AHRQ Toolkit Helps Hospitals Reduce Catheter-Associated Urinary Tract infections

Issue 495
AHRQ's Electronic Newsletter summarizes Agency research and programmatic activities.
November 19, 2015

AHRQ Stats: Treatment for Drug Use

In 2012, just under 11 percent of people ages 12 and older who needed treatment for illicit drug use or an alcohol problem received such treatment at a specialty facility. (Source: Agency for Healthcare Research and Quality, 2014 National Healthcare Quality and Disparities Report, Chartbook on Effective Treatment).

Today's Headlines

  1. AHRQ Toolkit Helps Hospitals Reduce Catheter-Associated Urinary Tract infections.
  2. AHRQ Introduces First-Ever Readmissions Database.
  3. AHRQ Study: Process Breakdowns Cause Two-Thirds of Abdominal Pain Diagnostic Errors in Emergency Departments.
  4. Behavioral Health, Chronic Conditions Underlie Health Spending for High-Utilization Adolescents, AHRQ-Funded Study Finds.
  5. Register Now: Webinar on Using AHRQ Quality Indicators To Improve Quality and Safety.
  6. Featured Case Study: Ohio Hospital Employees Boost Team Support, Respect With AHRQ Training.
  7. AHRQ in the Professional Literature.

1. AHRQ Toolkit Helps Hospitals Reduce Catheter-Associated Urinary Tract infections

AHRQ released a new toolkit today to help hospital staff prevent catheter-associated urinary tract infections (CAUTI) in patients and improve safety culture at the unit level. CAUTIs are healthcare-associated infections that cause suffering for approximately 250,000 hospital patients each year at a cost of about $250 million. CAUTIs are largely preventable, and stopping them can reduce the chance that hospital superbugs will develop resistance to overused antibiotics. The new Toolkit for Reducing CAUTI in Hospitals builds on the framework of the core CUSP Toolkit to help ensure that hospital teams adhere to guidelines from the Centers for Disease Control and Prevention (CDC). It includes checklists and modifiable teaching tools and resources to help clinical teams specifically address questions about whether catheters need to be used, and, if so, to place them safely and to remove them before patients develop infections. It also includes special resources for resident physicians and nurses in intensive care units and emergency departments. The toolkit is the latest in a series of AHRQ tools and training materials that help frontline providers go beyond the "what" of improving care to actually show them "how" to make changes in workflow processes to keep patients safer.

2. AHRQ Introduces First-Ever Readmissions Database

AHRQ has introduced a new database, the Nationwide Readmissions Database (NRD), to analyze national hospital readmission rates. The NRD is the first all-payer nationwide database that supports tracking hospital readmissions, a critical health policy issue, thus addressing a major gap in health care data. Researchers, public health professionals, administrators, policymakers and clinicians will be able to use the new database in their analyses and decision-making. The NRD is part of the AHRQ-sponsored Healthcare Cost and Utilization Project (HCUP), a group of related databases that includes information from administrative billing data. The value of the NRD is illustrated in a new HCUP Statistical Brief examining trends in hospital readmissions for four high-volume conditions: congestive heart failure, chronic obstructive pulmonary disease, heart attack and pneumonia. According to the statistical brief, there were 500,000 readmissions totaling $6.8 billion in aggregate hospital costs for those four conditions in 2013. HCUP includes the largest and most robust databases available of inpatient and outpatient care provided to patients in U.S. hospitals, including information on 97 percent of all U.S. hospital discharges. For information on the NRD, visit the HCUP User Support website.

3. AHRQ Study: Process Breakdowns Cause Two-Thirds of Abdominal Pain Diagnostic Errors in Emergency Departments

More than two-thirds of diagnostic errors involving abdominal pain in the emergency department (ED) involved breakdowns in communication between patients and clinicians, according to a new AHRQ-funded study. The study, funded in part by AHRQ, reviewed a high-risk cohort of patients presenting to the ED with abdominal pain to evaluate for possible diagnostic errors and associated process breakdowns. Researchers found that diagnostic errors occurred in 35 of 100 high-risk cases. More than two-thirds had breakdowns involving the patient–provider encounter (most commonly history-taking or ordering additional tests) and/or follow-up and tracking of diagnostic information (most commonly follow-up of abnormal test results). The most frequently missed diagnoses were gallbladder pathology and urinary infections. Read an abstract of the study, which was published in Emergency Medicine Journal.

4. Behavioral Health, Chronic Conditions Underlie Health Spending for High-Utilization Adolescents, AHRQ-Funded Study Finds

Behavioral health and chronic conditions are behind a significant amount of health spending for privately insured adolescents, a new study partially funded by AHRQ suggests. In the study, published in the journal JAMA Pediatrics, researchers analyzed 2012 data from 13,103 privately insured adolescents (ages 13 to 21) at 82 primary care pediatric clinics in Massachusetts. They found that just 1 percent of patients (132) accounted for 23 percent of total expenses, a total of $52,577 per patient, compared with overall median direct medical expenses of $1,167 per patient. Of the high-cost cohort of patients, 59 percent had at least one behavioral health diagnosis. Pharmacy costs accounted for 28 percent of total direct medical expenses for these high-cost patients. Characteristics of high-cost patients included having at least one (and in many cases two or more) complex chronic conditions, having any behavioral health diagnosis and being obese. The authors concluded that cost reduction strategies should be tailored according to medical complexity, mental health and obesity. Read the abstract.

5. Register Now: Webinar on Using AHRQ Quality Indicators To Improve Quality and Safety

Registration is open for a December 9 webinar from 3 to 4 p.m. ET about AHRQ Quality Indicators, standardized, evidence-based quality measures that can be used with hospital inpatient administrative data to measure and track clinical performance and outcomes, including inpatient mortality, surgical complications and certain hospital-acquired infections. The webinar will feature representatives from two health systems who will share their experiences implementing the Patient Safety Indicators as part of their efforts to improve the quality and safety of care.

6. Featured Case Study: Ohio Hospital Employees Boost Team Support, Respect With AHRQ Training

At Fairfield Medical Center in Lancaster, Ohio, employee ratings on providing mutual support and treating each other with respect increased by 30 percent following the TeamSTEPPS® patient safety training program. The training impact was measured with AHRQ’s Hospital Survey on Patient Safety Culture. Read the case study.

7. AHRQ in the Professional Literature

Differing perceptions of safety culture across job roles in the ambulatory setting: analysis of the AHRQ Medical Office Survey on Patient Safety Culture. Hickner J, Smith SA, Yount N, et al. BMJ Qual Saf 2015 Oct 14. pii: bmjqs-2014-003914. Select to access the abstract on PubMed®.

Hospital use in the last year of life for children with life-threatening complex chronic conditions. Ananth P, Melvin P, Feudtner C, et al. Pediatrics 2015 Nov;136(5):938-46. Epub 2015 Oct 5. Select to access the abstract on PubMed®.

Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors. Kenzik KM, Morey MC, Cohen HJ, et al. J Geriatr Oncol 2015 Sep 9. pii: S1879-4068(15)00079-X. Select to access the abstract on PubMed®.

The impact of social media on dissemination and implementation of clinical practice guidelines: a longitudinal observational study. Narayanaswami P, Gronseth G, Dubinsky, et al. J Med Internet Res 2015 Aug 13;17(8):e193. Select to access the abstract on PubMed®.

Preventing central line-associated bloodstream infections: a qualitative study of management practices. Scheck McAlearney A, Hefner JL, Robbins J, et al. Infect Control Hosp Epidemiol 2015 May; 36(5):557-63. Epub 2015 Feb 23. Select to access the abstract on PubMed®.

Comparisons of hospitalization rates among younger atrial fibrillation patients receiving different antiarrhythmic drugs. Allen LaPointe NM, Dai D, Thomas L, et al. Circ Cardiovasc Qual Outcomes 2015 May; 8(3):292-300. Epub 2015 Mar 31. Select to access the abstract on PubMed®.

Gaming hospital-level pneumonia 30-day mortality and readmission measures by legitimate changes to diagnostic coding Sjoding MW, Iwashyna TJ, Dimick JB, et al. Crit Care Med 2015 May; 43(5):989-95. Select to access the abstract on PubMed®.

Nursing home 5-star rating system exacerbates disparities in quality, by payer source. Konetzka R, Grabowski DC, Perraillon MC, et al. Health Aff 2015 May; 34(5):819-27. Select to access the abstract on PubMed®.

Editor's note: Last week's article on a September 15 BMJ Quality & Safety article, "Impact of an Electronic Alert Notification System Embedded in Radiologists' Workflow on Closed-Loop Communication of Critical Results: A Time Series Analysis," incorrectly summarized the study’s results. It found that an alert notification system reduced from 19 percent to 5 percent the rate at which radiologists failed to document communication about critical test results to patients' doctors. Read the abstract.

 

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Page last reviewed November 2015
Page originally created November 2015
Internet Citation: AHRQ Toolkit Helps Hospitals Reduce Catheter-Associated Urinary Tract infections. Content last reviewed November 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/495.html