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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Antimicrobial Stewardship (1)
- Care Coordination (1)
- Clinical Decision Support (CDS) (2)
- Communication (2)
- Comparative Effectiveness (1)
- Dementia (1)
- Diagnostic Safety and Quality (2)
- Elderly (6)
- Falls (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Home Healthcare (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Influenza (1)
- Long-Term Care (5)
- Medication (4)
- (-) Nursing Homes (16)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (1)
- Pressure Ulcers (1)
- Prevention (3)
- Provider: Health Personnel (1)
- Public Reporting (1)
- Quality Improvement (2)
- Quality Measures (1)
- Quality of Care (5)
- Shared Decision Making (1)
- Vaccination (1)
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 DisplayedHwang D, Teno JM, Clark M
Family perceptions of quality of hospice care in the nursing home.
The investigators examined bereaved family members' perceptions of nursing home-hospice collaborations in terms of what family members believe went well or could have been improved. The focus group participants identified three major aspects of collaboration as important to care delivery: knowing who (nursing home or hospice) is responsible for which aspects of patient care, concern about information coordination between the nursing home and hospice, and the need for hospice to advocate for high-quality care rather than their having to directly do so on behalf of their family members. These concerns have been incorporated into the revised Family Evaluation of Hospice Care, a post-death survey used to evaluate quality of hospice care.
AHRQ-funded; HS019675.
Citation: Hwang D, Teno JM, Clark M .
Family perceptions of quality of hospice care in the nursing home.
J Pain Symptom Manage 2014 Dec;48(6):1100-7. doi: 10.1016/j.jpainsymman.2014.04.003.
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Keywords: Care Coordination, Nursing Homes, Palliative Care, Quality of Care
Thomas KS, Rahman M, Mor V
Influence of hospital and nursing home quality on hospital readmissions.
The authors sought to determine whether the quality of the hospital and of the nursing home (NH) to which a patient was discharged were related to the likelihood of rehospitalization. They found that patients discharged from higher-quality hospitals and patients who received care in higher-quality NHs were less likely to be rehospitalized within 30 days. They concluded that the passage of the Affordable Care Act changed the accountability of hospitals for patients' outcomes after discharge, and that their study highlights the joint accountability of hospitals and NHs for rehospitalization of patients.
AHRQ-funded; HS000011.
Citation: Thomas KS, Rahman M, Mor V .
Influence of hospital and nursing home quality on hospital readmissions.
Am J Manag Care 2014 Nov;20(11):e523-31.
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Keywords: Quality of Care, Hospitals, Nursing Homes, Patient-Centered Outcomes Research, Hospital Readmissions
Boyce RD, Perera S, Nace DA
A survey of nursing home physicians to determine laboratory monitoring adverse drug event alert preferences.
The researchers conducted a survey to learn about the laboratory value thresholds that clinical event monitors should use to generate alerts about potential adverse drug events (ADEs). They found that the majority of physicians surveyed prefer alerting thresholds that would generally lead to fewer alerts than if widely accepted standardized laboratory ranges were used.
AHRQ-funded; HS019461; HS018721.
Citation: Boyce RD, Perera S, Nace DA .
A survey of nursing home physicians to determine laboratory monitoring adverse drug event alert preferences.
Appl Clin Inform 2014 Oct 29;5(4):895-906. doi: 10.4338/aci-2014-06-ra-0053..
Keywords: Nursing Homes, Clinical Decision Support (CDS), Adverse Events
Lucas JA, Chakravarty S, Bowblis JR
Antipsychotic medication use in nursing homes: a proposed measure of quality.
There is an important need for a more specific measure of quality related to antipsychotic medication (APM) use. This paper proposes such a measure, compares it with the APM quality measure introduced by CMS in 2012 and examines variation in these two measures across resident and facility characteristics using a multi-state case demonstration of long-stay NH residents.
AHRQ-funded; HS021112.
Citation: Lucas JA, Chakravarty S, Bowblis JR .
Antipsychotic medication use in nursing homes: a proposed measure of quality.
Int J Geriatr Psychiatry 2014 Oct;29(10):1049-61. doi: 10.1002/gps.4098..
Keywords: Medication, Nursing Homes, Elderly, Quality Measures, Quality Measures
Campbell LJ, Li Q, Li Y
Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
The authors identified nursing home (NH) characteristics that may be associated with employee influenza vaccination rates (EVRs). They concluded that, as NHs generally have low EVRs, it may be necessary to target low-performing facilities to achieve substantial improvements.
AHRQ-funded; HS000044.
Citation: Campbell LJ, Li Q, Li Y .
Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
J Am Med Dir Assoc 2014 Oct;15(10):768-72. doi: 10.1016/j.jamda.2014.06.005.
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Keywords: Provider: Health Personnel, Influenza, Nursing Homes, Prevention, Vaccination
Kahvecioglu D, Ramiah K, McMaughan D
Multidrug-resistant organism infections in US nursing homes: a national study of prevalence, onset, and transmission across care settings, October 1, 2010-December 31, 2011.
The investigators sought to understand the prevalence of multidrug-resistant organism (MDRO) infections among nursing home (NH) residents and the potential for their spread between NHs and acute care hospitals (ACHs). They found that, although NHs are the most likely setting where residents would acquire MDROs after admission to an NH, a significant fraction of NH residents acquire MDRO infection at ACHs, suggesting a need for effective MDRO infection control for NH residents with simultaneous, cooperative interventions among NHs and ACHs in the same community.
AHRQ-funded; HS019989.
Citation: Kahvecioglu D, Ramiah K, McMaughan D .
Multidrug-resistant organism infections in US nursing homes: a national study of prevalence, onset, and transmission across care settings, October 1, 2010-December 31, 2011.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S48-55. doi: 10.1086/677835.
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Keywords: Elderly, Healthcare-Associated Infections (HAIs), Medication, Nursing Homes, Patient Safety
Furuno JP, Comer AC, Johnson JK
Using antibiograms to improve antibiotic prescribing in skilled nursing facilities.
The researchers describe the design and implementation of a skilled nursing facility (SNF) specific antibiogram to improve empirical antibiotic prescribing. They estimated the frequency of inappropriate antibiotic prescribing in 3 Maryland SNFs and measured the effectiveness of the antibiograms on antibiotic prescribing in 1 of the SNFs.
AHRQ-funded; 290200600020I
Citation: Furuno JP, Comer AC, Johnson JK .
Using antibiograms to improve antibiotic prescribing in skilled nursing facilities.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S56-61. doi: 10.1086/677818..
Keywords: Long-Term Care, Antimicrobial Stewardship, Nursing Homes, Diagnostic Safety and Quality
Arling PA, Abrahamson K, Miech EJ
Communication and effectiveness in a US nursing home quality-improvement collaborative.
The investigators explored the relationship between changes in resident health outcomes, practitioner communication patterns, and practitioner perceptions of group effectiveness within a quality-improvement collaborative of nursing home clinicians. They found that reductions in fall rates were highest in facilities where respondents experienced the highest levels of communication with collaborative members outside of scheduled meetings. Clinician and practitioner observations were discussed.
AHRQ-funded; HS018464.
Citation: Arling PA, Abrahamson K, Miech EJ .
Communication and effectiveness in a US nursing home quality-improvement collaborative.
Nurs Health Sci 2014 Sep;16(3):291-7. doi: 10.1111/nhs.12098.
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Keywords: Communication, Falls, Nursing Homes, Quality of Care, Prevention, Quality Improvement
Abrahamson K, Mueller C, Davila HW
Nurses as boundary-spanners in reducing avoidable hospitalizations among nursing home residents.
The researchers interviewed 76 nurses working at 38 nursing homes that were implementing quality improvement projects to reduce avoidable hospitalizations. They explored the role of the nurse as boundary-spanner between the organizational goals of the nursing home and external stakeholder systems and how that influences the nursing staff experience.
AHRQ-funded; HS018464
Citation: Abrahamson K, Mueller C, Davila HW .
Nurses as boundary-spanners in reducing avoidable hospitalizations among nursing home residents.
Res Gerontol Nurs. 2014 Sep-Oct;7(5):235-43. doi: 10.3928/19404921-20140519-01..
Keywords: Nursing Homes, Long-Term Care, Elderly, Quality of Care, Quality Improvement
Huybrechts KF, Gerhard T, Franklin JM
Instrumental variable applications using nursing home prescribing preferences in comparative effectiveness research.
The objective of this study was to explore the presence of unexplained between-nursing home (NH) variation in prescribing and to empirically evaluate the validity of instruments based on NH prescribing preference. High-prescribing and low-prescribing nursing homes differed by a factor of 2. There was no evidence that instrument status was associated with markers of nursing home quality of care.
AHRQ-funded; 290200500161; HS021112
Citation: Huybrechts KF, Gerhard T, Franklin JM .
Instrumental variable applications using nursing home prescribing preferences in comparative effectiveness research.
Pharmacoepidemiol Drug Saf 2014 Aug;23(8):830-8. doi: 10.1002/pds.3611..
Keywords: Nursing Homes, Comparative Effectiveness, Medication, Quality of Care
Alexander GL, Pasupathy KS, Steege LM
Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.
The researchers describe a mixed methods approach to communications strategies for skin risk used by health care providers in nursing homes with high IT sophistication. Using rigorous observation and social networking tools as well as focus groups, they sought to understand where and when skin risk communications took place between nurses and nurse assistants in nursing homes with greater IT adoption.
AHRQ-funded; HS016862
Citation: Alexander GL, Pasupathy KS, Steege LM .
Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.
Int J Med Inform. 2014 Aug;83(8):581-91. doi: 10.1016/j.ijmedinf.2014.05.001..
Keywords: Communication, Health Information Technology (HIT), Nursing Homes
Olsho LE, Spector WD, Williams CS
AHRQ Author: Spector WD
Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes.
The researchers evaluated the effectiveness of the On-Time Quality Improvement for Long Term Care (On-Time) program in reducing the rate of in-house-acquired pressure ulcers among nursing home residents. They found that On-Time implementation is associated with sizable reductions in pressure ulcer incidence.
AHRQ-authored; AHRQ-funded; 290200600011I.
Citation: Olsho LE, Spector WD, Williams CS .
Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes.
Med Care 2014 Mar;52(3):258-66. doi: 10.1097/mlr.0000000000000080.
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Keywords: Clinical Decision Support (CDS), Long-Term Care, Nursing Homes, Pressure Ulcers, Prevention
Konetzka RT, Brauner DJ, Shega J
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
The purpose of this paper was to assess whether reductions in physical restraint use associated with quality reporting may have had the unintended consequence of increasing antipsychotic use in nursing home (NH) residents with severe cognitive impairment. Physical restraint use declined significantly from 1999 to 2008 in NH residents with severe cognitive impairment. Correspondingly, antipsychotic use in the same residents increased more in NHs that were subject to public reporting. This analysis suggests that public reporting of physical restraint use had the unintended consequence of increasing use of antipsychotics in NH residents with severe cognitive impairment.
AHRQ-funded; HS018718.
Citation: Konetzka RT, Brauner DJ, Shega J .
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
J Am Geriatr Soc 2014 Mar;62(3):454-61. doi: 10.1111/jgs.12711.
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Keywords: Dementia, Elderly, Medication, Nursing Homes, Public Reporting
Thomas KS
The relationship between Older Americans Act in-home services and low-care residents in nursing homes.
This study examining the relationship between the proportion of older adults in a State who receive in-home services funded by the Older Americans Act and the proportion of residents in nursing homes finds that for every additional 1 percent of the 65+ population that receives personal care services, there is a 0.8% decrease in the proportion of low-care residents in nursing homes.
AHRQ-funded; HS00011
Citation: Thomas KS .
The relationship between Older Americans Act in-home services and low-care residents in nursing homes.
J Aging Health. 2014 Mar;26(2):250-60. doi: 10.1177/0898264313513611..
Keywords: Elderly, Long-Term Care, Home Healthcare, Nursing Homes, Healthcare Delivery
Spector WD
AHRQ Author: Spector WD
Response to letter to the editor regarding the paper "potentially avoidable hospitalization for elderly long-stay residents in nursing homes".
The author argues against the strategy than is implied by Dr. Powers’ letter to the editor. Rather than adding one aspect of care organization at a time to administrative data, he states that we should identify a small set of easily collected measures that generally modify the effects of care organization innovations. With these in place, we can then add measures like consistent assignment to better understand how it improves clinical outcomes.
AHRQ-authored
Citation: Spector WD .
Response to letter to the editor regarding the paper "potentially avoidable hospitalization for elderly long-stay residents in nursing homes".
Med Care 2014 Jan;52(1):93-4. doi: 10.1097/mlr.0000000000000072..
Keywords: Hospitalization, Elderly, Outcomes, Long-Term Care, Nursing Homes
Sloane PD, Kistler C, Mitchell CM
Role of body temperature in diagnosing bacterial infection in nursing home residents.
The goals of this study were to provide empirically based guidance on the role of body temperature and fever in the clinical diagnosis of infections. When the researchers compared their empirically derived definitions of fever with those commonly used to justify the prescription of antibiotics for systemic infections, they concluded that the empirical, less-stringent definitions appeared to better fit the clinical realities of nursing home work.
AHRQ-funded; 290200600011I.
Citation: Sloane PD, Kistler C, Mitchell CM .
Role of body temperature in diagnosing bacterial infection in nursing home residents.
J Am Geriatr Soc 2014 Jan;62(1):135-40..
Keywords: Nursing Homes, Diagnostic Safety and Quality, Shared Decision Making