National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (4)
- (-) Central Line-Associated Bloodstream Infections (CLABSI) (14)
- Disparities (1)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (12)
- Healthcare Costs (1)
- Home Healthcare (1)
- Hospitals (1)
- Infectious Diseases (2)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (3)
- Medical Errors (1)
- Medicare (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Nursing (1)
- Outcomes (1)
- Patient Safety (11)
- Payment (1)
- Practice Patterns (1)
- Prevention (5)
- Provider (1)
- Provider Performance (1)
- Quality Improvement (1)
- Quality Measures (2)
- Quality of Care (4)
- Sepsis (2)
- Urinary Tract Infection (UTI) (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 14 of 14 Research Studies DisplayedKeller SC, Williams D, Rock C
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
As more home infusion agencies consider ways to perform surveillance for central line–associated bloodstream infection (CLABSI), an understanding of the assorted challenges is necessary. The authors discussed these challenges, which include a lack of a widely accepted standard definition of CLABSIs in home infusion therapy, the lack of a reporting platform, the absence of a reporting requirement, and barriers in obtaining the needed information to identify the presence of a potential CLABSI and adjudicate whether it meets a CLABSI definition. The 21st Century Cures Act will expand Medicare coverage for home infusion therapy services by 2021, likely leading to increased pressure for home infusion therapy CLABSI surveillance. Benchmarking of CLABSI data can usher in informed work to reduce CLABSIs and enhance patient safety in home infusion therapy.
AHRQ-funded; HS025782.
Citation: Keller SC, Williams D, Rock C .
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
Am J Infect Control 2018 Dec;46(12):1419-21. doi: 10.1016/j.ajic.2018.05.016..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Home Healthcare, Patient Safety, Sepsis, Infectious Diseases, Prevention
Calderwood MS, Kawai AT, Jin R
Centers for Medicare and Medicaid services hospital-acquired conditions policy for central line-associated bloodstream infection (CLABSI) and cather-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement.
In 2008, the Centers for Medicare and Medicaid Services (CMS) stopped reimbursing for hospital-acquired conditions (HACs) not present on admission (POA). This study sought to understand why this policy did not impact central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) trends.
AHRQ-funded; HS018414.
Citation: Calderwood MS, Kawai AT, Jin R .
Centers for Medicare and Medicaid services hospital-acquired conditions policy for central line-associated bloodstream infection (CLABSI) and cather-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement.
Infect Control Hosp Epidemiol 2018 Aug;39(8):897-901. doi: 10.1017/ice.2018.137..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety
Lee YSH, Stone PW, Pogorzelska-Maziarz M
Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.
The objective of this study was to determine what aspects of the work environment lead to better adherence to best safety practice for central line-associated bloodstream infections (CLABSIs) prevention. Data was obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey with data on ICU and hospital characteristics obtained from the National Healthcare Safety Network. Workload and a quality-conscious environment were the most important factors associated with CLABSI bundle compliance.
AHRQ-funded; HS018987.
Citation: Lee YSH, Stone PW, Pogorzelska-Maziarz M .
Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.
Health Care Manage Rev 2018 Apr/Jun;43(2):138-47. doi: 10.1097/hmr.0000000000000134..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Patient Safety, Prevention
Paje D, Conlon A, Kaatz S
Patterns and predictors of short-term peripherally inserted central catheter use: a multicenter prospective cohort study.
The goal of this study was to identify patient, provider, and device characteristics and the clinical outcomes associated with short-term peripherally inserted central catheters (PICCs). Trained abstractors collected data from the medical records of adults that received PICCs during hospitalization; patients were prospectively followed until PICC removal, death, or 70 days after insertion. Complications associated with short-term use were assessed. Major complications included venous thromboembolism or central line associated bloodstream infection. Common minor complications were catheter occlusion and tip migration.
AHRQ-funded; HS022835.
Citation: Paje D, Conlon A, Kaatz S .
Patterns and predictors of short-term peripherally inserted central catheter use: a multicenter prospective cohort study.
J Hosp Med 2018 Feb;13(2):76-82. doi: 10.12788/jhm.2847..
Keywords: Adverse Events, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Inpatient Care, Patient Safety, Practice Patterns
Patel PK, Gupta A, Vaughn VM
Review of strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs.
This systematic review was conducted back in October 2015 within PubMed and Cochrane databases on interventions to reduce central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI). The interventions were categorized by stages applicable to both CAUTI and CLABSI prevention. Stage 0: avoid catheter if possible; Stage 1: ensure aseptic placement; Stage 2: maintain awareness and proper care of catheters in place, and Stage 3: promptly remove unnecessary catheters. They also looked for effective components that the 5 stages were most successful with. The review is designed for hospitalists to use to formulate quality improvement interventions for infection reduction.
AHRQ-funded; HS018334.
Citation: Patel PK, Gupta A, Vaughn VM .
Review of strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs.
J Hosp Med 2018 Feb;13(2):105-16. doi: 10.12788/jhm.2856..
Keywords: Care Management, Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Infectious Diseases, Intensive Care Unit (ICU), Patient Safety, Urinary Tract Infection (UTI)
Govindan S, Wallace B, Iwashyna TJ
Do experts understand performance measures? A mixed-methods study of infection preventionists.
This study assessed expert interpretation of CLABSI quality data using a cross-sectional survey of members of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). The investigators found that significant variability in the interpretation of CLABSI data exists among experts. They assert that this finding is likely related to data complexity, particularly with respect to risk-adjusted data. They suggest that improvements appear necessary in data sharing and public policy efforts to account for this complexity.
AHRQ-funded; HS022835.
Citation: Govindan S, Wallace B, Iwashyna TJ .
Do experts understand performance measures? A mixed-methods study of infection preventionists.
Infect Control Hosp Epidemiol 2018 Jan;39(1):71-76. doi: 10.1017/ice.2017.243..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Provider, Provider Performance, Quality of Care, Quality Measures
Nuckols TK, Keeler E, Morton SC
Economic evaluation of quality improvement interventions for bloodstream infections related to central catheters: a systematic review.
The authors systematically reviewed economic evaluations of QI interventions designed to prevent central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI) in acute care hospitals. They concluded that interventions related to central venous catheters were, on average, associated with 57% fewer bloodstream infections and substantial savings to hospitals. Larger initial investments may be associated with greater savings.
AHRQ-funded.
Citation: Nuckols TK, Keeler E, Morton SC .
Economic evaluation of quality improvement interventions for bloodstream infections related to central catheters: a systematic review.
JAMA Intern Med 2016 Dec;176(12):1843-54. doi: 10.1001/jamainternmed.2016.6610.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Healthcare Costs, Quality Improvement
Mimoz O, Chopra V, Widmer A
What's new in skin antisepsis for short-term intravascular catheters: new data to address old problems?
Catheter-related infections remain a leading cause of healthcare-associated infections (HAI) in ICUs and the most preventable HAI. The authors discussed skin antiseptic solutions and included a table of practical recommendations for skin antisepsis before insertion of a short-term vascular catheter.
AHRQ-funded; HS022835.
Citation: Mimoz O, Chopra V, Widmer A .
What's new in skin antisepsis for short-term intravascular catheters: new data to address old problems?
Intensive Care Med 2016 Dec;42(12):2043-45. doi: 10.1007/s00134-016-4490-5.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
McAlearney AS, Hefner JL
Getting to zero: goal commitment to reduce blood stream infections.
The researchers examined goal-setting as a factor contributing to program outcomes in eight hospitals focused on preventing central line-associated bloodstream infections (CLABSIs). They conducted qualitative case studies to compare higher- and lower-performing hospitals, and explored differences in contextual factors that might contribute to performance variation. Finally, they present a goal commitment framework that characterizes factors associated with successful CLABSI program outcomes.
AHRQ-funded; 290200600022.
Citation: McAlearney AS, Hefner JL .
Getting to zero: goal commitment to reduce blood stream infections.
Med Care Res Rev 2016 Aug;73(4):458-77. doi: 10.1177/1077558715616028.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Outcomes, 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)
Pronovost PJ, Cleeman JI, Wright D
AHRQ Author: Cleeman JI
Fifteen years after to Err is Human: a success story to learn from.
This paper provides a historical profile of the central line-associated bloodstream infection (CLABSI) success story, comparing infection rates before and 15 years after the IOM report. It discusses the five elements essential to the national success in reducing CLABSI rates: a reliable and valid measurement system, evidence-based care practices, investment in implementation sciences, local ownership and peer learning communities, and coordination and alignment of CLABSI reduction efforts.
AHRQ-authored.
Citation: Pronovost PJ, Cleeman JI, Wright D .
Fifteen years after to Err is Human: a success story to learn from.
BMJ Qual Saf 2016 Jun;25(6):396-9. doi: 10.1136/bmjqs-2015-004720.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Medical Errors, Evidence-Based Practice, Quality of Care
Rock C, Thom KA, Harris AD
A multicenter longitudinal study of hospital-onset bacteremia: time for a new quality outcome measure?
This study evaluates hospital-onset bacteremia (HOB) as a healthcare-associated infection-related outcome measure by assessing the association between HOB and central-line-associated bloodstream infection (CLABSI) rates and comparing the power of each to discriminate quality among intensive care units (ICUs). The researchers found that change in HOB rate is strongly associated with change in CLABSI rate and has greater power to discriminate between ICU performances.
AHRQ-funded; HS022291.
Citation: Rock C, Thom KA, Harris AD .
A multicenter longitudinal study of hospital-onset bacteremia: time for a new quality outcome measure?
Infect Control Hosp Epidemiol 2016 Feb;37(2):143-8. doi: 10.1017/ice.2015.261.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Quality Measures, Quality Measures
Ricciardi R, Moy E, Wilson NJ
AHRQ Author: Ricciardi R and Moy E
Finding the true north: lessons from the National Healthcare Quality and Disparities Report.
The authors delineate important features and findings of the 2014 report. For example, it shows that one measure of patient safety improved quickly. The rate of central line–associated bloodstream infection per 1000 medical and surgical discharges (age 18+ years or obstetric admissions) improved at an annual rate of change of more than 10 percent. This success reflects the direct impact that nurses can have in making care safer for their patients.
AHRQ authors Ricciardi and Moy
Citation: Ricciardi R, Moy E, Wilson NJ .
Finding the true north: lessons from the National Healthcare Quality and Disparities Report.
J Nurs Care Qual 2016 Jan-Mar;31(1):9-12. doi: 10.1097/ncq.0000000000000164..
Keywords: Quality of Care, Disparities, Patient Safety, Nursing, Central Line-Associated Bloodstream Infections (CLABSI)
Calderwood MS, Vaz LE, Tse Kawai A
Impact of hospital operating margin on central line-associated bloodstream infections following Medicare's hospital-acquired conditions payment policy.
In October 2008, Medicare ceased additional payment for hospital-acquired conditions not present on admission. The researchers evaluated the policy's differential impact in hospitals with high vs low operating margins. They concluded that Medicare's payment policy may have had an impact on reducing central line-associated bloodstream infections in hospitals with low operating margins.
AHRQ-funded; HS018414.
Citation: Calderwood MS, Vaz LE, Tse Kawai A .
Impact of hospital operating margin on central line-associated bloodstream infections following Medicare's hospital-acquired conditions payment policy.
Infect Control Hosp Epidemiol 2016 Jan;37(1):100-3. doi: 10.1017/ice.2015.250.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Medicare, Quality of Care, Payment, Sepsis