National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (3)
- Cardiovascular Conditions (1)
- Care Management (1)
- Case Study (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (5)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Communication (3)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (2)
- Data (3)
- Dementia (1)
- Disabilities (1)
- Disparities (2)
- Elderly (1)
- Electronic Health Records (EHRs) (4)
- Electronic Prescribing (E-Prescribing) (1)
- Evidence-Based Practice (3)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (3)
- Health Services Research (HSR) (1)
- Hospitals (4)
- Implementation (1)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (3)
- Long-Term Care (2)
- Neonatal Intensive Care Unit (NICU) (1)
- (-) Nursing (28)
- Nursing Homes (1)
- Organizational Change (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Patient Safety (7)
- Pressure Ulcers (3)
- Prevention (2)
- Primary Care (2)
- Provider: Health Personnel (2)
- Provider: Nurse (1)
- Quality Measures (1)
- Quality of Care (4)
- Quality of Life (1)
- Research Methodologies (1)
- Shared Decision Making (2)
- Teams (1)
- Transitions of Care (1)
- Urinary Tract Infection (UTI) (1)
- Vulnerable Populations (1)
- Workflow (2)
- Workforce (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 28 Research Studies DisplayedBakken S, Reame N
http://www.ingentaconnect.com/content/springer/arnr/2016/00000034/00000001/art00013
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
The purposes of this chapter are to (a) briefly summarize the current drivers for the use of big data in research; (b) describe the promise of big data and associated data science methods for advancing symptom management research; and (c) explicate the potential perils of big data and data science from the perspective of the ethical principles of autonomy, beneficence, and justice.
AHRQ-funded; HS022961
Citation: Bakken S, Reame N .
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
Annu Rev Nurs Res 2016;34:247-60. doi: 10.1891/0739-6686.34.247..
Keywords: Data, Disparities, Nursing, Patient-Centered Outcomes Research
Martsolf GR, Gibson TB, Benevent R
AHRQ Author: Jiang HJ, Stocks C
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
The researchers studied the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. After controlling for unobserved hospital characteristics, they found that the positive influences of increased nurse staffing levels and skill mix were relatively small in size and limited to a few measures of patients' inpatient experience.
AHRQ-authored.
Citation: Martsolf GR, Gibson TB, Benevent R .
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
Health Serv Res 2016 Dec;51(6):2221-41. doi: 10.1111/1475-6773.12462.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Nursing, Patient Experience, Patient Experience, Healthcare Cost and Utilization Project (HCUP)
Harrod M, Montoya A, Mody L
Challenges for nurses caring for individuals with peripherally inserted central catheters in skilled nursing facilities.
The researchers sought to understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. They noted differences between resident self-reported PICC concerns (quality of life) and those described by frontline nurses.
AHRQ-funded; HS019979; HS022835.
Citation: Harrod M, Montoya A, Mody L .
Challenges for nurses caring for individuals with peripherally inserted central catheters in skilled nursing facilities.
J Am Geriatr Soc 2016 Oct;64(10):2059-64. doi: 10.1111/jgs.14341.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Nursing, Quality of Life, Transitions of Care
Grundy Q
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
The author analyzed the ways that committee members constructed and evaluated a case for a product's value, concluding that purchasing committees need unique support that emphasizes local contexts and expertise, while maintaining rigor and minimizing bias. Grundy proposed a guiding framework to support this decision-making.
AHRQ-funded; HS022383.
Citation: Grundy Q .
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
Soc Sci Med 2016 Sep;165:82-91. doi: 10.1016/j.socscimed.2016.07.042.
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Keywords: Shared Decision Making, Healthcare Costs, Hospitals, Nursing
Connor JA, Larson C, Baird J
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
The authors aimed to identify and develop standardized measures representative of pediatric nursing care of the cardiovascular patient for benchmarking within freestanding children's hospitals. The Consortium of Congenital Cardiac Care-Measurement of Nursing Practice members developed quality measures within working groups and then individually critiqued all drafted measures. The process resulted in 10 measures eligible for testing. The Consortium will continue with implementation and testing of each measure, supporting the development of benchmarks and the evaluation of the association of the measures with patient outcomes.
AHRQ-funded; HS000063.
Citation: Connor JA, Larson C, Baird J .
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
J Pediatr Nurs 2016 Sep-Oct;31(5):471-7. doi: 10.1016/j.pedn.2016.04.010.
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Keywords: Children/Adolescents, Cardiovascular Conditions, Nursing, Quality Measures, Hospitals
Poghosyan L, Liu J
Nurse practitioner autonomy and relationships with leadership affect teamwork in primary care practices: a cross-sectional survey.
The authors investigated whether nurse practitioner (NP) autonomy within primary care practices and the relationships they have with leadership affect teamwork between NPs and physicians. They concluded that NP autonomy and favorable relationships with leadership improve teamwork, and they recommended that policy and organizational change focus on promoting NP autonomy and improving the relationship between NPs and leadership to improve teamwork and consequently improve patient care and outcomes.
AHRQ-funded; HS020999.
Citation: Poghosyan L, Liu J .
Nurse practitioner autonomy and relationships with leadership affect teamwork in primary care practices: a cross-sectional survey.
J Gen Intern Med 2016 Jul;31(7):771-7. doi: 10.1007/s11606-016-3652-z.
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Keywords: Nursing, Organizational Change, Primary Care, Teams
Silber JH, Rosenbaum PR, McHugh MD
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
This study tested whether hospitals with better nursing work environments displayed better value than those with worse nursing. It found that hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients.
AHRQ-funded; HS018338.
Citation: Silber JH, Rosenbaum PR, McHugh MD .
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
JAMA Surg 2016 Jun;151(6):527-36. doi: 10.1001/jamasurg.2015.4908.
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Keywords: Healthcare Costs, Quality of Care, Nursing, Workforce
Navarra AM, Schlau R, Murray M
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
The researchers designed and tested the Nursing-Kids Intensity of Care Survey (N-KICS) tool and describe intensity of nursing care for children with complex medical conditions. Their psychometric evaluation confirmed an acceptable standard for reliability and validity and feasibility. Intensity scores were highest for nursing care related to infection control, medication administration, nutrition, diaper changes, hygiene, neurological and respiratory support, and standing program.
AHRQ-funded; HS021470.
Citation: Navarra AM, Schlau R, Murray M .
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
J Pediatr Nurs 2016 May-Jun;31(3):299-310. doi: 10.1016/j.pedn.2015.11.012.
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Keywords: Children/Adolescents, Chronic Conditions, Disabilities, Long-Term Care, Nursing, Vulnerable Populations
Baird J, Rehm RS, Hinds PS
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
The objective of this analysis was to explore the delivery of continuity of nursing care in the pediatric intensive care unit (PICU), from the perspective of both parents and nurses. Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child's care regimen.
AHRQ-funded; HS000063.
Citation: Baird J, Rehm RS, Hinds PS .
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
Nurs Res 2016 Mar-Apr;65(2):142-50. doi: 10.1097/nnr.0000000000000135.
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Keywords: Care Management, Children/Adolescents, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU), Nursing
Schondelmeyer AC, Brady PW, Landrigan CP
Alarm fatigue: clearing the air.
The authors discuss an article in the same issue of the Journal of Hospital Medicine by Paine and colleagues that sets out to review the small but growing body of literature addressing physiologic monitor alarms and interventions that have tried to address alarm fatigue. They conclude that the review demonstrates that the great majority of alarms do not help clinicians and likely contribute to alarm fatigue.
AHRQ-funded; HS023827.
Citation: Schondelmeyer AC, Brady PW, Landrigan CP .
Alarm fatigue: clearing the air.
J Hosp Med 2016 Feb;11(2):153-4. doi: 10.1002/jhm.2521.
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Keywords: Patient Safety, Nursing, Adverse Events, Hospitals
Abraham J, Kannampallil T, Brenner C
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
This paper describes Sequential Conversational Analysis (SCA) - a mixed-method approach integrating qualitative conversational analysis with quantitative sequential pattern analysis. This approach allows characterization of the nature of nurse handoff communication, highlighting the relationships underlying verbal content. The authors also discuss how SCA can help in understanding the dynamics of communication in other settings.
AHRQ-funded; HS017586.
Citation: Abraham J, Kannampallil T, Brenner C .
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
J Biomed Inform 2016 Feb;59:76-88. doi: 10.1016/j.jbi.2015.11.009.
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Keywords: Communication, Quality of Care, Intensive Care Unit (ICU), Nursing, Workflow
Jones K, Sibai J, Battjes R
How and when nurses collect urine cultures on catheterized patients: a survey of 5 hospitals.
Obtaining a specimen for urine culture is a key element in evaluating for catheter-associated urinary tract infections (CAUTIs). Nurses at 5 hospitals completed a survey regarding their knowledge, training, and practices of appropriate reasons for obtaining urine cultures. The researchers concluded that important opportunities exist for nurses to optimize the decisions to obtain urine cultures and the process for obtaining them.
AHRQ-funded; 290201000025I; 29032001T.
Citation: Jones K, Sibai J, Battjes R .
How and when nurses collect urine cultures on catheterized patients: a survey of 5 hospitals.
Am J Infect Control 2016 Feb;44(2):173-6. doi: 10.1016/j.ajic.2015.09.003.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Hospitals, Nursing, Provider: Nurse, Urinary Tract Infection (UTI)
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)
Gephart S, Carrington JM, Finley B
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
The purpose of this article is to present the state of the science on nurses' experiences with unintended consequences of electronic health records (EHRs). Findings demonstrate that nurses experience changes to workflow, must continually adapt to meet patient's needs in the context of imperfect EHR systems, and have difficulty accessing the information they need to make patient care decisions. Implications for nurse administrators include the need for continual engagement with nurses along the continuum of EHR design, as well as the need to encourage nurses to speak up and acknowledge workflow changes that threaten patient safety or do not support work efficiency.
AHRQ-funded; HS021074.
Citation: Gephart S, Carrington JM, Finley B .
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
Nurs Adm Q 2015 Oct-Dec;39(4):345-56. doi: 10.1097/naq.0000000000000119.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Electronic Health Records (EHRs), Nursing, Workflow
Gephart SM
Fostering best practice: strategies for writing evidence-based practice briefs.
In this editorial, the author provides instructions to make the task of writing a brief manageable for even the newest of authors. From asking a compelling clinical question to telling the story of a critical appraisal of evidence to making recommendations, the overall goal of writing such a brief is to support best practice care in the neonatal intensive care unit.
AHRQ-funded; HS022908.
Citation: Gephart SM .
Fostering best practice: strategies for writing evidence-based practice briefs.
Adv Neonatal Care 2015 Oct;15(5):299-306. doi: 10.1097/anc.0000000000000222.
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Keywords: Evidence-Based Practice, Nursing, Research Methodologies, Neonatal Intensive Care Unit (NICU)
Price LE, Shea K, Gephart S
The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice.
This article described the developments in research associated with the VHA's transition into the world of Big Data analytics through Corporate Data Warehouse (CDW) utilization. The authors found that the most commonly-occurring research topics are pharmacy/medications, systems issues, and weight management/obesity. They concluded that, despite the potential benefit of data mining techniques to improve patient care and services, the CDW and alternative analytical approaches are underutilized by researchers and clinicians.
AHRQ-funded; HS022908.
Citation: Price LE, Shea K, Gephart S .
The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice.
Nurs Adm Q 2015 Oct-Dec;39(4):311-8. doi: 10.1097/naq.0000000000000118.
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Keywords: Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Ricciardi R
AHRQ Author: Ricciardi R
I'm in an NP state of mind: a tribute to Dr. Henry K. Silver on the 50th anniversary of the nurse practitioner profession.
The author gives a personal tribute to Dr. Henry K Silver who co-founded the nurse practitioner role with Dr. Loretta Ford and founded the Child Health Associate/Physician Assistant program at the University of Colorado.
AHRQ-authored.
Citation: Ricciardi R .
I'm in an NP state of mind: a tribute to Dr. Henry K. Silver on the 50th anniversary of the nurse practitioner profession.
J Pediatr Health Care 2015 Sep-Oct;29(5):397-9. doi: 10.1016/j.pedhc.2015.06.009..
Keywords: Nursing, Children/Adolescents, Provider: Health Personnel
Stifter J, Yao Y, Lodhi MK
Nurse continuity and hospital-acquired pressure ulcers: A comparative analysis using an electronic health record "big data" set.
The aim of this study was to examine the association of nurse continuity with the prevention of hospital-acquired pressure ulcers (HAPU). It found that patient characteristics including nutrition, mobility, and perfusion were associated with HAPUs, but nurse continuity was not.
AHRQ-funded; HS023072.
Citation: Stifter J, Yao Y, Lodhi MK .
Nurse continuity and hospital-acquired pressure ulcers: A comparative analysis using an electronic health record "big data" set.
Nurs Res 2015 Sep-Oct;64(5):361-71. doi: 10.1097/nnr.0000000000000112..
Keywords: Patient Safety, Pressure Ulcers, Nursing
Brennan PF, Bakken S
Nursing needs big data and big data needs nursing.
Nursing science and nursing practice has much to gain from the data science initiatives. Existing approaches to large data set analysis provide a necessary but not sufficient foundation for nursing to participate in the big data revolution. Nursing’s Social Policy Statement provides a principled, ethical perspective on big data and data science.
AHRQ-funded; HS022961; HS02254.
Citation: Brennan PF, Bakken S .
Nursing needs big data and big data needs nursing.
J Nurs Scholarsh 2015 Sep;47(5):477-84. doi: 10.1111/jnu.12159..
Keywords: Nursing, Data, Health Information Technology (HIT)
Abbott AA, Fuji KT, Galt KA
A qualitative case study exploring nurse engagement with electronic health records and e-prescribing.
The purpose of this qualitative case study was to describe how nurses adapt to using an electronic health record with electronic prescribing (e-Rx) system in a rural ambulatory care practice. Findings showed that nurses adjust their routine in response to providers' preferential behavior yet retained focus on the patient and care coordination. e-Rx adoption increased workload and introduced safety risks.
AHRQ-funded; HS018625.
Citation: Abbott AA, Fuji KT, Galt KA .
A qualitative case study exploring nurse engagement with electronic health records and e-prescribing.
West J Nurs Res 2015 Jul;37(7):935-51. doi: 10.1177/0193945914567359.
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Keywords: Case Study, Electronic Health Records (EHRs), Electronic Prescribing (E-Prescribing), Nursing, Patient Safety
Pierson CA, Ricciardi R
AHRQ Author: Ricciardi R
A tribute to our heritage.
This article recognizes the contributions of Dr. Henry K. Silver, co-founder of the first nurse practitioner (NP) program and pioneer collaborator who has so greatly influenced the NP profession. The author, Richard Ricciardi, PhD, NP, FAAN, FAANP, knew Dr. Silver personally and professionally. This tribute was read at the June Fellows Induction Ceremony in New Orleans. There is another longer article about Dr. Silver by Dr. Ricciardi in the June 2015 issue of the FAANP Forum.
AHRQ-authored.
Citation: Pierson CA, Ricciardi R .
A tribute to our heritage.
J Am Assoc Nurse Pract 2015 Jul;27(7):350. doi: 10.1002/2327-6924.12287..
Keywords: Nursing, Children/Adolescents, Provider: Health Personnel
Ricciardi R
AHRQ Author: Ricciardi R
AHRQ focuses on ambulatory patient safety.
As AHRQ looks to expand its ambulatory safety research efforts, the agency seeks the involvement of a variety of nurses to provide expert opinion and consultation and to conduct research. The author emphasizes that this is an opportunity for both PhD and Doctor of Nursing Practice prepared nurses to lead interprofessional teams to conduct research that can translate into meaningful improvements in ambulatory quality.
AHRQ-authored.
Citation: Ricciardi R .
AHRQ focuses on ambulatory patient safety.
J Nurs Care Qual 2015 Jul-Sep;30(3):193-6. doi: 10.1097/ncq.0000000000000124..
Keywords: Patient Safety, Nursing, Primary Care, Adverse Events, Health Services Research (HSR)
Carrington JM, Gephart SM, Verran JA
Development of an instrument to measure the unintended consequences of EHRs.
The authors examined the creation and design of an instrument measuring unintended consequences of electronic health records. They suggested that other researchers will find their methods article informative for similar undertakings.
AHRQ-funded; HS022908.
Citation: Carrington JM, Gephart SM, Verran JA .
Development of an instrument to measure the unintended consequences of EHRs.
West J Nurs Res 2015 Jul;37(7):842-58. doi: 10.1177/0193945915576083.
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Keywords: Communication, Shared Decision Making, Electronic Health Records (EHRs), Nursing, Patient Safety
Padula WV, Valuck RJ, Makic MB
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced, the overall reduction of pressure ulcers (PUs). It found that several internal factors influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns and data sharing among peer institutions.
AHRQ-funded; HS023710.
Citation: Padula WV, Valuck RJ, Makic MB .
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
J Wound Ostomy Continence Nurs 2015 Jul-Aug;42(4):327-30. doi: 10.1097/won.0000000000000145..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Prevention
Kiyoshi-Teo H, Blegen M
Influence of institutional guidelines on oral hygiene practices in intensive care units.
The purpose of this study was to explore how characteristics of institutional guidelines for oral hygiene influence nurses’ oral hygiene practices and perceptions of that practice. It concluded that the content and dissemination method of institutional guidelines on oral hygiene do influence the oral hygiene practices of critical care nurses.
AHRQ-funded; HS018879.
Citation: Kiyoshi-Teo H, Blegen M .
Influence of institutional guidelines on oral hygiene practices in intensive care units.
Am J Crit Care 2015 Jul;24(4):309-18. doi: 10.4037/ajcc2015920..
Keywords: Intensive Care Unit (ICU), Nursing, Critical Care, Prevention, Guidelines