National Healthcare Quality and Disparities Report
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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
401 to 422 of 422 Research Studies DisplayedSchweizer ML, Cullen JJ, Perencevich EN
Costs associated with surgical site infections in Veterans Affairs hospitals.
This study evaluated surgical site infections(SSIs) in 1,756 Veterans Administration patients to determine the excess costs associated with total, deep, and superficial SSIs. It found that the highest risk-adjusted costs occurred with deep SSIs and SSIs associated with neurosurgery patients.
AHRQ-funded; HS021992
Citation: Schweizer ML, Cullen JJ, Perencevich EN .
Costs associated with surgical site infections in Veterans Affairs hospitals.
JAMA Surg. 2014 Jun;149(6):575-581. doi:10.1001/jamasurg.2013.4663..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Healthcare Costs
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)
Leotsakos A, Zheng H, Croteau R
Standardization in patient safety: the WHO High 5s project.
This paper reports on a global safety initiative of the World Health Organization to facilitate development, implementation, and evaluation of Standard Operating Protocols (SOPs) within a global learning community. Thus far, 3 SOPs—correct surgery, medication reconciliation, concentrated injectable medicines—have been developed, implemented and evaluated in hospitals in 7 participating countries.
AHRQ-funded; 290201200006C
Citation: Leotsakos A, Zheng H, Croteau R .
Standardization in patient safety: the WHO High 5s project.
Int J Qual Health Care. 2014 Apr;26(2):109-16. doi: 10.1093/intqhc/mzu010..
Keywords: Patient Safety, Quality of Care, Surgery, Medication: Safety, Healthcare-Associated Infections (HAIs)
Streiff MB, Brady JP, Grant AM
AHRQ Author: Brady JP
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
Approximately half of new venous thromboembolism (VTE) cases occur during a hospital stay or within 90 days of an inpatient admission or surgical procedure, and many are not diagnosed until after discharge. Prevention of VTE can be complicated as physicians must balance the risk for thrombosis with the risk for bleeding from anticoagulants. A collaborative, team-based approach to care is needed for significant and sustained improvement, and it also offers efficiency and capacity to tackle other patient safety problems.
AHRQ-authored.
Citation: Streiff MB, Brady JP, Grant AM .
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
MMWR Morb Mortal Wkly Rep 2014 Mar 7;63(9):190-3.
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Keywords: Blood Clots, Healthcare-Associated Infections (HAIs), Hospitalization, Prevention, Teams
Owens PL, Barrett ML, Raetzman S
AHRQ Author: Owens PL, Steiner CA
Surgical site infections following ambulatory surgery procedures.
The authors determined the incidence of clinically significant surgical site infections (CS-SSIs) following low- to moderate-risk ambulatory surgery in patients with low risk for surgical complications. They found that among patients in 8 states undergoing ambulatory surgery, rates of postsurgical visits for CS-SSIs were low relative to all causes but may represent a substantial number of adverse outcomes in aggregate, thus meriting quality improvement efforts to minimize their occurrence.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Owens PL, Barrett ML, Raetzman S .
Surgical site infections following ambulatory surgery procedures.
JAMA 2014 Feb 19;311(7):709-16. doi: 10.1001/jama.2014.4.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare-Associated Infections (HAIs), Injuries and Wounds, Ambulatory Care and Surgery, Surgery, Hospitalization, Patient Safety, Adverse Events
Battles JB, Farr SL, Weinberg DA
AHRQ Author: Battles JB
From research to nationwide implementation: the impact of AHRQ's HAI prevention program.
The authors sought to provide insight to AHRQ's healthcare-associated infection (HAI) prevention strategies by: first, discussing the context and structure of AHRQ's HAI research portfolio and funding decisions; secondly, describing the process of prevention practice implementation and lessons learned; and third, explaining the outcomes and national impact of the AHRQ program. Their paper described major contributions that have emerged from AHRQ-funded HAI projects.
AHRQ-authored.
Citation: Battles JB, Farr SL, Weinberg DA .
From research to nationwide implementation: the impact of AHRQ's HAI prevention program.
Med Care 2014 Feb;52(2 Suppl 1):S91-6. doi: 10.1097/mlr.0000000000000037.
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Keywords: Quality of Care, Healthcare-Associated Infections (HAIs), Quality Improvement, Patient Safety, Prevention
Berenholtz SM, Lubomski LH, Weeks K
Eliminating central line-associated bloodstream infections: a national patient safety imperative.
The researchers conducted a collaborative cohort study to evaluate the impact of the national "On the CUSP: Stop BSI" program on CLABSI rates among participating adult intensive care units (ICUs). It found that one thousand and seventy-one adult ICUs from 44 states, the District of Columbia, and Puerto Rico implemented the national program and achieved a 43% reduction in the overall rate of CLABSI.
AHRQ-funded; 2902006000222.
Citation: Berenholtz SM, Lubomski LH, Weeks K .
Eliminating central line-associated bloodstream infections: a national patient safety imperative.
Infect Control Hosp Epidemiol 2014 Jan;35(1):56-62. doi: 10.1086/674384..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Central Line-Associated Bloodstream Infections (CLABSI), Intensive Care Unit (ICU), Healthcare-Associated Infections (HAIs)
Rangachari P, Madaio M, Rethemeyer RK
Role of communication content and frequency in enabling evidence-based practices.
The study sought to promote central line bundle (CLB) implementation in a medical ICU and a pediatric ICU through periodic quality improvement (QI) interventions over a 52-week period. It found that proactive communications increased by 68 percent in the MICU and 61 percent in the PICU. During the same timeframe, both units increased CLB adherence to 100 percent. Both units also demonstrated statistically significant declines in catheter days.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Role of communication content and frequency in enabling evidence-based practices.
Qual Manag Health Care 2014 Jan-Mar;23(1):43-58. doi: 10.1097/qmh.0000000000000017..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Communication, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Quality of Care, Quality Improvement
Letourneau AR, Calderwood MS, Huang SS
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
The researchers conducted retrospective cohort studies at 2 academic medical centers, extending analyses of patients undergoing hysterectomy or colorectal surgery. They concluded that claims-enhanced surveillance can help to identify surgical site infections (SSIs) missed by routine surveillance, identifying nearly twice as many SSIs following hysterectomy and 4 times more SSIs following colorectal surgery.
AHRQ-funded; HS021424.
Citation: Letourneau AR, Calderwood MS, Huang SS .
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
Infect Control Hosp Epidemiol 2013 Dec;34(12):1321-3. doi: 10.1086/673975..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Patient Safety, Adverse Events, Women, Digestive Disease and Health
Harris AD, Pineles L, Belton B
Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial.
Antibiotic-resistant bacteria are associated with increased patient morbidity and mortality. It is unknown whether wearing gloves and gowns for all patient contact in the intensive care unit (ICU) decreases acquisition of antibiotic-resistant bacteria. The purpose of this study was to assess whether wearing gloves and gowns for all patient contact in the ICU decreases acquisition of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) compared with usual care.
AHRQ-funded; HS018111; 290200600015.
Citation: Harris AD, Pineles L, Belton B .
Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial.
JAMA 2013 Oct 16;310(15):1571-80. doi: 10.1001/jama.2013.277815..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Infectious Diseases, Intensive Care Unit (ICU), Hospitals, Prevention, Critical Care
Clancy CM
AHRQ Author: Clancy CM
Creating a healing environment.
Healthcare-associated infections, or HAIs, are as familiar as they are distressing but they are also largely preventable. The author, a former director of AHRQ, argues that the design of the healthcare facility environment (including layout, placement of equipment, and ease of access to materials) has the ability to improve patient safety, and more specifically, prevent the spread of HAIs.
Citation: Clancy CM .
Creating a healing environment.
HERD 2013 Oct;7(1 suppl):5-7..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Lenfestey NF, Denham ME, Hall KK
http://journals.sagepub.com/doi/full/10.1177/193758671300701S05
Expert opinions on the role of facility design in the acquisition and prevention of healthcare-associated infections.
The purpose of this study was to assess expert knowledge, perceptions, and experience on the role of the built environment in the acquisition and transmission of healthcare-associated infections (HAIs), facility design decision-making considerations, and strategies for intervention through facility design and technologies. It concluded that no single intervention is entirely effective in mitigating HAI risk; multiple interventions are needed.
AHRQ-funded; 290201000024I.
Citation: Lenfestey NF, Denham ME, Hall KK .
Expert opinions on the role of facility design in the acquisition and prevention of healthcare-associated infections.
HERD 2013 Oct;7(1 suppl):31-45..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Fakih MG, George C, Edson BS
Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies.
The authors describe a large-scale national effort funded by AHRQ to reduce catheter-associated urinary tract infections (CAUTI). They elucidate the importance of the collaboration between the different national and local associations, societies, and agencies that is required for a successful program. They also illustrate the complexities of implementing both the technical and socioadaptive improvement efforts focused on reducing CAUTI.
AHRQ-funded; 290201000025I; 29032001T
Citation: Fakih MG, George C, Edson BS .
Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies.
Infect Control Hosp Epidemiol. 2013 Oct;34(10):1048-54. doi: 10.1086/673149..
Keywords: Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Quality of Care, Patient Safety, Catheter-Associated Urinary Tract Infection (CAUTI)
Zimring C, Denham ME, Jacob JT
http://journals.sagepub.com/doi/10.1177/193758671300701S09
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
The objective of this report was to summarize the findings and provide recommendations based on the multidisciplinary literature review and industry scan, focusing on the links between the built environment and healthcare-associated infections. It concluded that there are currently few data that demonstrate a reduction in infection rates. There is a need for multidisciplinary collaboration and increased efforts to standardize the evaluation of environmental studies.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Denham ME, Jacob JT .
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
HERD 2013 Oct;7(1 suppl):127-39..
Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Hospitals
Zimring C, Jacob JT, Denham ME
http://journals.sagepub.com/doi/pdf/10.1177/193758671300701S04
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
This paper describes the conceptual framework and methodology used to conduct a comprehensive literature review of current evidence evaluating the role of the built environment in the transmission of healthcare-associated infections. The methodology involves a chain of transmission interventions model that is a multidisciplinary conceptualization of the interaction between pathogens and the built environment. This model facilitated a systematic literature review of a very large amount of data.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Jacob JT, Denham ME .
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
HERD 2013 Oct;7(1 suppl):18-30.
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Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Research Methodologies
Jacob JT, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S07
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
This review assesses and synthesizes available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in the air that cause healthcare-associated infections (HAIs). It found that current evidence is limited by the complexity of the interactions between pathogens and potential hosts, and in the methods used to assess impact of these strategies.
AHRQ-funded; 290201000024I.
Citation: Jacob JT, Kasali A, Steinberg JP .
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
HERD 2013 Oct;7(1 suppl):74-98..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Steinberg JP, Denham ME, Zimring C
https://www.researchgate.net/publication/276382905/download
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
The authors describe the role of the hospital environment in the spread of pathogens by direct and indirect contact. In addition, the prevention of transmission through interventions involving the built environment is discussed. They conclude that enhanced environmental cleaning including touchless technologies and self-cleaning surfaces can reduce environmental contamination and may prevent infections.
AHRQ-funded; 290201000024I.
Citation: Steinberg JP, Denham ME, Zimring C .
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
HERD 2013 Oct;7(1 suppl):46-73..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Prevention, Patient Safety
Denham ME, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S08
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
The purpose of this review was to assess and synthesize available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in water that cause healthcare-associated infections (HAIs). It determined that current evidence clearly identifying the environment’s role in the chain of infection is limited.
AHRQ-funded; 290201000024I.
Citation: Denham ME, Kasali A, Steinberg JP .
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
HERD 2013 Oct;7(1 suppl):99-126..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Hall KK, Kamerow DB
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S03
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
The authors characterize the HAI-Design project and discuss briefly each paper in this issue. These papers highlight how the built environment can impact patient safety through the use of a specific and high-impact example: healthcare-associated infections. The overall goal is to identify design strategies that appear to be effective in interrupting pathogen transmission and reducing HAIs.
AHRQ-funded; 290201000024I.
Citation: Hall KK, Kamerow DB .
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
HERD 2013 Oct;7(1 suppl):13-17..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Hong AL, Sawyer MD, Shore A
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
This study demonstrated that the Comprehensive Unit-based Safety Program, a multifaceted approach to prevent central line-associated bloodstream infections (CLABSIs) could be implemented in Connecticut (following successful implementation in Michigan). The program was associated with a reduction in CLABSI rates in Connecticut, even though the State’s baseline CLABSI rate was already low.
AHRQ-funded; 290200600022
Citation: Hong AL, Sawyer MD, Shore A .
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
J Healthc Qual. 2013 Sep-Oct;35(5):78-87. doi: 10.1111/j.1945-1474.2012.00210.x..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Quality of Care
Huang SS, Septimus E, Kleinman K
Targeted versus universal decolonization to prevent ICU infection.
In this pragmatic, cluster-randomized trial the authors compared targeted versus universal decolonization of patients in intensive care units (ICUs) as strategies for preventing health care-associated infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA). They found that in routine ICU practice, universal decolonization was more effective than targeted decolonization or screening and isolation in reducing rates of MRSA clinical isolates and bloodstream infection from any pathogen.
AHRQ-funded; 290201000008I.
Citation: Huang SS, Septimus E, Kleinman K .
Targeted versus universal decolonization to prevent ICU infection.
N Engl J Med 2013 Jun 13;368(24):2255-65. doi: 10.1056/NEJMoa1207290..
Keywords: Comparative Effectiveness, Infectious Diseases, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Intensive Care Unit (ICU), Patient-Centered Healthcare, Patient Safety, Prevention
Clancy C
AHRQ Author: Clancy C
AHRQ: CUSP – scaling up a safety framework.
In this article, the author describes the Comprehensive Unit-based Safety Program, or CUSP, toolkit and its role in addressing healthcare-associated infections (HAIs) and other patient safety factors. The author outlines the components of the core CUSP toolkit which help clinicians: learn about CUSP, assemble the team, engage senior executives, understand the science of safety, identify defects through “sensemaking”, implement teamwork and communications and apply CUSP.
AHRQ-authored.
Citation: Clancy C .
AHRQ: CUSP – scaling up a safety framework.
Patient Safety & Quality Healthcare 2013 May/Jun..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Quality of Care, Healthcare-Associated Infections (HAIs), Patient Safety, Teams