National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (22)
- Ambulatory Care and Surgery (2)
- Antibiotics (6)
- Antimicrobial Stewardship (6)
- Cancer (2)
- Cardiovascular Conditions (3)
- Caregiving (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (13)
- Central Line-Associated Bloodstream Infections (CLABSI) (15)
- Children/Adolescents (8)
- Clostridium difficile Infections (12)
- Communication (1)
- Comparative Effectiveness (2)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Critical Care (4)
- Data (1)
- Diagnostic Safety and Quality (1)
- Education: Continuing Medical Education (1)
- Elderly (6)
- Electronic Health Records (EHRs) (4)
- Evidence-Based Practice (3)
- Guidelines (2)
- (-) Healthcare-Associated Infections (HAIs) (86)
- Healthcare Costs (2)
- Health Information Technology (HIT) (4)
- Heart Disease and Health (1)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospital Readmissions (1)
- Hospitals (21)
- Infectious Diseases (17)
- Injuries and Wounds (12)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (9)
- Long-Term Care (7)
- Medical Devices (2)
- Medical Errors (1)
- Medicare (3)
- Medication (6)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (10)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (3)
- Nursing (2)
- Nursing Homes (7)
- Outcomes (1)
- Patient-Centered Outcomes Research (4)
- Patient Safety (51)
- Pneumonia (3)
- Policy (1)
- Pressure Ulcers (1)
- Prevention (33)
- Provider Performance (3)
- Public Health (3)
- Quality Improvement (6)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (8)
- Registries (2)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Risk (14)
- Sepsis (1)
- Shared Decision Making (2)
- Surgery (23)
- Treatments (1)
- Urinary Tract Infection (UTI) (9)
- Women (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 25 of 86 Research Studies DisplayedKim 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
Hsu HE, Mathew R, Wang R
Health care-associated infections among critically ill children in the US, 2013-2018.
The purpose of this study was to examine changes over time in CLABSI and CAUTI rates between 2013 and 2018 in neonatal intensive care units (NICUs) and pediatric intensive care units (PICUs) using prospective surveillance data from community hospitals, children's hospitals, and pediatric units within general hospitals. The investigators concluded that recent trends in CLABSI rates noted in this study among critically ill neonates and children in a large cohort of US hospitals indicated that past gains have held, without evidence of further improvements, suggesting novel approaches for CLABSI prevention are needed.
AHRQ-funded; HS025008; HS018414.
Citation: Hsu HE, Mathew R, Wang R .
Health care-associated infections among critically ill children in the US, 2013-2018.
https://www.pubmed.ncbi.nlm.nih.gov/33017011
JAMA Pediatr 2020 Dec;174(12):1176-83. doi: 10.1001/jamapediatrics.2020.3223..
JAMA Pediatr 2020 Dec;174(12):1176-83. doi: 10.1001/jamapediatrics.2020.3223..
Keywords: Children/Adolescents, Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU)
McKinnell JA, Miller LG, Singh RD
High prevalence of multidrug-resistant organism colonization in 28 nursing homes: an "iceberg effect."
The objective of this study was to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), extended-spectrum beta-lactamase producing organisms (ESBLs), and carbapenem-resistant Enterobacteriaceae (CRE) among residents and in the environment of nursing homes (NHs). The investigators concluded that in more than half of the NHs, more than 50% of residents were colonized with MDROs of clinical and public health significance, most commonly MRSA and ESBL. Additionally, the vast majority of resident rooms and common areas were MDRO contaminated.
AHRQ-funded; HS024286.
Citation: McKinnell JA, Miller LG, Singh RD .
High prevalence of multidrug-resistant organism colonization in 28 nursing homes: an "iceberg effect."
J Am Med Dir Assoc 2020 Dec;21(12):1937-43.e2. doi: 10.1016/j.jamda.2020.04.007..
Keywords: Nursing Homes, Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs)
Rinke ML, Oyeku SO, Ford WJH
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This retrospective case control study estimated additional costs associated with pediatric ambulatory central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery. The authors concluded that ambulatory HAI in pediatric patients were associated with significant additional costs.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Ford WJH .
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Infect Control Hosp Epidemiol 2020 Nov;41(11):1292-97. doi: 10.1017/ice.2020.305..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Ambulatory Care and Surgery, Healthcare Costs, Surgery
Reeder B, Makic MBF, Morrow C
AHRQ Author: Rodrick D
Design and evaluation of low-fidelity visual display prototypes for multiple hospital-acquired conditions.
Hospital-acquired conditions such as catheter-associated urinary tract infection, stage 3 or 4 hospital-acquired pressure injury, and falls with injury are common, costly, and largely preventable. This study used participatory design methods to design and evaluate low-fidelity prototypes of clinical dashboards to inform high-fidelity prototype designs to visualize integrated risks based on patient profiles.
AHRQ-authored; AHRQ-funded; 233201500025I; 23337003T.
Citation: Reeder B, Makic MBF, Morrow C .
Design and evaluation of low-fidelity visual display prototypes for multiple hospital-acquired conditions.
Comput Inform Nurs 2020 Nov;38(11):562-71. doi: 10.1097/cin.0000000000000668..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Risk, Hospitals, Prevention
Thate JA, Couture B, Schnock KO
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
It is clear that interdisciplinary communication and collaboration have the potential to mitigate healthcare-associated harm, yet there is limited research on how communication through documentation in the patient record can support collaborative decision making. Understanding what information is needed to support collaborative decision making is necessary to design electronic health information systems that facilitate effective communication and, ultimately, safe care. To explore this issue, the investigators focused on information needs related to central venous catheter management and the prevention of central line-associated blood stream infections.
AHRQ-funded; HS0235335.
Citation: Thate JA, Couture B, Schnock KO .
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
Comput Inform Nurs 2020 Nov 2;39(4):208-14. doi: 10.1097/cin.0000000000000683..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Shared Decision Making, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Anderson DJ, Ilieş I, Foy K
Early recognition and response to increases in surgical site infections using optimized statistical process control charts-the Early 2RIS Trial: a multicenter cluster randomized controlled trial with stepped wedge design.
This paper discusses the study protocol that was used to conduct the Early 2RIS Trial, which was a multicenter cluster randomized controlled trial from 2016 to 2020 to reduce surgical site infection (SSI) rates. The trial was performed in 29 hospitals in the Duke Infection Control Outreach Network (DICON) and 105 clusters over 4 years. All patients who underwent one of 13 targeted procedures at study hospitals were included. Six clusters were identified: cardiac, orthopedic, gastrointestinal, OB-GYN, vascular, and spinal. Clusters were randomized to intervention, and also underwent surveillance and feedback using optimized SPC charts. Surveillance data feedback was provided to all clusters, regardless of allocation or type of surveillance. The goal was to lower SSI through SPC intervention compared to traditional surveillance and feedback alone.
AHRQ-funded; HS023821.
Citation: Anderson DJ, Ilieş I, Foy K .
Early recognition and response to increases in surgical site infections using optimized statistical process control charts-the Early 2RIS Trial: a multicenter cluster randomized controlled trial with stepped wedge design.
Trials 2020 Oct 28;21(1):894. doi: 10.1186/s13063-020-04802-4..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety
Vaughn VM, O'Malley M, Flanders SA
Association of infectious disease physician approval of peripherally inserted central catheter with appropriateness and complications.
The purpose of this study was to evaluate whether infectious disease physician approval prior to PICC placement for intravenous antimicrobials was associated with more appropriate device use and fewer complications. The authors concluded that this cohort study suggested that, when PICCs were placed for intravenous antimicrobial therapy, infectious disease physician approval of PICC insertion was associated with more appropriate device use and fewer complications.
AHRQ-funded; HS026530; HS025891.
Citation: Vaughn VM, O'Malley M, Flanders SA .
Association of infectious disease physician approval of peripherally inserted central catheter with appropriateness and complications.
JAMA Netw Open 2020 Oct;3(10):e2017659. doi: 10.1001/jamanetworkopen.2020.17659..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases, Adverse Events
Bucher BT, Shi J, Ferraro JP
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
The authors presented the development and validation of a portable natural language processing (NLP) approach for automated surveillance of surgical site infections (SSIs). Patient clinical text notes from EHRs following surgical procedures from two independent healthcare systems were abstracted. The authors found that automated surveillance of SSIs can be achieved using NLP of clinical notes with high sensitivity and specificity.
AHRQ-funded; HS025776.
Citation: Bucher BT, Shi J, Ferraro JP .
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
Ann Surg 2020 Oct;272(4):629-36. doi: 10.1097/sla.0000000000004133..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Gall E, Long A, Hall KK
Chlorhexidine bathing strategies for multidrug-resistant organisms: a summary of recent evidence.
This systematic literature review investigated the latest evidence for patient bathing with a 2%-4% chlorhexidine gluconate solution to reduce multidrug-resistant organism (MDRO) transmission and infection. Three databases were searched for articles from 2008 through 2018, as well as any key articles published after 2018. Findings focused on health care-associated infections (HAIs) and 3 categories of MDROs: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and carbapenem-resistant Enterobacteriaceae (CRE). Chlorhexidine reduced MRSA acquisition and carriage, but no studies found significant reductions in infections. Several studies found that chlorhexidine bathing reduced VRE acquisition and carriage. Two very large studies found bathing significantly reduced HAIs, but these reductions may be smaller when HAIs are already controlled with other anti-infection measures.
AHRQ-funded; HHSP233201500013I.
Citation: Gall E, Long A, Hall KK .
Chlorhexidine bathing strategies for multidrug-resistant organisms: a summary of recent evidence.
J Patient Saf 2020 Sep;16(3S Suppl 1):S16-s22. doi: 10.1097/pts.0000000000000743..
Keywords: Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety, Infectious Diseases
Schoyer E, Hall K
Environmental cleaning and decontamination to prevent clostridioides difficile infection in health care settings: a systematic review.
The aim of this systematic review was to examine the most effective and feasible methods for environmental cleaning and decontamination to prevent Clostridioides difficile infection (CDI) in health care settings. The investigators concluded that the studied practices for environmental cleaning and decontamination were associated with significant decreases in facility-level CDI rates in most of the reviewed studies; however, study quality was low.
AHRQ-funded; 233201500013I.
Citation: Schoyer E, Hall K .
Environmental cleaning and decontamination to prevent clostridioides difficile infection in health care settings: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S12-s15. doi: 10.1097/pts.0000000000000749..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Patient Safety
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
Zachariah P, Sanabria E, Liu J
Novel strategies for predicting healthcare-associated infections at admission: implications for nursing care.
Accurate, real-time models to predict hospital adverse events could facilitate timely and targeted interventions to improve patient outcomes. Advances in computing enable the use of supervised machine learning (SML) techniques to predict hospital-onset infections. The purpose of this study was to trial SML methods to predict urinary tract infections (UTIs) during inpatient hospitalization at the time of admission.
AHRQ-funded; HS024915.
Citation: Zachariah P, Sanabria E, Liu J .
Novel strategies for predicting healthcare-associated infections at admission: implications for nursing care.
Nurs Res 2020 Sep/Oct;69(5):399-403. doi: 10.1097/nnr.0000000000000449..
Keywords: Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Adverse Events, Patient Safety, Risk
Keller S, Salinas A, Williams D
Reaching consensus on a home infusion central line-associated bloodstream infection surveillance definition via a modified Delphi approach.
A consensus on a central line-associated bloodstream infection (CLABSI) surveillance definition in home infusion is needed to standardize measurement and benchmark CLABSI to provide data to drive improvement initiatives. Experts across fields including home infusion therapy, infectious diseases, and healthcare epidemiology convened to perform a 3-step modified Delphi approach to obtain input and achieve consensus on a candidate home infusion CLABSI definition. This paper describes the process.
AHRQ-funded; HS025782.
Citation: Keller S, Salinas A, Williams D .
Reaching consensus on a home infusion central line-associated bloodstream infection surveillance definition via a modified Delphi approach.
Am J Infect Control 2020 Sep;48(9):993-1000. doi: 10.1016/j.ajic.2019.12.015..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Home Healthcare
Song J, Cohen B, Zachariah P
Temporal change of risk factors in hospital-acquired Clostridioides difficile infection using time-trend analysis.
Given recent changes in the epidemiology of Clostridioides difficile infection (CDI) and prevention efforts, the authors investigated temporal changes over a period of 11 years (2006-2016) in incidence and risk factors for CDI using a retrospective matched case-control study design. The investigators concluded that although the incidence of HA-CDI decreased over time, CA-CDI simultaneously increased.
Citation: Song J, Cohen B, Zachariah P .
Temporal change of risk factors in hospital-acquired Clostridioides difficile infection using time-trend analysis.
Infect Control Hosp Epidemiol 2020 Sep;41(9):1048-57. doi: 10.1017/ice.2020.206..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Risk, Patient Safety
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
Sankaran R, Gulseren B, Nuliyalu U R, Gulseren B, Nuliyalu U
A comparison of estimated cost savings from potential reductions in hospital-acquired conditions to levied penalties under the CMS Hospital-Acquired Condition Reduction Program.
The Hospital-Acquired Condition Reduction Program (HACRP) from the Centers for Medicare & Medicaid Services (CMS) reduces Medicare payments to hospitals with high rates of hospital-acquired conditions (HACs) by 1% each year. It is not known how the savings accruing to CMS from such penalties compare to savings resulting from a reduction in HACs driven by this program. This study compared the reported savings to CMS from financial penalties levied under the HACRP with savings resulting from potential reductions in HACs.
AHRQ-funded; HS000053; HS026244.
Citation: Sankaran R, Gulseren B, Nuliyalu U R, Gulseren B, Nuliyalu U .
A comparison of estimated cost savings from potential reductions in hospital-acquired conditions to levied penalties under the CMS Hospital-Acquired Condition Reduction Program.
Jt Comm J Qual Patient Saf 2020 Aug;46(8):438-47. doi: 10.1016/j.jcjq.2020.05.002.
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Keywords: Healthcare Costs, Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Medicare
Chatterjee P, Williams MD, Coppin JD
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
This study examined whether using novel coper-impregnated solid materials on high-touch surfaces in patient rooms lowered bacterial contamination which may lead to health care-associated infections in acute care hospitals. Sixteen rooms were installed with copper-impregnated surfaces and were compared to standard noncopper laminate surfaces in 16 rooms over a 3-day period. Samples were taken 3 times per day. A lower level of microbial contamination was found in copper-impregnated solid surfaces as compared to standard surfaces.
AHRQ-funded; HS025598.
Citation: Chatterjee P, Williams MD, Coppin JD .
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
Open Forum Infect Dis 2020 Aug;7(8). doi: 10.1093/ofid/ofaa238..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Comparative Effectiveness, Prevention, Evidence-Based Practice
Rinke ML, Oyeku SO, Heo M
Pediatric ambulatory catheter-associated urinary tract infections (CAUTIs): incidence, risk factors, and patient outcomes.
Catheter-associated urinary tract infections (CAUTIs) occur frequently in pediatric inpatients, and they are associated with increased morbidity and cost. Few studies have investigated ambulatory CAUTIs, despite at-risk children utilizing home urinary catheterization. This retrospective cohort and case-control study determined incidence, risk factors, and outcomes of pediatric patients with ambulatory CAUTI. The investigators concluded that pediatric ambulatory CAUTIs occurred in 18% of patients with catheters; they were associated with morbidity and healthcare utilization. Ambulatory indwelling catheter CAUTI incidence exceeded national inpatient incidence.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Heo M .
Pediatric ambulatory catheter-associated urinary tract infections (CAUTIs): incidence, risk factors, and patient outcomes.
Infect Control Hosp Epidemiol 2020 Aug;41(8):891-99. doi: 10.1017/ice.2020.204..
Keywords: Children/Adolescents, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Risk, Ambulatory Care and Surgery, Adverse Events
Sheetz KH, Ryan A
Accuracy of quality measurement for the hospital acquired conditions reduction program.
Accuracy of quality measurement for the hospital acquired conditions reduction program.
AHRQ-funded; HS026244; HS000053.
Citation: Sheetz KH, Ryan A .
Accuracy of quality measurement for the hospital acquired conditions reduction program.
BMJ Qual Saf 2020 Jul;29(7):605-07. doi: 10.1136/bmjqs-2019-009747..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Quality Measures, Quality Improvement, Quality of Care, Surgery, Infectious Diseases
Hsu HE, Wang R, Broadwell C
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
The authors assessed the association of Hospital-Acquired Condition Reduction Program (HACRP) and Hospital Value-Based Purchasing (HVBP) implementation with changes in rates of targeted health care-associated infections and disparities in rates among safety-net and non-safety-net hospitals. They found that HACRP and HVBP implementation was not associated with any improvements in targeted health care-associated infections among safety-net or non-safety-net hospitals or with changes in disparities in infection rates. They concluded that, given the persistent health care-associated infection rate disparities, these programs appear to function as a disproportionate penalty system for safety-net hospitals that offer no measurable benefits for patients.
AHRQ-funded; HS018414.
Citation: Hsu HE, Wang R, Broadwell C .
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
JAMA Netw Open 2020 Jul;3(7):e209700. doi: 10.1001/jamanetworkopen.2020.9700..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Medicare, Patient Safety
Luzum M, Sebolt J, Chopra V
Catheter-associated urinary tract infection, Clostridioides difficile colitis, central line-associated bloodstream infection, and methicillin-resistant Staphylococcus aureus.
This article provides summaries of the background, epidemiology, diagnosis, and treatment of central line-associated bloodstream infection, catheter-associated urinary tract infection, Clostridioides difficile, and methicillin-resistant Staphylococcus aureus colonization and infections. Additional prevention strategies, including those related to recent national interventions, are also reviewed.
AHRQ-funded; HS022835.
Citation: Luzum M, Sebolt J, Chopra V .
Catheter-associated urinary tract infection, Clostridioides difficile colitis, central line-associated bloodstream infection, and methicillin-resistant Staphylococcus aureus.
Med Clin North Am 2020 Jul;104(4):663-79. doi: 10.1016/j.mcna.2020.02.004..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Clostridium difficile Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases
Ilieş I, Anderson DJ, Salem J
Large-scale empirical optimisation of statistical control charts to detect clinically relevant increases in surgical site infection rates.
Researchers sought to determine which statistical process control chart types and design parameters maximized the detection of clinically relevant surgical site infection (SSI) rate increases while minimizing false alarms. Statistically significant SSI rate increases (signals) at individual hospitals were identified using 50 different statistical process control chart variations; blinded epidemiologists evaluated the clinical significance of 2709 representative signals of potential outbreaks and rated them as requiring action or no action. The researchers concluded that an optimized combination of two moving average charts had the best performance for identifying clinically relevant small but sustained above-network SSI rates and large short-term individual hospital increases.
AHRQ-funded; HS023821.
Citation: Ilieş I, Anderson DJ, Salem J .
Large-scale empirical optimisation of statistical control charts to detect clinically relevant increases in surgical site infection rates.
BMJ Qual Saf 2020 Jun;29(6):472-81. doi: 10.1136/bmjqs-2018-008976..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Patient Safety
Baker AW, Nehls N, Ilies I
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
This study analyzed the use of optimized dual statistical process control (SPC) charts to predict surgical site infection (SSI) outbreaks. The researchers retrospectively applied an optimized pair of moving average (MA) SPC charts to all 30 SSI outbreaks previously identified and investigated from 2007 to 2015 in the Duke Infection Control Outreach Network (DICON), which is a network of more than 50 community hospitals. The dual MA SPC chart approach detected all 30 outbreaks at a median of 16 months prior to traditional surveillance detection.
AHRQ-funded; HS23821.
Citation: Baker AW, Nehls N, Ilies I .
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
BMJ Qual Saf 2020 Jun;29(6):517-20. doi: 10.1136/bmjqs-2019-010586..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Hospitals, Public Health, Infectious Diseases
Bartsch SM, Wong KF, Stokes-Cawley OJ
Knowing more of the iceberg: how detecting a greater proportion of carbapenem-resistant Enterobacteriaceae carriers influences transmission.
This study examined the impact of detecting a greater proportion of carbapenem-resistant Enterobacteriaceae (CRE) carriers in the hospital inpatient population. The researchers used the Regional Healthcare Ecosystem Analyst-generated agent-based model of adult inpatient healthcare facilities in Orange County, California. They found that only if the detection level is increased to 1 in 5 carriers does it garner large reductions in the number of new CRE carriers. At the present time the detection level is 1 in 9 carriers.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Wong KF, Stokes-Cawley OJ .
Knowing more of the iceberg: how detecting a greater proportion of carbapenem-resistant Enterobacteriaceae carriers influences transmission.
J Infect Dis 2020 May 11;221(11):1782-94. doi: 10.1093/infdis/jiz288..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Patient Safety, Prevention