 7, the overall infection score consists of age 70 years or more, history of diabetes, and National Institutes of Health Stroke Scale score. Patients with an infection score of 4 or more were at 5 times greater odds of developing an infection. They concluded that, if validated in other populations, this score could assist providers in predicting infections after ischemic stroke.
AHRQ-funded; HS013852.
Citation: Friedant AJ, Gouse BM, Boehme AK .
A simple prediction score for developing a hospital-acquired infection after acute ischemic stroke.
J Stroke Cerebrovasc Dis 2015 Mar;24(3):680-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.11.014.
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Keywords: Shared Decision Making, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Risk, Stroke
Sanger P, Hartzler A, Lober WB
Design considerations for post-acute care mHealth: patient perspectives.
The authors are developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Their key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. In this article, they illustrated their application of these guiding design considerations and proposed a new framework for mHealth design based on illness duration and intensity.
AHRQ-funded; HS019482.
Citation: Sanger P, Hartzler A, Lober WB .
Design considerations for post-acute care mHealth: patient perspectives.
AMIA Annu Symp Proc 2014 Nov 14;2014:1920-9.
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Keywords: Telehealth, Patient Self-Management, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Adverse Events
Rothberg MB, Haessler S, Lagu T
Outcomes of patients with healthcare-associated pneumonia: worse disease or sicker patients?
The researchers sought to determine the contribution of healthcare-associated pneumonia (HCAP) criteria to case-fatality rate. They found that, after adjustment for differences in patient characteristics, HCAP was associated with greater case-fatality rate than community-acquired pneumonia, possibly due to HCAP organisms or to HCAP criteria themselves.
AHRQ-funded; HS018723.
Citation: Rothberg MB, Haessler S, Lagu T .
Outcomes of patients with healthcare-associated pneumonia: worse disease or sicker patients?
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S107-15. doi: 10.1086/677829.
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Keywords: Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Mortality, Patient-Centered Outcomes Research, Pneumonia
Baillie CA, Epps M, Hanish A
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
The researchers evaluated the usability and effectiveness of a computerized clinical decision support (CDS) intervention aimed at reducing the duration of urinary tract catheterizations. They found that usability improved to 15% with the revised reminder. The catheter utilization ratio declined over the 3 time periods, as did CAUTIs per 1,000 patient-days. They concluded that the usability of the reminder was highly dependent on its user interface, with a homegrown version of the reminder resulting in higher impact than a stock reminder.
AHRQ-funded; HS016946.
Citation: Baillie CA, Epps M, Hanish A .
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2014 Sep;35(9):1147-55. doi: 10.1086/677630.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Urinary Tract Infection (UTI)
Meddings J, Rogers MA, Krein SL
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
The authors updated a prior systematic review and a meta-analysis regarding interventions prompting urinary catheter (UC) removal by reminders or stop orders. They found that UC reminders and stop orders appear to reduce catheter-associated urinary tract infection rates and should be used to improve patient safety.
AHRQ-funded; 290200710062I; HS019767; HS018344.
Citation: Meddings J, Rogers MA, Krein SL .
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
BMJ Qual Saf 2014 Apr;23(4):277-89. doi: 10.1136/bmjqs-2012-001774.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Patient-Centered Outcomes Research, Prevention, Quality Improvement, Urinary Tract Infection (UTI)