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Topics
- Antibiotics (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (4)
- Children/Adolescents (6)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (1)
- Comparative Effectiveness (1)
- Dental and Oral Health (1)
- Elderly (6)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (12)
- Health Information Technology (HIT) (1)
- Infectious Diseases (2)
- Influenza (1)
- (-) Long-Term Care (20)
- Medication (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (3)
- Nursing Homes (11)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (8)
- Pneumonia (1)
- Pressure Ulcers (2)
- (-) Prevention (20)
- Public Health (1)
- Respiratory Conditions (1)
- Urinary Tract Infection (UTI) (3)
- 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 20 of 20 Research Studies DisplayedCannon JL, Park GW, Anderson B
Hygienic monitoring in long-term care facilities using ATP, crAssphage, and human noroviruses to direct environmental surface cleaning.
Norovirus and C. difficile can be transmitted by contaminated environmental surfaces and are associated with diarrheal illnesses and deaths in long-term care (LTC) facilities. Hygienic monitoring tools such as adenosine triphosphate (ATP) bioluminescence and indicators of fecal contamination can help to identify LTC facility surfaces with cleaning deficiencies. The researchers swabbed and tested high-touch surfaces in 11 LTC facilities for contamination by norovirus, a fecal indicator virus, crAssphage, and ATP. The study found that greater than 90% of surfaces tested positive for crAssphage or failed in their ATP scores. Norovirus contamination was not detected. Handrails, equipment controls, and patient beds were 4 times more likely than other surfaces or locations to have high levels of crAssphage. Patient bed handrails and tables and chairs in patient lounges had high levels of both ATP and crAssphage.
AHRQ-funded; HS025987.
Citation: Cannon JL, Park GW, Anderson B .
Hygienic monitoring in long-term care facilities using ATP, crAssphage, and human noroviruses to direct environmental surface cleaning.
Am J Infect Control 2022 Mar; 50(3):289-94. doi: 10.1016/j.ajic.2021.11.014..
Keywords: Nursing Homes, Long-Term Care, Prevention, Healthcare-Associated Infections (HAIs), Clostridium difficile Infections
Kim JJ, Johnson JK, Stucke EM
Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves.
Transmission of Staphylococcus aureus (S. aureus) to health care workers (HCWs) on gowns and gloves has been an issue in nursing homes. This study evaluated the effect of the burden in 13 community-based nursing homes in Maryland and Michigan. Residents were cultured for S. aureus at the perianal skin and the anterior nares areas. A total of 403 residents were enrolled, with 169 colonized with methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA). Transmission to HCW gowns and gloves was greater from those colonized with greater quantities of S. aureus on the perianal skin. These findings inform future infection control practices for both MRSA and MSSA in nursing homes.
AHRQ-funded; HS019979; HS025451.
Citation: Kim JJ, Johnson JK, Stucke EM .
Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves.
Infect Control Hosp Epidemiol 2020 Dec;41(12):1396-401. doi: 10.1017/ice.2020.336..
Keywords: Elderly, Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs), Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention
Zimmerman S, Sloane PD, Ward K
Effectiveness of a mouth care program provided by nursing home staff vs standard care on reducing pneumonia incidence: a cluster randomized trial.
Pneumonia affects more than 250 000 nursing home (NH) residents annually. A strategy to reduce pneumonia is to provide daily mouth care, especially to residents with dementia. The objective of this study was to evaluate the effectiveness of Mouth Care Without a Battle, a program that increases staff knowledge and attitudes regarding oral hygiene, changes mouth care, and improves oral hygiene, in reducing the incidence of pneumonia among NH residents.
AHRQ-funded; HS022298.
Citation: Zimmerman S, Sloane PD, Ward K .
Effectiveness of a mouth care program provided by nursing home staff vs standard care on reducing pneumonia incidence: a cluster randomized trial.
JAMA Netw Open 2020 Jun;3(6):e204321. doi: 10.1001/jamanetworkopen.2020.4321..
Keywords: Pneumonia, Nursing Homes, Long-Term Care, Dental and Oral Health, Prevention, Patient Safety
Zullo AR, Ofori-Asenso R, Wood M
Effects of statins for secondary prevention on functioning and other outcomes among nursing home residents.
Studies examining the effects of statins after acute myocardial infarction (AMI) excluded frail older adults, especially nursing home (NH) residents, and few examined functional outcomes. Older NH residents may benefit less from statins and be particularly susceptible to adverse drug events like myopathy-related functional decline. In this retrospective cohort study, the investigators evaluated the effects of statins on 1-year functional decline, rehospitalization, and death in NH residents.
AHRQ-funded; HS022998.
Citation: Zullo AR, Ofori-Asenso R, Wood M .
Effects of statins for secondary prevention on functioning and other outcomes among nursing home residents.
J Am Med Dir Assoc 2020 Apr;21(4):500-07.e8. doi: 10.1016/j.jamda.2020.01.102..
Keywords: Elderly, Nursing Homes, Long-Term Care, Medication, Prevention, Outcomes, Evidence-Based Practice, Patient-Centered Outcomes Research
Adams C, Young D, Gastanaduy PA
Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks.
Norovirus transmissibility is poorly understood and the goal of this study was to examine transmission via vomiting, diarrhea, and patient exposures. Six nursing home outbreaks in South Carolina were examined from 2014 to 2016. Vomiting infected 2.12 times the number of individuals as non-vomiters, diarrhea 1.39 times, and resident cases infected 1.53 times the number of individuals as staff cases. This finding is important for not just nursing homes, but other sites of norovirus outbreaks such as cruise ships.
AHRQ-funded; HS025987.
Citation: Adams C, Young D, Gastanaduy PA .
Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks.
PLoS Comput Biol 2020 Mar;16(3):e1007271. doi: 10.1371/journal.pcbi.1007271..
Keywords: Elderly, Nursing Homes, Long-Term Care, Infectious Diseases, Healthcare-Associated Infections (HAIs), Prevention, Public Health
Wilmont S, Hessels AJ, Kelly AM
Family experiences and perspectives on infection prevention in pediatric long-term care.
The aims of this qualitative study were to (a) explore perspectives on infection prevention among families visiting children in pediatric long-term care facilities and (b) identify facilitators of and barriers to optimal hand hygiene using semistructured in-depth interviews with 10 family members visiting two New York City metropolitan area facilities.
AHRQ-funded; HS021470.
Citation: Wilmont S, Hessels AJ, Kelly AM .
Family experiences and perspectives on infection prevention in pediatric long-term care.
Children/Adolescents, Healthcare-Associated Infections, Long-term Care, Pediatrics, Prevention Practices.
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Prevention, Patient Safety
Krein SL, Greene MT, King B
Assessing a national collaborative program to prevent catheter-associated urinary tract infection in a Veterans Health Administration nursing home cohort.
Collaborative programs have helped reduce catheter-associated urinary tract infection (CAUTI) rates in community-based nursing homes. This study assessed whether collaborative participation produced similar benefits among Veterans Health Administration (VHA) nursing homes. The researchers found that no changes in CAUTI rates, catheter use, or urine culture orders were found during the program period. One potential reason was the relatively low baseline CAUTI rate, as compared with a cohort of community-based nursing homes.
AHRQ-funded; 290201000025I.
Citation: Krein SL, Greene MT, King B .
Assessing a national collaborative program to prevent catheter-associated urinary tract infection in a Veterans Health Administration nursing home cohort.
Infect Control Hosp Epidemiol 2018 Jul;39(7):820-25. doi: 10.1017/ice.2018.99..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Long-Term Care, Nursing Homes, Patient Safety, Prevention, Urinary Tract Infection (UTI)
Larson EL, Murray MT, Cohen B
Behavioral interventions to reduce infections in pediatric long-term care facilities: the keep it clean for kids trial.
Researchers examined the success of behavioral interventions to reduce infections in pediatric long-term care facilities. The intervention, called Keep it Clean for Kids, included leadership commitment, frequent hand-washing, and electronic monitoring of hand hygiene. Improvements were show in infection reduction in two sites, fewer hospitalizations in all sites, and varied outcomes in the number of outbreaks/cases.
AHRQ-funded; HS021470.
Citation: Larson EL, Murray MT, Cohen B .
Behavioral interventions to reduce infections in pediatric long-term care facilities: the keep it clean for kids trial.
Behav Med 2018 Apr-Jun;44(2):141-50. doi: 10.1080/08964289.2017.1288607..
Keywords: Children/Adolescents, Long-Term Care, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Mody L, Greene MT, Meddings J
AHRQ Author: Burwen DR, Battles J
A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents.
The researchers developed, implemented, and evaluated an intervention to reduce catheter-associated urinary tract infection (UTI). They found that in a large-scale, national implementation project involving community-based nursing homes, combined technical and socioadaptive catheter-associated UTI prevention interventions successfully reduced the incidence of catheter-associated UTIs.
AHRQ-authored; AHRQ-funded; 290201000025I; HS019767; HS024385; HS018334.
Citation: Mody L, Greene MT, Meddings J .
A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents.
JAMA Intern Med 2017 Aug;177(8):1154-62. doi: 10.1001/jamainternmed.2017.1689.
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Keywords: Antibiotics, Catheter-Associated Urinary Tract Infection (CAUTI), Elderly, Long-Term Care, Nursing Homes, Prevention, Urinary Tract Infection (UTI)
Meddings J, Saint S, Krein SL
Systematic review of interventions to reduce urinary tract infection in nursing home residents.
This paper is a systematic literature review of strategies to reduce urinary tract infections (UTIs) in nursing home residents. It concludes that several practices, often implemented in bundles, such as improving hand hygiene, reducing and improving catheter use, managing incontinence without catheters, and enhanced barrier precautions, appear to reduce UTI or catheter-associated UTI in nursing home residents.
AHRQ-funded; HS019767; HS018334; 290201000025I.
Citation: Meddings J, Saint S, Krein SL .
Systematic review of interventions to reduce urinary tract infection in nursing home residents.
J Hosp Med 2017 May;12(5):356-68. doi: 10.12788/jhm.2724.
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Keywords: Antibiotics, Catheter-Associated Urinary Tract Infection (CAUTI), Elderly, Evidence-Based Practice, Long-Term Care, Nursing Homes, Patient Safety, Prevention, Urinary Tract Infection (UTI)
Mody L, Greene MT, Saint S
Comparing catheter-associated urinary tract infection prevention programs between Veterans Affairs nursing homes and non-Veterans Affairs nursing homes.
Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to catheter-associated urinary tract infection (CAUTI) prevention via a needs assessment questionnaire. Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems.
AHRQ-funded; 290201000025I; HS019767; HS024385; HS018334.
Citation: Mody L, Greene MT, Saint S .
Comparing catheter-associated urinary tract infection prevention programs between Veterans Affairs nursing homes and non-Veterans Affairs nursing homes.
Infect Control Hosp Epidemiol 2017 Mar;38(3):287-93. doi: 10.1017/ice.2016.279.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Long-Term Care, Nursing Homes, Prevention
Albrecht JS, Croft L, Morgan DJ
Perceptions of gown and glove use to prevent methicillin-resistant staphylococcus aureus transmission in nursing homes.
This qualitative study explored current use and perceptions of glove and gown use in nursing homes. Analysis of recordings of three focus group discussions revealed that direct care staff reported using gowns and gloves primarily as self-protection against contact with bodily fluids, not to prevent MRSA transmission. Glove use was described as common and more acceptable to staff and residents than gown use.
AHRQ-funded; HS024560; HS022135.
Citation: Albrecht JS, Croft L, Morgan DJ .
Perceptions of gown and glove use to prevent methicillin-resistant staphylococcus aureus transmission in nursing homes.
J Am Med Dir Assoc 2017 Feb;18(2):158-61. doi: 10.1016/j.jamda.2016.08.016.
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Keywords: Healthcare-Associated Infections (HAIs), Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Nursing Homes, Prevention, Patient Safety
Cohen B, Murray M, Jia H
Is hand hygiene frequency associated with the onset of outbreaks in pediatric long-term care?
The authors studied the possibility of a correlation between hand hygiene and viral outbreak reduction in pediatric long-term care facilities. Contrary to findings in adult long-term care facilities, they found no association between hand hygiene frequency and subsequent outbreak onset in pediatric long-term care facilities.
AHRQ-funded; HS021470.
Citation: Cohen B, Murray M, Jia H .
Is hand hygiene frequency associated with the onset of outbreaks in pediatric long-term care?
Am J Infect Control 2016 Dec;44(12):1492-94. doi: 10.1016/j.ajic.2016.06.022.
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Keywords: Prevention, Children/Adolescents, Long-Term Care, Healthcare-Associated Infections (HAIs), Patient Safety, Children/Adolescents
Peterson LR, Boehm S, Beaumont JL
Reduction of methicillin-resistant Staphylococcus aureus infection in long-term care is possible while maintaining patient socialization: a prospective randomized clinical trial.
The researchers sought to demonstrate that a novel, minimally invasive program not interfering with activities of daily living or socialization could lower methicillin-resistant Staphylococcus aureus (MRSA) disease in long-term care facilities (LTCFs). They found that the MRSA infection rate decreased 65% between baseline and year 2, with a significant reduction observed at each of the three participating LTCFs. They concluded that on-site MRSA surveillance with targeted decolonization resulted in a significant decrease in clinical MRSA infection among LTCF residents.
AHRQ-funded; HS019968.
Citation: Peterson LR, Boehm S, Beaumont JL .
Reduction of methicillin-resistant Staphylococcus aureus infection in long-term care is possible while maintaining patient socialization: a prospective randomized clinical trial.
Am J Infect Control 2016 Dec;44(12):1622-27. doi: 10.1016/j.ajic.2016.04.251.
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Keywords: Healthcare-Associated Infections (HAIs), Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Patient Safety, Prevention
Muray MT, Jackson O, Cohen B
Impact of infection prevention and control initiatives on acute respiratory infections in a pediatric long-term care facility.
Researchers evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly.
AHRQ-funded; HS021470.
Citation: Muray MT, Jackson O, Cohen B .
Impact of infection prevention and control initiatives on acute respiratory infections in a pediatric long-term care facility.
Infect Control Hosp Epidemiol 2016 Jul;37(7):859-62. doi: 10.1017/ice.2016.73.
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Keywords: Healthcare-Associated Infections (HAIs), Children/Adolescents, Long-Term Care, Prevention, Respiratory Conditions
Loyland B, Wilmont S, Hessels AJ
Staff knowledge, awareness, perceptions, and beliefs about infection prevention in pediatric long-term care facilities.
The aims of this study were to explore direct care providers' knowledge about infection prevention and hand hygiene, attitudes regarding their own and others' hand hygiene practices, and ideas and advice for improving infection prevention efforts. Findings suggested that one essential driver of staff behavior change is having expectations that are meaningful to staff, and many staff members stated that they wanted more in-person staff meetings with education and hands-on, practical advice. Also, workflow patterns and/or the physical environment need to be carefully evaluated to identify systems and methods to minimize cross-contamination.
AHRQ-funded; HS021470.
Citation: Loyland B, Wilmont S, Hessels AJ .
Staff knowledge, awareness, perceptions, and beliefs about infection prevention in pediatric long-term care facilities.
Nurs Res 2016 Mar-Apr;65(2):132-41. doi: 10.1097/nnr.0000000000000136.
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Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Children/Adolescents, Prevention
Loyland B, Wilmont S, Cohen B
Hand-hygiene practices and observed barriers in pediatric long-term care facilities in the New York metropolitan area.
The authors described hand-hygiene practices in pediatric long-term care (pLTC) facilities and identified observed barriers to, and potential solutions for, improved infection prevention. They found that hand hygiene was performed for 40% of the 847 indications observed and recorded, and that adherence appeared to be influenced by individuals' knowledge, attitudes, beliefs and work setting. They concluded by offering suggestions for overcoming barriers or mitigating their effect and suggesting an adaptation of the '5 Moments for Hand Hygiene' to improve infection prevention in pLTC.
AHRQ-funded; HS021470.
Citation: Loyland B, Wilmont S, Cohen B .
Hand-hygiene practices and observed barriers in pediatric long-term care facilities in the New York metropolitan area.
Int J Qual Health Care 2016 Feb;28(1):74-80. doi: 10.1093/intqhc/mzv097.
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Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Children/Adolescents, Prevention
Nace DA, Lin CJ, Ross TM
Randomized, controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities.
The researchers compared high-dose to standard-dose inactivated influenza vaccine in residents of long-term-care facilities (LTCFs) during the 2011-2012 and 2012-2013 influenza seasons. They found that, among frail, elderly residents of LTCFs, high-dose influenza vaccine produced superior responses for all strains except influenza A(H1N1) in 2012-2013.
AHRQ-funded; HS023779.
Citation: Nace DA, Lin CJ, Ross TM .
Randomized, controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities.
J Infect Dis 2015 Jun 15;211(12):1915-24. doi: 10.1093/infdis/jiu622.
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Keywords: Elderly, Influenza, Long-Term Care, Prevention, Vaccination
Shepherd MM, Wipke-Tevis DD, Alexander GL
Analysis of qualitative interviews about the impact of information technology on pressure ulcer prevention programs: implications for the wound, ostomy and continence nurse.
The purpose of this study was to compare pressure ulcer prevention programs in 2 long-term care facilities with diverse Information Technology Sophistication (ITS), one with high sophistication and one with low sophistication, and to identify implications for the WOC nurse. Its findings suggest that effective strategies for staff education and communication regarding pressure ulcer prevention differ based on the level of ITS within a given facility.
AHRQ-funded; HS016862.
Citation: Shepherd MM, Wipke-Tevis DD, Alexander GL .
Analysis of qualitative interviews about the impact of information technology on pressure ulcer prevention programs: implications for the wound, ostomy and continence nurse.
J Wound Ostomy Continence Nurs 2015 May-Jun;42(3):235-41. doi: 10.1097/won.0000000000000136.
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Keywords: Health Information Technology (HIT), Pressure Ulcers, Prevention, Long-Term Care, Comparative Effectiveness
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