AHRQ Releases Best Practices for Safe COVID-19 Vaccine Administration in Nursing Homes

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Today's Headlines:

• AHRQ Releases Best Practices for Safe COVID-19 Vaccine Administration in Nursing Homes.
• Health System-Affiliated, Rural Clinics Face Unique Barriers to Using Clinical Decision Support Tools.
• Grantee Profile Highlights Work of Jason Adelman, M.D., M.S., To Reduce Wrong-Patient Errors.
• Highlights From AHRQ’s Patient Safety Network.
• Electronic Health Record Trigger Helped Reduce Missed Diagnosis of Stroke.
• AHRQ in the Professional Literature.

AHRQ Releases Best Practices for Safe COVID-19 Vaccine Administration in Nursing Homes

A new AHRQ resource on best practices for safe vaccine administration is intended to support experienced vaccinators and others administering the COVID-19 vaccine to nursing home residents and staff. The Intramuscular Injections: Best Practices for Safe Vaccine Administration in Nursing Homes resource offers guidance before, during and after intramuscular injections. Proper intramuscular administration is critical to vaccine effectiveness and avoidance of shoulder injuries. The resource also lists considerations for vaccinating older nursing home residents, including muscle wasting, involuntary movement and dementia-related confusion. Access additional tools in AHRQ’s COVID-19 Resources Catalog for Nursing Homes.

Health System-Affiliated, Rural Clinics Face Unique Barriers to Using Clinical Decision Support Tools

Adoption of clinical decision support (CDS) tools at health system-affiliated clinics was hindered by barriers such as limited resources, workflow redesign complications and low user acceptance, according to an AHRQ-funded review of 821 clinics in the Minnesota Community Measurement’s annual Health Information Technology Survey. Rural clinics were more likely to report barriers to provider and staff training. Despite facing more barriers overall, 66 percent of health-system clinics surveyed utilized all seven CDS tools measured in 2016, compared with just 38 percent of clinics not in health systems. Access the abstract published by the Journal of the American Medical Informatics Association.

Grantee Profile Highlights Work of Jason Adelman, M.D., M.S., To Reduce Wrong-Patient Errors

A wrong-patient error that resulted in a high drug dosage mistakenly given to an elderly patient motivated Jason Adelman, M.D., M.S., chief patient safety officer at Columbia University Irving Medical Center/New York-Presbyterian Hospital, to focus his research, operations and clinical skills on reducing these risks. The subject of a new AHRQ grantee profile, Dr. Adelman has headed several large-scale studies that test and validate health information technology measures to the improve the safety of hospitals’ electronic health records systems. Access Dr. Adelman’s profile as well as additional AHRQ profiles.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Experiences and perspectives of transgender youths in accessing health care: a systematic review.
• Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations.
• Mortality review as a tool to assess the contribution of healthcare-associated infections to death: results of a multicentre validity and reproducibility study, 11 European Union countries, 2017 to 2018.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Electronic Health Record Trigger Helped Reduce Missed Diagnosis of Stroke

Implementation of an electronic health record e-trigger—based on the SPADE framework, which maps frequently missed diagnoses to one or more previously documented high-risk symptoms—helped identify missed diagnoses of stroke victims in an emergency department (ED), according to an AHRQ-funded study in the Journal of the American Medical Informatics Association. Diagnostic errors, especially in chaotic EDs, are a major contributor to patient harm. Researchers used the Safer Dx Trigger Tools Framework to develop the e-trigger to identify misdiagnosed stoke patients over a two-year period at 130 Veterans Affairs facilities. A review of 46,931 stroke-related admissions yielded 398 triggers for review. Of those, 124 cases (about 31 percent) had missed opportunities for diagnosis of stroke or transient ischemic attack. The findings suggested that a number of patients who presented with red flags and multiple stroke risk factors did not receive appropriate evaluation. Access the abstract.

AHRQ in the Professional Literature

A taxonomy for external support for practice transformation. Solberg LI, Kuzel A, Parchman ML, et al. J Am Board Fam Med 2021 Jan-Feb;34(1):32-9. Access the abstract on PubMed®.

Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations. Reese TJ, Schlechter CR, Potter LN, et al. JAMA Netw Open 2021 Jan 4;4(1):e2033769. Access the abstract on PubMed®.

Are state telemedicine parity laws associated with greater use of telemedicine in the emergency department? Zachrison KS, Boggs KM, Cash RE, et al. J Am Coll Emerg Physicians Open 2021 Feb;2(1):e212359. Epub 2021 Jan 14. Access the abstract on PubMed®.

TELEmedicine as an intervention for sepsis in emergency departments: a multicenter, comparative effectiveness study (TELEvISED Study). Mohr NM, Harland KK, Okoro UE, et al. J Comp Eff Res 2021 Feb;10(2):77-91. Epub 2021 Jan 20. Access the abstract on PubMed®.

Black-white disparities in maternal in-hospital mortality according to teaching and Black-serving hospital status. Burris HH, Passarella M, Handley SC, et al. Am J Obstet Gynecol 2021 Jul;225(1):83.e1-.e9. Epub 2021 Jan 13. Access the abstract on PubMed®.

Identifying urinary tract infection-related information in home care nursing notes. Woo K, Adams V, Wilson P, et al. J Am Med Dir Assoc 2021 May;22(5):1015-21.e2. Epub 2021 Jan 9. Access the abstract on PubMed®.

A qualitative analysis of outpatient medication use in community settings: observed safety vulnerabilities and recommendations for improved patient safety. Lyson HC, Sharma AE, Cherian R, et al. J Patient Saf 2021 Jun 1;17(4):e335-42. Access the abstract on PubMed®.

Timing of co-occurring chronic conditions in children with neurologic impairment. Thomson J, Hall M, Nelson K, et al. Pediatrics 2021 Feb;147(2):e2020009217. Epub 2021 Jan 7. Access the abstract on PubMed®.