National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Antibiotics (2)
- (-) Catheter-Associated Urinary Tract Infection (CAUTI) (17)
- Central Line-Associated Bloodstream Infections (CLABSI) (5)
- Communication (2)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- COVID-19 (1)
- Critical Care (1)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (14)
- Hospitals (2)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (2)
- Long-Term Care (4)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Nursing Homes (5)
- Patient-Centered Outcomes Research (2)
- Patient Safety (9)
- Practice Patterns (2)
- (-) Prevention (17)
- Quality Improvement (3)
- Quality of Care (1)
- Surgery (1)
- Urinary Tract Infection (UTI) (9)
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 17 of 17 Research Studies DisplayedJones KM, Krein SL, Mantey J
Characterizing infection prevention programs and urinary tract infection prevention practices in nursing homes: a mixed-methods study.
This study assessed nursing home (NH) infection prevention and control (IPC) resources and practices related to catheter and non-catheter-associated urinary tract infection (CAUTI and UTI). This mixed-methods study was conducted from April 2018 through November 2019 using quantitative surveys and semistructured qualitative interviews. Surveys were completed by 51 NH infection preventionists (IPs), and interviews were conducted with 13 participants from 7 NHs. The participating IPs had limited experience and/or additional roles, and in 36.7% of NHs, IPs had no specific IPC training, with a high turnover rate often mentioned during interviews. Most NHs were aware of their CAUTI and UTI rates and reported using prevention practices, such as hydration (85.7%) or nurse-initiated catheter discontinuation (65.3%). Interviewees expressed concerns about overuse of urine testing and antibiotics. Transfer sheets were used by 84% to communicate about infection, but the information received was described as suboptimal.
AHRQ-funded; HS25451.
Citation: Jones KM, Krein SL, Mantey J .
Characterizing infection prevention programs and urinary tract infection prevention practices in nursing homes: a mixed-methods study.
Infect Control Hosp Epidemiol 2024 Jan; 45(1):40-47. doi: 10.1017/ice.2023.127..
Keywords: Urinary Tract Infection (UTI), Nursing Homes, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Prevention
Krauss DM, Molefe A, Hung L
AHRQ Author: Henderson S, Miller M
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
MacEwan SR, Beal EW, Gaughan AA
Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections.
The purpose of this study was to contribute to evidence of standardized approaches to educate patients about how they can prevent infections. The researchers explored the perspectives of hospital leaders and staff across 18 hospitals about patient education for device-related healthcare-associated infections (HAIs) including catheter-associated urinary tract infections (CAUTIs) and central-line-associated bloodstream infections (CLABSIs). A total of 471 interviews were conducted with key informants and analyzed to identify themes within the topic of preventing infection through patient education. The study found that the key informants identified CAUTI and CLABSI infection-prevention-specific patient education topics including: the necessity of hand hygiene, the importance of maintenance care, the risks of indwelling urinary catheters and central lines, and having the support to voice concerns. The study concluded that hospital leaders and staff identified patient education topics and ways to deliver the information that were important in the prevention of CAUTIs and CLABSIs, and can provide guidance on how patient education can be improved.
AHRQ-funded; HS024958.
Citation: MacEwan SR, Beal EW, Gaughan AA .
Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections.
Infect Control Hosp Epidemiol 2022 Sep;43(9):1129-34. doi: 10.1017/ice.2021.271..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Education: Patient and Caregiver, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI)
McAlearney AS, MacEwan SR, Gregory ME
Identifying management practices for promoting infection prevention: perspectives on strategic communication.
The purpose of this study was to better understand the topics and communication strategies used by hospital administrative and clinical leaders to facilitate healthcare-associated infection prevention. Between 2017 and 2019 the researchers interviewed 188 administrative and clinical leaders in 18 U.S. Hospitals and interviewed them about management practices used to promote the prevention of HAI, with a focus on strategic communications. The study found that information sharing regarding infection prevention focused on two main topics: facilitators of success and barriers to success. The researchers also reported that storytelling using examples of real events was useful. The study concluded that the findings provide useful information about how the strategic communication of HAI information can contribute to improvement and advance hospitals’ infection prevention plans and efforts.
AHRQ-funded; HS024958.
Citation: McAlearney AS, MacEwan SR, Gregory ME .
Identifying management practices for promoting infection prevention: perspectives on strategic communication.
Am J Infect Control 2022 Jun;50(6):593-97. doi: 10.1016/j.ajic.2021.11.025..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Prevention, Communication
McAlearney AS, Gaughan AA, DePuccio MJ
Management practices for leaders to promote infection prevention: lessons from a qualitative study.
This study looked at the management practices around prevention of catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSI) that hospital leaders can take to promote healthcare associated infection (HAI) prevention efforts. Interviews were conducted with 420 managers and frontline staff in 18 hospitals across the United States. The three management practices characterized as important facilitators of HAI prevention were 1) engagement of executive leadership; 2) information sharing; and 3) manager coaching.
AHRQ-funded; HS024958.
Citation: McAlearney AS, Gaughan AA, DePuccio MJ .
Management practices for leaders to promote infection prevention: lessons from a qualitative study.
Am J Infect Control 2021 May;49(5):536-41. doi: 10.1016/j.ajic.2020.09.001..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Prevention, Communication
De Roo AC, Hendren S, Ameling JM
Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.
Researchers applied Michigan Appropriate Perioperative criteria to statewide registry data to identify improvement targets for urinary catheter use. They found that perioperative urinary catheter use was appropriate for most simple abdominal procedures, but duration of use varied in all categories.
AHRQ-funded; HS019767; HS024385; HS018334; HS000053.
Citation: De Roo AC, Hendren S, Ameling JM .
Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.
Am J Surg 2020 Sep;220(3):706-13. doi: 10.1016/j.amjsurg.2020.01.008..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Patient Safety, Surgery, Prevention, Adverse Events
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)
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
Meddings J, Reichert H, Greene MT
Evaluation of the association between Hospital Survey on Patient Safety Culture (HSOPS) measures and catheter-associated infections: results of two national collaboratives.
This study examined the association between hospital units' results for the Hospital Survey on Patient Safety Culture (HSOPS) and catheter-associated infection rates. It found no association between results of the HSOPS and catheter-associated infection rates when measured at baseline and postintervention in two successful large national collaboratives focused on prevention of central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI).
AHRQ-funded; 290201000025I; 29032001T; HS019767.
Citation: Meddings J, Reichert H, Greene MT .
Evaluation of the association between Hospital Survey on Patient Safety Culture (HSOPS) measures and catheter-associated infections: results of two national collaboratives.
BMJ Qual Saf 2017 Mar;26(3):226-35. doi: 10.1136/bmjqs-2015-005012.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Prevention
Dicks KV, Lofgren E, Lewis SS
A multicenter pragmatic interrupted time series analysis of chlorhexidine gluconate bathing in community hospital intensive care units.
This study sought to determine whether daily chlorhexidine gluconate (CHG) bathing of intensive care unit (ICU) patients leads to a decrease in hospital-acquired infections (HAIs), particularly infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). It concluded that hospitals that implemented CHG bathing attained a decrease in ICU central-line-associated bloodstream infections (CLABSIs), ICU primary BSIs, and VRE central-line-associated bloodstream infections.
AHRQ-funded; HS023866.
Citation: Dicks KV, Lofgren E, Lewis SS .
A multicenter pragmatic interrupted time series analysis of chlorhexidine gluconate bathing in community hospital intensive care units.
Infect Control Hosp Epidemiol 2016 Jul;37(7):791-7. doi: 10.1017/ice.2016.23.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety, Healthcare-Associated Infections (HAIs)
Fakih MG, Gould CV, Trautner BW
Beyond infection: device utilization ratio as a performance measure for urinary catheter harm.
As multiple definitions for measuring catheter-associated urinary tract infections exist, the authors advocate use of the device utilization ratio (DUR) as an additional performance measure for potential urinary catheter harm. The DUR is currently captured as part of National Healthcare Safety Network reporting, and the data are readily obtainable from electronic medical records. This method also provides a more direct reflection of improvement efforts focused on reducing inappropriate urinary catheter use.
AHRQ-funded; 290201000025I.
Citation: Fakih MG, Gould CV, Trautner BW .
Beyond infection: device utilization ratio as a performance measure for urinary catheter harm.
Infect Control Hosp Epidemiol 2016 Mar;37(3):327-33. doi: 10.1017/ice.2015.287.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Prevention, Patient-Centered Outcomes Research
Chopra V, Saint S
Vascular catheter infections: time to get technical.
Combining technical and socioadaptive factors within a bundle of best practices has substantially reduced catheter-related bloodstream infections in the past decade, but which elements of this bundle are most responsible for reducing catheter infections? Although a key technical solution should become the standard of care to prevent vascular catheter infections, the authors recommended getting even more technical to prevent other health-care-associated infections.
AHRQ-funded; HS022835.
Citation: Chopra V, Saint S .
Vascular catheter infections: time to get technical.
Lancet 2015 Nov 21;386(10008):2034-36. doi: 10.1016/s0140-6736(15)00245-7.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Fakih MG, Krein SL, Edson B
AHRQ Author: Battles JB
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
This article discusses catheter-associated urinary tract infection (CAUTI) prevention efforts, describes the national collaboration between different organizations, briefly reviews the technical and socio-adaptive components of the program, and specifically describes an approach to engaging health care workers as an essential part of CAUTI prevention and averting patient harm.
AHRQ-authored; AHRQ-funded; 290201000025I; 29032001T
Citation: Fakih MG, Krein SL, Edson B .
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
Am J Infect Control. 2014 Oct;42(10 Suppl):S223-9. doi: 10.1016/j.ajic.2014.03.355..
Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention, Practice Patterns, Quality Improvement
Fakih MG, Krein SL, Edson B
AHRQ Author: Battles JB
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
The "On the CUSP: Stop CAUTI" initiative represents the single largest national effort to mitigate urinary catheter risk. The program brings together key organizations to assist hospitals by providing education and coaching support. Continuity is secured by integrating the process into the health care worker's daily routine activities.
AHRQ-authored; AHRQ-funded; 290201000025I; 29032001T.
Citation: Fakih MG, Krein SL, Edson B .
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
Am J Infect Control 2014 Oct;42(10 Suppl):S223-9. doi: 10.1016/j.ajic.2014.03.355.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention, Practice Patterns
Meddings J, Rogers MA, Krein SL
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
The authors updated a prior systematic review and a meta-analysis regarding interventions prompting urinary catheter (UC) removal by reminders or stop orders. They found that UC reminders and stop orders appear to reduce catheter-associated urinary tract infection rates and should be used to improve patient safety.
AHRQ-funded; 290200710062I; HS019767; HS018344.
Citation: Meddings J, Rogers MA, Krein SL .
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
BMJ Qual Saf 2014 Apr;23(4):277-89. doi: 10.1136/bmjqs-2012-001774.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Patient-Centered Outcomes Research, Prevention, Quality Improvement, Urinary Tract Infection (UTI)