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Topics
- Antibiotics (4)
- (-) Antimicrobial Stewardship (9)
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- (-) Healthcare-Associated Infections (HAIs) (9)
- Healthcare Costs (1)
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- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Neonatal Intensive Care Unit (NICU) (1)
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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 9 of 9 Research Studies DisplayedAnderson DJ, Watson S, Moehring RW
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Watson S, Moehring RW .
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Hospitals, Infectious Diseases, Medication, Patient Safety
Monsees EA, Tamma PD, Cosgrove SE
AHRQ Author: Miller MA
Integrating bedside nurses into antibiotic stewardship: a practical approach.
This study looked into a framework for nurses to integrate antibiotic stewardship (AS) into their clinical work with patients. The practices that nurses can take include improving antibiotic prescribing practices through appropriate obtainment of Cloistridioides difficile tests, appropriate urine culturing practices, optimal antibiotic administration, accurate and detailed documentation of antibiotic allergy histories, and through the prompting of antibiotic time outs. Barriers were also identified to engagement of nurses in AS and offered potential solutions.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Monsees EA, Tamma PD, Cosgrove SE .
Integrating bedside nurses into antibiotic stewardship: a practical approach.
Infect Control Hosp Epidemiol 2019 May;40(5):579-84. doi: 10.1017/ice.2018.362..
Keywords: Antibiotics, Antimicrobial Stewardship, Guidelines, Healthcare-Associated Infections (HAIs), Medication, Nursing, Patient Safety
Kline SE, Sanstead EC, Johnson JR
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
In this study, the investigators developed a decision analytic model to evaluate the impact of a preoperative Staphylococcus aureus decolonization bundle on surgical site infections (SSIs), health-care-associated costs (HCACs), and deaths due to SSI. The investigators predict that the treat-all strategy would be the most effective and cost-saving strategy for preventing SSIs. However, they concluded that because this strategy might select more extensively for mupirocin-resistant S. aureus and cause more medication adverse effects than the test-and-treat approach or the SOC, additional studies are needed to define its comparative benefits and harms.
AHRQ-funded; HS022912.
Citation: Kline SE, Sanstead EC, Johnson JR .
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
Infect Control Hosp Epidemiol 2018 Nov;39(11):1340-46. doi: 10.1017/ice.2018.228..
Keywords: Surgery, Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention, Healthcare Costs
Johnson SP, Zhong L, Chung KC
Perioperative antibiotics for clean hand surgery: a national study.
This research is a national study on the use of prophylactic antibiotics in soft tissue hand surgery when antimicrobials are not indicated. Insurance claims from the Truven MarketScan Databases were used to identify patients who had 1 of 5 outpatient surgery procedures including: open or endoscopic carpal tunnel release; trigger finger release; de Ouervain release, and wrist ganglion excision between 2009 and 2015. An increase of 72.5% in prophylactic intravenous antibiotics was shown from 2009 to 2015. Patients with a younger age, male sex, lower income, or obesity had higher odds of receiving antibiotics. Total charge for these antibiotics equaled $1.6 million.
AHRQ-funded; HS023313.
Citation: Johnson SP, Zhong L, Chung KC .
Perioperative antibiotics for clean hand surgery: a national study.
J Hand Surg Am 2018 May;43(5):407-16.e1. doi: 10.1016/j.jhsa.2017.11.018..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Medication, Patient Safety, Surgery
Anderson DJ, Addison R, Lokhnygina Y
The Antimicrobial Scrub Contamination and Transmission (ASCOT) trial: a three-arm, blinded, randomized controlled trial with crossover design to determine the efficacy of antimicrobial-impregnated scrubs in preventing healthcare provider contamination.
The objective of the study was to determine whether antimicrobial-impregnated textiles decrease the acquisition of pathogens by healthcare provider (HCP) clothing. The authors found that antimicrobial-impregnated scrubs were not effective at reducing HCP contamination. They indicated, however, that the environment was an important source of HCP clothing contamination.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Addison R, Lokhnygina Y .
The Antimicrobial Scrub Contamination and Transmission (ASCOT) trial: a three-arm, blinded, randomized controlled trial with crossover design to determine the efficacy of antimicrobial-impregnated scrubs in preventing healthcare provider contamination.
Infect Control Hosp Epidemiol 2017 Oct;38(10):1147-54. doi: 10.1017/ice.2017.181..
Keywords: Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Barker AK, Ngam C, Musuuza JS
Reducing Clostridium difficile in the inpatient setting: a systematic review of the adherence to and effectiveness of C. difficile prevention bundles.
Researchers conducted a systematic review to examine the components of Clostridium difficile infection (CDI) prevention bundles, their implementation processes, and their impact on CDI rates. They concluded that given the lack of randomized controlled trials in the literature, assessing a causal relationship between bundled interventions and CDI rates is currently impossible.
AHRQ-funded; HS023791.
Citation: Barker AK, Ngam C, Musuuza JS .
Reducing Clostridium difficile in the inpatient setting: a systematic review of the adherence to and effectiveness of C. difficile prevention bundles.
Infect Control Hosp Epidemiol 2017 Jun;38(6):639-50. doi: 10.1017/ice.2017.7.
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Keywords: Antimicrobial Stewardship, Guidelines, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Moehring RW, Anderson DJ, Cochran RL
Expert consensus on metrics to assess the impact of patient-level antimicrobial stewardship interventions in acute-care settings.
Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. Researchers used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. On a 9-point Likert scale, six metrics were rated >6 in all criteria and fourteen metrics rated >6 in all criteria except feasibility.
AHRQ-funded; HS023866.
Citation: Moehring RW, Anderson DJ, Cochran RL .
Expert consensus on metrics to assess the impact of patient-level antimicrobial stewardship interventions in acute-care settings.
Clin Infect Dis 2017 Feb 1;64(3):377-83. doi: 10.1093/cid/ciw787.
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Keywords: Critical Care, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Trautner BW, Greene MT, Krein SL
Infection prevention and antimicrobial stewardship knowledge for selected infections among nursing home personnel.
This study assessed knowledge about infection prevention among nursing home personnel and identified gaps potentially addressable through a quality improvement collaborative. It found that, while 99.1 percent of licensed personnel recognized the definition of asymptomatic bacteriuria, only 36.1 percent knew that pyuria could not distinguish a urinary tract infection from asymptomatic bacteriuria.
AHRQ-funded; 290201000025I.
Citation: Trautner BW, Greene MT, Krein SL .
Infection prevention and antimicrobial stewardship knowledge for selected infections among nursing home personnel.
Infect Control Hosp Epidemiol 2017 Jan;38(1):83-88. doi: 10.1017/ice.2016.228.
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Keywords: Antimicrobial Stewardship, Education: Continuing Medical Education, Healthcare-Associated Infections (HAIs), Nursing Homes, Prevention, Patient Safety
Reich PJ, Boyle MG, Hogan PG
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Methicillin-resistant Staphylococcus aureus (MRSA) infections cause significant morbidity and mortality in neonatal intensive care units (NICUs). The researchers characterized the clinical and molecular epidemiology of MRSA strains colonizing NICU patients. They found that community-acquired MRSA strains are prominent in the NICU and associated with distinct risk factors.
AHRQ-funded; HS021736; HS024269.
Citation: Reich PJ, Boyle MG, Hogan PG .
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Clin Microbiol Infect 2016 Jul;22(7):645.e1-8. doi: 10.1016/j.cmi.2016.04.013.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Neonatal Intensive Care Unit (NICU), Patient Safety, Prevention, Antimicrobial Stewardship, Newborns/Infants, Healthcare-Associated Infections (HAIs)