National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- (-) Central Line-Associated Bloodstream Infections (CLABSI) (15)
- Children/Adolescents (1)
- Communication (1)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Critical Care (1)
- Disparities (1)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (12)
- Healthcare Costs (1)
- Hospitals (1)
- Intensive Care Unit (ICU) (3)
- Medical Errors (1)
- Medicare (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Nursing (1)
- Nursing Homes (1)
- Organizational Change (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (11)
- Payment (1)
- Prevention (6)
- Quality Improvement (2)
- Quality Measures (1)
- Quality of Care (3)
- Risk (1)
- Sepsis (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 15 of 15 Research Studies DisplayedNuckols 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
Theodoro D, Olsen MA, Warren DK
Emergency department central line-associated bloodstream infections (CLABSI) incidence in the era of prevention practices.
The incidence of central line–associated bloodstream infections (CLABSI) attributed to central venous catheters (CVCs) inserted in the emergency department (ED) is not widely reported. The goal of this study was to report the incidence of ED CLABSI. It concluded that the CLABSI rates in this academic medical center ED were in the range of those reported by the ICU.
AHRQ-funded; HS018092; HS019455.
Citation: Theodoro D, Olsen MA, Warren DK .
Emergency department central line-associated bloodstream infections (CLABSI) incidence in the era of prevention practices.
Acad Emerg Med 2015 Sep;22(9):1048-55. doi: 10.1111/acem.12744..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Emergency Department, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Prevention
Chopra V, Montoya A, Joshi D
Peripherally inserted central catheter use in skilled nursing facilities: a pilot study.
The purpose of this study was to describe patterns of use, care practices, and outcomes related to peripherally inserted central catheter (PICC) use in skilled nursing facilities (SNFs). The most common indication for PICC use was intravenous antibiotic delivery. The average PICC dwell time was 43 days, and most devices were single-lumen PICCs. Major and minor complications were common and occurred in 11 (20 percent) and 18 (32 percent) participants, respectively.
AHRQ-funded; HS022835; HS019979.
Citation: Chopra V, Montoya A, Joshi D .
Peripherally inserted central catheter use in skilled nursing facilities: a pilot study.
J Am Geriatr Soc 2015 Sep;63(9):1894-9. doi: 10.1111/jgs.13600..
Keywords: Adverse Events, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Nursing Homes, Patient Safety
Vaz LE, Kleinman KP, Kawai AT
Impact of Medicare's hospital-acquired condition policy on infections in safety net and non-safety net hospitals.
The researchers sought to determine whether the 2008 Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in safety net compared with non–safety net hospitals. They found that this policy did not have an impact, either positive or negative, on already declining rates of central line–associated bloodstream infection in safety net or non–safety net hospitals.
AHRQ-funded; HS018414.
Citation: Vaz LE, Kleinman KP, Kawai AT .
Impact of Medicare's hospital-acquired condition policy on infections in safety net and non-safety net hospitals.
Infect Control Hosp Epidemiol 2015 Jun;36(6):649-55. doi: 10.1017/ice.2015.38..
Keywords: Patient Safety, Medicare, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Scheck McAlearney A, Hefner J, Robbins J
AHRQ Author: Harrison MI
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
This study identified factors that may explain hospital-level differences in outcomes of programs to prevent central line–associated bloodstream infections. A main theme that differentiated higher- from lower-performing hospitals was a distinctive framing of the goal of “getting to zero” infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition.
AHRQ-authored; AHRQ-funded; 290200600022.
Citation: Scheck McAlearney A, Hefner J, Robbins J .
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
Infect Control Hosp Epidemiol 2015 May;36(5):557-63. doi: 10.1017/ice.2015.27..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Prevention
Rinke ML, Chen AR, Milstone AM
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
The researchers investigated (1) the extent to which best-practice central line maintenance practices were employed in the homes of pediatric oncology patients and by whom, (2) caregiver beliefs about central line care and central line-associated blood stream infection (CLABSI) risk, (3) barriers to optimal central line care by families, and (4) educational experiences and preferences regarding central line care. They concluded that interventions aimed at reducing ambulatory CLABSIs should target appropriate educational experiences for adult caregivers and patients and identify ways to improve compliance with best-practice care.
AHRQ-funded; HS021282.
Citation: Rinke ML, Chen AR, Milstone AM .
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
Jt Comm J Qual Patient Saf 2015 Apr;41(4):177-85.
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Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Ambulatory Care and Surgery, Quality Improvement
Pepin CS, Thom KA, Sorkin JD
Risk factors for central-line-associated bloodstream infections: a focus on comorbid conditions.
This cohort study explored risk factors for CLABSI using 2 comorbidity classification schemes, the Charlson Comorbidity Index (CCI) and the Chronic Disease Score (CDS). It found that individual comorbid conditions obtained electronically by ICD-9 codes and admission medications can be used to identify factors for increased risk for CLABSI. The composite CDS and CCI scores were not risk factors.
AHRQ-funded; HS022291.
Citation: Pepin CS, Thom KA, Sorkin JD .
Risk factors for central-line-associated bloodstream infections: a focus on comorbid conditions.
Infect Control Hosp Epidemiol 2015 Apr;36(4):479-81. doi: 10.1017/ice.2014.81..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Rangachari P, Madaio M, Rethemeyer RK
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
There are gaps in understanding the mechanisms by which top-down communications enable practice change. The authors sought to address these gaps in order to help identify evidence-based management strategies for successful practice change at the unit level. They found that both intensive care units studied experienced substantially improved outcomes and indicated a statistically significant increase in proactive communications. Early in the study, champions emerged within each unit to initiate process improvements. The authors concluded that the study helped to identify evidence-based management strategies for successful practice change at the unit level.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
Health Care Manage Rev 2015 Jan-Mar;40(1):65-78. doi: 10.1097/hmr.0000000000000001.
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Keywords: Intensive Care Unit (ICU), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Critical Care, Communication, Evidence-Based Practice, Organizational Change, Prevention, Patient Safety