National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Ambulatory Care and Surgery (1)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (8)
- (-) Central Line-Associated Bloodstream Infections (CLABSI) (16)
- Children/Adolescents (3)
- Clostridium difficile Infections (1)
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- Critical Care (1)
- Electronic Health Records (EHRs) (1)
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- Healthcare-Associated Infections (HAIs) (16)
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- Infectious Diseases (5)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (5)
- Medicare (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Nursing (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (9)
- Practice Patterns (1)
- Prevention (3)
- Provider (1)
- Provider Performance (1)
- Quality Measures (1)
- Quality of Care (1)
- Risk (1)
- Sepsis (1)
- Shared Decision Making (1)
- Surgery (1)
- Urinary Tract Infection (UTI) (5)
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 16 of 16 Research Studies DisplayedHsu HE, Mathew R, Wang R
Health care-associated infections among critically ill children in the US, 2013-2018.
The purpose of this study was to examine changes over time in CLABSI and CAUTI rates between 2013 and 2018 in neonatal intensive care units (NICUs) and pediatric intensive care units (PICUs) using prospective surveillance data from community hospitals, children's hospitals, and pediatric units within general hospitals. The investigators concluded that recent trends in CLABSI rates noted in this study among critically ill neonates and children in a large cohort of US hospitals indicated that past gains have held, without evidence of further improvements, suggesting novel approaches for CLABSI prevention are needed.
AHRQ-funded; HS025008; HS018414.
Citation: Hsu HE, Mathew R, Wang R .
Health care-associated infections among critically ill children in the US, 2013-2018.
https://www.pubmed.ncbi.nlm.nih.gov/33017011
JAMA Pediatr 2020 Dec;174(12):1176-83. doi: 10.1001/jamapediatrics.2020.3223..
JAMA Pediatr 2020 Dec;174(12):1176-83. doi: 10.1001/jamapediatrics.2020.3223..
Keywords: Children/Adolescents, Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU)
Rinke ML, Oyeku SO, Ford WJH
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This retrospective case control study estimated additional costs associated with pediatric ambulatory central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery. The authors concluded that ambulatory HAI in pediatric patients were associated with significant additional costs.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Ford WJH .
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Infect Control Hosp Epidemiol 2020 Nov;41(11):1292-97. doi: 10.1017/ice.2020.305..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Ambulatory Care and Surgery, Healthcare Costs, Surgery
Thate JA, Couture B, Schnock KO
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
It is clear that interdisciplinary communication and collaboration have the potential to mitigate healthcare-associated harm, yet there is limited research on how communication through documentation in the patient record can support collaborative decision making. Understanding what information is needed to support collaborative decision making is necessary to design electronic health information systems that facilitate effective communication and, ultimately, safe care. To explore this issue, the investigators focused on information needs related to central venous catheter management and the prevention of central line-associated blood stream infections.
AHRQ-funded; HS0235335.
Citation: Thate JA, Couture B, Schnock KO .
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
Comput Inform Nurs 2020 Nov 2;39(4):208-14. doi: 10.1097/cin.0000000000000683..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Shared Decision Making, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Vaughn VM, O'Malley M, Flanders SA
Association of infectious disease physician approval of peripherally inserted central catheter with appropriateness and complications.
The purpose of this study was to evaluate whether infectious disease physician approval prior to PICC placement for intravenous antimicrobials was associated with more appropriate device use and fewer complications. The authors concluded that this cohort study suggested that, when PICCs were placed for intravenous antimicrobial therapy, infectious disease physician approval of PICC insertion was associated with more appropriate device use and fewer complications.
AHRQ-funded; HS026530; HS025891.
Citation: Vaughn VM, O'Malley M, Flanders SA .
Association of infectious disease physician approval of peripherally inserted central catheter with appropriateness and complications.
JAMA Netw Open 2020 Oct;3(10):e2017659. doi: 10.1001/jamanetworkopen.2020.17659..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases, Adverse Events
Keller S, Salinas A, Williams D
Reaching consensus on a home infusion central line-associated bloodstream infection surveillance definition via a modified Delphi approach.
A consensus on a central line-associated bloodstream infection (CLABSI) surveillance definition in home infusion is needed to standardize measurement and benchmark CLABSI to provide data to drive improvement initiatives. Experts across fields including home infusion therapy, infectious diseases, and healthcare epidemiology convened to perform a 3-step modified Delphi approach to obtain input and achieve consensus on a candidate home infusion CLABSI definition. This paper describes the process.
AHRQ-funded; HS025782.
Citation: Keller S, Salinas A, Williams D .
Reaching consensus on a home infusion central line-associated bloodstream infection surveillance definition via a modified Delphi approach.
Am J Infect Control 2020 Sep;48(9):993-1000. doi: 10.1016/j.ajic.2019.12.015..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Home Healthcare
Hsu HE, Wang R, Broadwell C
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
The authors assessed the association of Hospital-Acquired Condition Reduction Program (HACRP) and Hospital Value-Based Purchasing (HVBP) implementation with changes in rates of targeted health care-associated infections and disparities in rates among safety-net and non-safety-net hospitals. They found that HACRP and HVBP implementation was not associated with any improvements in targeted health care-associated infections among safety-net or non-safety-net hospitals or with changes in disparities in infection rates. They concluded that, given the persistent health care-associated infection rate disparities, these programs appear to function as a disproportionate penalty system for safety-net hospitals that offer no measurable benefits for patients.
AHRQ-funded; HS018414.
Citation: Hsu HE, Wang R, Broadwell C .
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
JAMA Netw Open 2020 Jul;3(7):e209700. doi: 10.1001/jamanetworkopen.2020.9700..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Medicare, Patient Safety
Luzum M, Sebolt J, Chopra V
Catheter-associated urinary tract infection, Clostridioides difficile colitis, central line-associated bloodstream infection, and methicillin-resistant Staphylococcus aureus.
This article provides summaries of the background, epidemiology, diagnosis, and treatment of central line-associated bloodstream infection, catheter-associated urinary tract infection, Clostridioides difficile, and methicillin-resistant Staphylococcus aureus colonization and infections. Additional prevention strategies, including those related to recent national interventions, are also reviewed.
AHRQ-funded; HS022835.
Citation: Luzum M, Sebolt J, Chopra V .
Catheter-associated urinary tract infection, Clostridioides difficile colitis, central line-associated bloodstream infection, and methicillin-resistant Staphylococcus aureus.
Med Clin North Am 2020 Jul;104(4):663-79. doi: 10.1016/j.mcna.2020.02.004..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Clostridium difficile Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases
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
Gohil SK, Yim J, Quan K
Impact of a Central-Line Insertion Site Assessment (CLISA) score on localized insertion site infection to prevent central-line-associated bloodstream infection (CLABSI).
This study assessed the impact of a newly developed Central-Line Insertion Site Assessment (CLISA) score on the incidence of site inflammation or infection for CLABSI prevention. A cohort of adult inpatients with central venous catheters (CVCs) hospitalized in an intensive care unit or oncology ward at a large academic medical center participated. CLISA score impacts were evaluated with a CLISA score of 2 or 3 indicating insertion site inflammation and infection. The baseline study period was June 2014 through January 2015 and the intervention period April 2015 through October 2017. During that time CLISA scores of 2 or 3 in the baseline and intervention periods decreased by 78.2%. Days to removal of lines on patients with a CLISA score of 2 or 3 was 3.19 days faster after the intervention. Line dwell time also decreased by 37.1% from a mean of 14 days to 8.8 days.
AHRQ-funded; HS024424.
Citation: Gohil SK, Yim J, Quan K .
Impact of a Central-Line Insertion Site Assessment (CLISA) score on localized insertion site infection to prevent central-line-associated bloodstream infection (CLABSI).
Infect Control Hosp Epidemiol 2020 Jan;41(1):59-66. doi: 10.1017/ice.2019.291..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Prevention, Patient Safety
Woods-Hill CZ, Srinivasan L, Schriver E
Novel risk factors for central-line associated bloodstream infections in critically ill children.
Central-line-associated bloodstream infections (CLABSI) cause morbidity and mortality in critically ill children. In this study the investigators examined novel and/or modifiable risk factors for CLABSI to identify new potential targets for infection prevention strategies. They found that novel risk factors for CLABSI in PICU patients included acute behavioral health needs and >80 CVC accessed in the 3 days before CLABSI. They suggest that interventions focused on these factors may reduce CLABSIs in this high-risk population.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Srinivasan L, Schriver E .
Novel risk factors for central-line associated bloodstream infections in critically ill children.
Infect Control Hosp Epidemiol 2020 Jan;41(1):67-72. doi: 10.1017/ice.2019.302..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Children/Adolescents, Intensive Care Unit (ICU), Risk, Patient Safety
Keller SC, Williams D, Rock C
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
As more home infusion agencies consider ways to perform surveillance for central line–associated bloodstream infection (CLABSI), an understanding of the assorted challenges is necessary. The authors discussed these challenges, which include a lack of a widely accepted standard definition of CLABSIs in home infusion therapy, the lack of a reporting platform, the absence of a reporting requirement, and barriers in obtaining the needed information to identify the presence of a potential CLABSI and adjudicate whether it meets a CLABSI definition. The 21st Century Cures Act will expand Medicare coverage for home infusion therapy services by 2021, likely leading to increased pressure for home infusion therapy CLABSI surveillance. Benchmarking of CLABSI data can usher in informed work to reduce CLABSIs and enhance patient safety in home infusion therapy.
AHRQ-funded; HS025782.
Citation: Keller SC, Williams D, Rock C .
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
Am J Infect Control 2018 Dec;46(12):1419-21. doi: 10.1016/j.ajic.2018.05.016..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Home Healthcare, Patient Safety, Sepsis, Infectious Diseases, Prevention
Calderwood MS, Kawai AT, Jin R
Centers for Medicare and Medicaid services hospital-acquired conditions policy for central line-associated bloodstream infection (CLABSI) and cather-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement.
In 2008, the Centers for Medicare and Medicaid Services (CMS) stopped reimbursing for hospital-acquired conditions (HACs) not present on admission (POA). This study sought to understand why this policy did not impact central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) trends.
AHRQ-funded; HS018414.
Citation: Calderwood MS, Kawai AT, Jin R .
Centers for Medicare and Medicaid services hospital-acquired conditions policy for central line-associated bloodstream infection (CLABSI) and cather-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement.
Infect Control Hosp Epidemiol 2018 Aug;39(8):897-901. doi: 10.1017/ice.2018.137..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety
Lee YSH, Stone PW, Pogorzelska-Maziarz M
Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.
The objective of this study was to determine what aspects of the work environment lead to better adherence to best safety practice for central line-associated bloodstream infections (CLABSIs) prevention. Data was obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey with data on ICU and hospital characteristics obtained from the National Healthcare Safety Network. Workload and a quality-conscious environment were the most important factors associated with CLABSI bundle compliance.
AHRQ-funded; HS018987.
Citation: Lee YSH, Stone PW, Pogorzelska-Maziarz M .
Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.
Health Care Manage Rev 2018 Apr/Jun;43(2):138-47. doi: 10.1097/hmr.0000000000000134..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Patient Safety, Prevention
Paje D, Conlon A, Kaatz S
Patterns and predictors of short-term peripherally inserted central catheter use: a multicenter prospective cohort study.
The goal of this study was to identify patient, provider, and device characteristics and the clinical outcomes associated with short-term peripherally inserted central catheters (PICCs). Trained abstractors collected data from the medical records of adults that received PICCs during hospitalization; patients were prospectively followed until PICC removal, death, or 70 days after insertion. Complications associated with short-term use were assessed. Major complications included venous thromboembolism or central line associated bloodstream infection. Common minor complications were catheter occlusion and tip migration.
AHRQ-funded; HS022835.
Citation: Paje D, Conlon A, Kaatz S .
Patterns and predictors of short-term peripherally inserted central catheter use: a multicenter prospective cohort study.
J Hosp Med 2018 Feb;13(2):76-82. doi: 10.12788/jhm.2847..
Keywords: Adverse Events, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Inpatient Care, Patient Safety, Practice Patterns
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)
Govindan S, Wallace B, Iwashyna TJ
Do experts understand performance measures? A mixed-methods study of infection preventionists.
This study assessed expert interpretation of CLABSI quality data using a cross-sectional survey of members of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). The investigators found that significant variability in the interpretation of CLABSI data exists among experts. They assert that this finding is likely related to data complexity, particularly with respect to risk-adjusted data. They suggest that improvements appear necessary in data sharing and public policy efforts to account for this complexity.
AHRQ-funded; HS022835.
Citation: Govindan S, Wallace B, Iwashyna TJ .
Do experts understand performance measures? A mixed-methods study of infection preventionists.
Infect Control Hosp Epidemiol 2018 Jan;39(1):71-76. doi: 10.1017/ice.2017.243..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Provider, Provider Performance, Quality of Care, Quality Measures