National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Antibiotics (4)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (7)
- Children/Adolescents (1)
- Communication (1)
- Community-Acquired Infections (3)
- Comparative Effectiveness (1)
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- Electronic Health Records (EHRs) (1)
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- Healthcare-Associated Infections (HAIs) (8)
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- Provider (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Provider Performance (1)
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- (-) Urinary Tract Infection (UTI) (15)
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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 15 of 15 Research Studies DisplayedHsu HE, Wang R, Jentzsch MS
The impact of measurement changes on evaluating hospital performance: the case of catheter-associated urinary tract infections.
Researchers observed that catheter-associated urinary tract infections in 592 hospitals immediately declined after federal value-based incentive program implementation, but found that this was fully attributable to a concurrent surveillance case definition revision. They found that post revision, more hospitals had favorable standardized infection ratios, likely leading to artificial inflation of their performance scores unrelated to changes in patient safety.
AHRQ-funded; HS000063; HS025008; HS018414.
Citation: Hsu HE, Wang R, Jentzsch MS .
The impact of measurement changes on evaluating hospital performance: the case of catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2019 Nov;40(11):1269-71. doi: 10.1017/ice.2019.240..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Provider Performance, Quality Measures, Urinary Tract Infection (UTI)
Manojlovich M, Ameling JM, Forman J
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
This study identified contextual barriers to communication between physicians and nurses that contribute to inappropriate use of catheters and increased risk of health care-associated infections. The researchers conducted individual and small-group semistructured interviewed with physicians and nurses in a progressive care unit of an academic hospital. Common barriers included workflow misalignment between clinicians, issues with electronic medical records and pagers, and strained relationships between clinicians.
AHRQ-funded; HS024385.
Citation: Manojlovich M, Ameling JM, Forman J .
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
Am J Crit Care 2019 Jul;28(4):290-98. doi: 10.4037/ajcc2019372..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Healthcare-Associated Infections (HAIs), Patient Safety, Provider, Provider: Nurse, Provider: Physician, Urinary Tract Infection (UTI), Workflow
Henderson JT, Webber EM, Bean SI
Screening for asymptomatic bacteriuria in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
Investigators systematically reviewed the benefits and harms of asymptomatic bacteriuria screening and treatment in adults, including during pregnancy, to inform the US Preventive Services Task Force. They found that screening and treatment for asymptomatic bacteriuria during pregnancy was associated with reduced rates of pyelonephritis and low birth weights, while benefits of asymptomatic bacteriuria treatment in nonpregnant adult populations were not found. Trial evidence was limited.
AHRQ-funded; 290201500007.
Citation: Henderson JT, Webber EM, Bean SI .
Screening for asymptomatic bacteriuria in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Sep 24;322(12):1195-205. doi: 10.1001/jama.2019.10060..
Keywords: Evidence-Based Practice, Guidelines, Infectious Diseases, Prevention, Screening, Urinary Tract Infection (UTI), U.S. Preventive Services Task Force (USPSTF)
Desai S, Aronson PL, Shabanova V
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
This study compared rates of recurring bacteremic urinary tract infections (UTIs) among hospitalized infants who received parenteral antibiotics 7 days or less compared with infants who received long-term treatment defined as greater than 7 days. Among 115 infants with bactermic UTI, half received short-course parenteral antibiotics and no difference in 30-day UTI recurrence was found.
AHRQ-funded; HS026006.
Citation: Desai S, Aronson PL, Shabanova V .
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
Pediatrics 2019 Sep;144(3). doi: 10.1542/peds.2018-3844..
Keywords: Newborns/Infants, Antibiotics, Urinary Tract Infection (UTI), Medication, Inpatient Care, Hospitalization, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Wang HH, Kurtz M, Logvinenko T
Why does prevention of recurrent urinary tract infection not result in less renal scarring? A deeper dive into the RIVUR trial.
The RIVUR (Randomized Intervention for Children with Vesicoureteral Reflux) trial reported that antibiotic prophylaxis reduced recurrent urinary tract infection but antibiotic prophylaxis was not associated with decreased new renal scarring. However, the original reports did not assess the relationship among recurrent urinary tract infection, new renal scarring and antibiotic prophylaxis in detail. Therefore, this study investigated the relationship among these issues.
AHRQ-funded; HS000063.
Citation: Wang HH, Kurtz M, Logvinenko T .
Why does prevention of recurrent urinary tract infection not result in less renal scarring? A deeper dive into the RIVUR trial.
J Urol 2019 Aug;202(2):400-05. doi: 10.1097/ju.0000000000000292..
Keywords: Newborns/Infants, Urinary Tract Infection (UTI), Antibiotics, Medication, Prevention
Elman MR, Williams CD, Bearden DT
Healthcare-associated urinary tract infections with onset post hospital discharge.
The objective of this study was to measure the incidence of potentially healthcare-associated (HA), community-onset (CO) urinary tract infection (UTI) in a retrospective cohort of hospitalized patients. Among 3,273 patients at risk for potentially HA-CO UTI, results found that the incidence of HA-CO UTI in the 30 days post discharge was 29.8 per 1,000 patients; independent risk factors included paraplegia, quadriplegia, indwelling catheter during index hospitalization, prior piperacillin-tazobactam prescription, prior penicillin class prescription, and private insurance. The authors conclude that HA-CO UTI may be common within 30 days following hospital discharge, and that their data suggests that surveillance efforts may need to be expanded to capture the full burden to patients and to better inform antibiotic prescribing decisions for patients with a history of hospitalization.
AHRQ-funded; HS020970.
Citation: Elman MR, Williams CD, Bearden DT .
Healthcare-associated urinary tract infections with onset post hospital discharge.
Infect Control Hosp Epidemiol 2019 Aug;40(8):863-71. doi: 10.1017/ice.2019.148..
Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Hospital Discharge, Hospitalization, Urinary Tract Infection (UTI)
Advanced Analytics Group of Pediatric Urology, ORC Personalized Medicine Group
Targeted workup after initial febrile urinary tract infection: using a novel machine learning model to identify children most likely to benefit from voiding cystourethrogram.
The authors sought to develop a model to predict the probability of recurrent urinary tract infection associated vesicoureteral reflux in children after an initial urinary tract infection. Their predictive model provided a promising performance to facilitate individualized treatment of children with an initial urinary tract infection and to identify those most likely to benefit from voiding cystourethrogram after the initial urinary tract infection. They conclude that this model would allow for more selective test application and increase yield while minimizing overuse.
AHRQ-funded; HS000063.
Citation: Advanced Analytics Group of Pediatric Urology, ORC Personalized Medicine Group .
Targeted workup after initial febrile urinary tract infection: using a novel machine learning model to identify children most likely to benefit from voiding cystourethrogram.
J Urol 2019 Jul;202(1):144-52. doi: 10.1097/ju.0000000000000186..
Keywords: Antibiotics, Care Management, Children/Adolescents, Guidelines, Medication, Urinary Tract Infection (UTI)
Weinstein EJ, Han JH, Lautenbach E
A clinical prediction tool for extended-spectrum cephalosporin resistance in community-onset Enterobacterales urinary tract infection.
Researchers sought to create a clinical prediction tool for community-onset urinary tract infections (UTIs) due to extended-spectrum cephalosporin-resistant (ESC-R) Enterobacterales (EB). Study participants included patients who presented to an emergency department or outpatient practice with an EB UTI; case patients had ESC-R EB UTIs and control patients had ESC-susceptible EB UTIs. The predictive model was develop by performing a multivariable conditional logistic regression. The researchers found after multivariable analysis that presentation with an ESC-R EB community-onset UTI could be predicted by the following factors: history of malignancy, history of diabetes, recent skilled nursing facility or hospital stay, recent trimethoprim-sulfamethoxazole exposure, pyelonephritis at the time of presentation. They conclude that community-onset ESC-R EB UTI can be predicted by using the proposed scoring system, which can be helpful to guide diagnostic and therapeutic interventions.
AHRQ-funded; HS020002.
Citation: Weinstein EJ, Han JH, Lautenbach E .
A clinical prediction tool for extended-spectrum cephalosporin resistance in community-onset Enterobacterales urinary tract infection.
Open Forum Infect Dis 2019 Apr;6(4):ofz164. doi: 10.1093/ofid/ofz164..
Keywords: Community-Acquired Infections, Risk, Urinary Tract Infection (UTI)
Colborn KL, Bronsert M, Hammermeister K
Identification of urinary tract infections using electronic health record data.
Using the American College of Surgeons National Surgical Quality Improvement Program UTI status of patients who underwent an operation at the University of Colorado Hospital, the investigators sought to develop an algorithm for identifying UTIs using data from the electronic health record. The investigators concluded that a model with 14 predictors from the electronic health record identifies UTIs well, and it could be used to scale up UTI surveillance or to estimate the impact of large-scale interventions on UTI rates.
AHRQ-funded; HS026019.
Citation: Colborn KL, Bronsert M, Hammermeister K .
Identification of urinary tract infections using electronic health record data.
Am J Infect Control 2019 Apr;47(4):371-75. doi: 10.1016/j.ajic.2018.10.009..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality of Care, Quality Improvement, Surgery, Urinary Tract Infection (UTI)
Anesi JA, Lautenbach E, Nachamkin I
The role of extended-spectrum cephalosporin-resistance in recurrent community-onset
This study found an association between the use of extended-spectrum cephalosporin-resistance (ESC-R) and recurring Enterobacteriacaea urinary tract infections (EB UTIs). There was a significant increase in emergency room visits within 12 months after the first UTI visit.
AHRQ-funded; HS020002.
Citation: Anesi JA, Lautenbach E, Nachamkin I .
The role of extended-spectrum cephalosporin-resistance in recurrent community-onset
BMC Infect Dis 2019 Feb 14;19(1):163. doi: 10.1186/s12879-019-3804-y..
Keywords: Antibiotics, Community-Acquired Infections, Medication, Urinary Tract Infection (UTI)
Hsu HE, Wang R, Jentzsch MS
Association between value-based incentive programs and catheter-associated urinary tract infection rates in the critical care setting.
This letter discussed a study which was done on value-based incentive programs to reduce the number of catheter-associated urinary tract infections (CAUTI) in intensive care units (ICUs). The study used data from 592 hospitals in the District of Columbia and 49 states. Researchers found these incentive programs did not significantly reduce CAUTI.
AHRQ-funded; HS000063; HS025008; HS018414.
Citation: Hsu HE, Wang R, Jentzsch MS .
Association between value-based incentive programs and catheter-associated urinary tract infection rates in the critical care setting.
JAMA 2019 Feb 5;321(5):509-11. doi: 10.1001/jama.2018.18997.
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Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Critical Care, Healthcare-Associated Infections (HAIs), Inpatient Care, Patient Safety, Urinary Tract Infection (UTI)
Meddings J, Skolarus TA, Fowler KE
Michigan Appropriate Perioperative (MAP) criteria for urinary catheter use in common general and orthopaedic surgeries: results obtained using the RAND/UCLA Appropriateness Method.
Using the RAND Corporation/University of California Los Angeles (RAND/UCLA) Appropriateness Method, the authors assessed the appropriateness of indwelling urinary catheter placement and different timings of catheter removal for routine general and orthopaedic surgery procedures. The investigators found that appropriateness of catheter use varied by procedure, accounting for procedure-specific risks as well as expected procedure time and intravenous fluids. Procedural appropriateness ratings for catheters were summarised for clinical use into three groups, described in detail in the paper.
AHRQ-funded; 2902010000251; 29032001T; HS19767.
Citation: Meddings J, Skolarus TA, Fowler KE .
Michigan Appropriate Perioperative (MAP) criteria for urinary catheter use in common general and orthopaedic surgeries: results obtained using the RAND/UCLA Appropriateness Method.
BMJ Qual Saf 2019 Jan;28(1):56-66. doi: 10.1136/bmjqs-2018-008025..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Urinary Tract Infection (UTI)
Kawai AT, Calderwood MS, Jin R
Impact of the Centers for Medicare and Medicaid services hospital-acquired conditions policy on billing rates for 2 targeted healthcare-associated infections.
The 2008 Centers for Medicare & Medicaid Services (CMS) hospital-acquired conditions policy limited additional payment for conditions deemed reasonably preventable. This study examined whether this policy was associated with decreases in billing rates for 2 targeted conditions, vascular catheter-associated infections (VCAI) and catheter-associated urinary tract infections (CAUTI). The CMS policy appears to have been associated with immediate reductions in billing rates for VCAI and CAUTI, followed by a slight decreasing trend or leveling-off in rates.
AHRQ-funded; HS018414.
Citation: Kawai AT, Calderwood MS, Jin R .
Impact of the Centers for Medicare and Medicaid services hospital-acquired conditions policy on billing rates for 2 targeted healthcare-associated infections.
Infect Control Hosp Epidemiol 2015 Aug;36(8):871-7. doi: 10.1017/ice.2015.86.
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Keywords: Healthcare-Associated Infections (HAIs), Policy, Medicare, Payment, Hospitals, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare Costs
Mody L, Meddings J, Edson BS
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
The authors describe a new initiative based on lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent catheter-associated urinary tract infections in over 950 acute care hospitals. This initiative will now be implemented in nearly 500 nursing homes through a project funded by AHRQ. It will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship.
AHRQ-funded; 2902010000251; HS019979; HS019767.
Citation: Mody L, Meddings J, Edson BS .
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
Clin Infect Dis 2015 Jul 1;61(1):86-94. doi: 10.1093/cid/civ236..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Inpatient Care
Dicks KV, Baker AW, Durkin MJ
The potential impact of excluding funguria from the surveillance definition of catheter-associated urinary tract infection.
The authors examined surveillance data from a network of community hospitals as well as a tertiary-care medical center to describe the potential impact of excluding yeast as a urinary pathogen from the catheter-associated urinary tract infection (CAUTI) definition on CAUTI rates. They found that excluding yeast from the CAUTI surveillance definition reduced CAUTI rates by nearly 25% in the studied medical centers.
AHRQ-funded; HS023866.
Citation: Dicks KV, Baker AW, Durkin MJ .
The potential impact of excluding funguria from the surveillance definition of catheter-associated urinary tract infection.
Infect Control Hosp Epidemiol 2015 Apr;36(4):467-9. doi: 10.1017/ice.2014.72.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Urinary Tract Infection (UTI)