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Topics
- Asthma (1)
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- Children/Adolescents (2)
- Evidence-Based Practice (3)
- (-) Guidelines (6)
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- Hospitalization (1)
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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 6 of 6 Research Studies DisplayedThom KA, Rock C, Robinson GL
Direct gloving vs hand hygiene before donning gloves in adherence to hospital infection control practices: a cluster randomized clinical trial.
The purpose of this study was to assess the effectiveness of a direct-gloving policy on adherence to infection prevention control practices in a hospital setting. In this study, hospital units were randomly assigned to either the intervention (hand hygiene not required before putting on gloves) or to usual care (hand hygiene required prior to before putting on nonsterile gloves). The primary study outcome was adherence to the expected practice upon room entry and room exit. Thirteen hospital units participated in the trial, and 3,790 health care personnel (HCP) were observed. The study found that adherence to expected practice was higher in the 6 units with the direct-gloving intervention than in the 7 usual care units even when controlling for baseline hand hygiene rates, unit type, and universal gloving policies. The intervention had no effect on hand hygiene adherence measured at entry to non-contact precautions rooms or at room exit. The intervention was related with increased total bacteria colony counts and increased detection of pathogenic bacteria on gloves in the ED and reduced colony counts in pediatrics units, with no change in either total colony count for adult intensive care unit or presence of pathogenic bacteria for adult intensive care unit.
AHRQ-funded; HS024108.
Citation: Thom KA, Rock C, Robinson GL .
Direct gloving vs hand hygiene before donning gloves in adherence to hospital infection control practices: a cluster randomized clinical trial.
JAMA Netw Open 2023 Oct 2; 6(10):e2336758. doi: 10.1001/jamanetworkopen.2023.36758..
Keywords: Hospitals, Patient Safety, Guidelines, Healthcare-Associated Infections (HAIs)
Adhia AH, Feinglass JM, Schlick CJR
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
This study developed quality measures for management of stage III esophageal cancer including: utilization of neoadjuvant therapy, surgical sampling of at least 15 lymph nodes, resection within 60 days of chemotherapy or radiation, and completeness of resection to determine whether hospital volume varies measure adherence of published guidelines. A total of 1345 hospitals participating in the National Cancer Database from 2004 to 2016 were included. The authors examined association of volume, program accreditation, safety net status, geographic region, and patient travel distance on adequate adherence (≥85% of patients are adherent) using logistic regression modeling. The rate of adequate adherence was worst in nodal staging at 12.6% and highest for utilization of neoadjuvant therapy at 84.8%. Academic programs had the highest rate of adequate adherence for induction therapy (77.2%), timing of surgery (56.6%), and completeness of resection (78.5%) but lowest for nodal staging at only 4.4%. Every additional esophagectomy performed per year increased the odds of adequate adherence for induction therapy and completeness of resection but decreased for nodal staging.
AHRQ-funded; HS026385.
Citation: Adhia AH, Feinglass JM, Schlick CJR .
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
Ann Thorac Surg 2022 Oct;114(4):1176-82. doi: 10.1016/j.athoracsur.2021.07.092..
Keywords: Hospitals, Cancer, Guidelines, Evidence-Based Practice
Kaiser SV, Lam Cabana, MD
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
The objective of this study was to identify potential best practices in pathway implementation. Building upon a previous observational study in which the researchers identified higher and lower performing children's hospitals based on hospital-level changes in asthma patient length of stay after implementation of a pathway, they conducted semi-structured interviews with a sample of healthcare providers involved in pathway implementation at these hospitals. They identified several potential best practices to support pathway implementation. They recommended that hospitals implementing pathways consider applying these strategies to ensure success in improving quality of asthma care for children.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Lam Cabana, MD .
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
J Asthma 2020 Jul;57(7):744-54. doi: 10.1080/02770903.2019.1606237..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Hospitals, Inpatient Care, Guidelines, Evidence-Based Practice, Implementation, Quality Improvement, Quality of Care
Leyenaar JK, Shevenell M, Rizzo PA
Multi-stakeholder informed guidelines for direct admission of children to hospital.
The purpose of this study is to develop pediatric direct admission guidelines and prioritize outcomes to evaluate the safety and effectiveness of hospital admission processes. The investigators concluded that these direct admission guidelines can be adapted by hospitals and health systems to inform hospital admission policies and protocols. Multistakeholder engagement in evaluation of hospital admission processes may improve transitions of care and health system integration.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Shevenell M, Rizzo PA .
Multi-stakeholder informed guidelines for direct admission of children to hospital.
J Pediatr 2018 Jul;198:273-78.e7. doi: 10.1016/j.jpeds.2018.03.007..
Keywords: Children/Adolescents, Guidelines, Hospitalization, Hospitals, Patient Safety
Ban KA, Gibbons MM, Ko CY
Surgical technical evidence review for colorectal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
The objective of this article is to provide a comprehensive review of the evidence supporting the surgical components of the Improving Surgical Care and Recovery (ISCR) colorectal (CR) pathway. This review will evaluate the evidence supporting CR pathways and develop an evidence-based CR protocol to help hospitals participating in the ISCR program implement evidence-based practices.
AHRQ-funded; 233201500020I.
Citation: Ban KA, Gibbons MM, Ko CY .
Surgical technical evidence review for colorectal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2017 Oct;225(4):548-57.e3. doi: 10.1016/j.jamcollsurg.2017.06.017.
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Keywords: Evidence-Based Practice, Hospitals, Patient Safety, Quality Improvement, Surgery, Quality of Care, Guidelines
Moehring RW, Hazen KC, Hawkins MR
Challenges in preparation of cumulative antibiogram reports for community hospitals.
This descriptive cohort study of antibiogram reporting practices included community hospitals enrolled in the Duke Infection Control Outreach Network. Survey respondents’ self-assessment of full or partial compliance with Clinical and Laboratory Standards Institute (CLSI) guidelines was 50 percent and 15 percent, respectively; 33 percent reported uncertainty with CLSI guidelines. Full adherence to CLSI guidelines for hospital antibiograms was uncommon.
AHRQ-funded; HS023866.
Citation: Moehring RW, Hazen KC, Hawkins MR .
Challenges in preparation of cumulative antibiogram reports for community hospitals.
J Clin Microbiol 2015 Sep;53(9):2977-82. doi: 10.1128/jcm.01077-15..
Keywords: Hospitals, Patient Safety, Guidelines