National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Antimicrobial Stewardship (1)
- Burnout (1)
- Caregiving (1)
- Children/Adolescents (1)
- Critical Care (2)
- Emergency Preparedness (2)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospitals (3)
- Intensive Care Unit (ICU) (9)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- (-) Neonatal Intensive Care Unit (NICU) (14)
- Newborns/Infants (13)
- Nursing (2)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Patient Safety (3)
- Prevention (1)
- Provider (1)
- Provider: Nurse (1)
- Quality Indicators (QIs) (1)
- Quality of Care (1)
- Respiratory Conditions (1)
- Shared Decision Making (2)
- Simulation (1)
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- Teams (3)
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- Transitions of Care (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 DisplayedUmoren RA, Sawyer TL, Ades A
Team stress and adverse events during neonatal tracheal intubations: a report from NEAR4NEOS.
This study aimed to examine the association between team stress level and adverse tracheal intubation (TI)-associated events during neonatal intubations. TIs from 10 academic neonatal intensive care units were analyzed. Team stress level was rated immediately after TI using a 7-point Likert scale (1 = high stress). Associations among team stress, adverse TI-associated events, and TI characteristics were evaluated. The investigators concluded that high team stress levels during TI were more frequently reported among TIs with adverse events.
AHRQ-funded; HS024511.
Citation: Umoren RA, Sawyer TL, Ades A .
Team stress and adverse events during neonatal tracheal intubations: a report from NEAR4NEOS.
Am J Perinatol 2020 Dec;37(14):1417-24. doi: 10.1055/s-0039-1693698..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Critical Care, Teams, Stress, Adverse Events
Smith JG, Rogowski JA, Lake ET
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
Being unable to provide required nursing care to infants could contribute to poorer neonatal nurse job outcomes, which may exacerbate staffing challenges. Little evidence exists about how missed nursing care relates to neonatal nurse job outcomes. The purpose of this study was to determine relationships among missed nursing care, job enjoyment and intention to leave for neonatal nurses.
AHRQ-funded; HS024918.
Citation: Smith JG, Rogowski JA, Lake ET .
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
J Nurs Manag 2020 Nov;28(8):1940-47. doi: 10.1111/jonm.12943..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Provider: Nurse, Provider, Burnout, Nursing
Lake ET, Smith JG, Staiger DO
Measuring parent satisfaction with care in neonatal intensive care units: the EMPATHIC-NICU-USA questionnaire.
This study’s objective was to adapt the Netherlands-developed parent satisfaction questionnaire on neonatal and pediatric intensive care units EMPATHIC for USA use and translation into English. The researchers selected the EMPATHIC-30 questionnaire due to its’ shorter length and availability of a validated Spanish-language version. Six items from the EMPATHIC-N survey were also added, two of which were split into separate items creating a new EMPATHIC-38 survey which was adapted to USA English. The survey was then tested with NICU and PICU parents. Data from 282 parents (61% White, 61% Black, and 20% Hispanic) was used as a test. Results were positive and indicated acceptable reliability.
Citation: Lake ET, Smith JG, Staiger DO .
Measuring parent satisfaction with care in neonatal intensive care units: the EMPATHIC-NICU-USA questionnaire.
Front Pediatr 2020 Oct 6;8:541573. doi: 10.3389/fped.2020.541573.
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Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Patient Experience, Hospitals
Rossol SL, Yang JK, Toney-Noland C
Non-contact video-based neonatal respiratory monitoring.
Respiratory rate (RR) has been shown to be a reliable predictor of cardio-pulmonary deterioration, but standard RR monitoring methods in the neonatal intensive care units (NICU) with contact leads have been related to iatrogenic complications. This iterative design study developed a novel algorithm that produced RR from footage analyzed from stable NICU patients in open cribs with corrected gestational ages ranging from 33 to 40 weeks. The final algorithm used a proprietary technique of micromotion and stationarity detection to model background noise to be able to amplify and record respiratory motions.
AHRQ-funded; HS023506.
Citation: Rossol SL, Yang JK, Toney-Noland C .
Non-contact video-based neonatal respiratory monitoring.
Children 2020 Oct 6;7(10). doi: 10.3390/children7100171..
Keywords: Newborns/Infants, Health Information Technology (HIT), Respiratory Conditions, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU)
Lake ET, Staiger DO, Cramer E
Association of patient acuity and missed nursing care in U.S. neonatal intensive care units.
The health outcomes of infants in neonatal intensive care units (NICUs) may be jeopardized when required nursing care is missed. The authors conducted a correlational study of using 2016 NICU registered nurse survey responses from the National Database of Nursing Quality Indicators. They found that 36% of nurses missed one or more care activities on their past shift. The most common activities missed involved patient comfort and counseling and parent education. They recommended that nurses' assignments account for patient acuity. NICU nurse staffing and work environments warrant attention to reduce missed care and promote optimal infant and family outcomes.
AHRQ-funded; HS024918.
Citation: Lake ET, Staiger DO, Cramer E .
Association of patient acuity and missed nursing care in U.S. neonatal intensive care units.
Med Care Res Rev 2020 Oct;77(5):451-60. doi: 10.1177/1077558718806743..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Nursing, Quality Indicators (QIs), Quality of Care
Ma AL, Cohen RS, Lee HC
Learning from wildfire disaster experience in California NICUs.
The authors’ objective was to learn how personnel working in neonatal intensive care units (NICUs) of California hospitals handled issues of neonatal transfer during wildfire disasters in recent years; their ultimate goal was to share lessons learned with healthcare teams on disaster preparedness. They found that while describing disaster preparedness, equipment (such as bassinets and backpacks), ambulance access/transport and documentation/charting were noted as important and essential. They concluded that teamwork, willingness to do other tasks that are not part of typical job descriptions, and unconventional strategies contributed to the success of keeping NICU babies safe when California wildfire strikes.
AHRQ-funded; HS023506.
Citation: Ma AL, Cohen RS, Lee HC .
Learning from wildfire disaster experience in California NICUs.
Children 2020 Oct;7(10):E155. doi: 10.3390/children7100155..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Transitions of Care, Emergency Preparedness, Teams, Healthcare Delivery
Dadiz R, Riccio J, Brown K
Qualitative analysis of latent safety threats uncovered by in situ simulation-based operations testing before moving into a single-family-room neonatal intensive care unit.
This study’s objective was to identify 1) latent safety threats (LSTs) in a new neonatal intensive care unit (NICU) through simulation-based pre-occupancy operations testing, and 2) LSTs that remained unresolved 1-year post-occupancy. This qualitative study included 111 healthcare professionals who participated in patient care simulations and debriefings in a new NICU. Debriefing transcripts were analyzed to characterize LSTs. Three-hundred threats with four major themes affecting staff function and patient safety emerged: relay of information, workplace design, patient care processes, and patient family and staff focus. One-year post occupancy 29 (9%) LSTs were still unresolved.
AHRQ-funded; R18 HS023460.
Citation: Dadiz R, Riccio J, Brown K .
Qualitative analysis of latent safety threats uncovered by in situ simulation-based operations testing before moving into a single-family-room neonatal intensive care unit.
J Perinatol 2020 Sep;40(Suppl 1):29-35. doi: 10.1038/s41372-020-0749-3..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Patient Safety, Simulation
Neu M, Klawetter S, Greenfield JC
Mothers' experiences in the NICU before family-centered care and in NICUs where it is the standard of care.
Family-centered care (FCC) in neonatal intensive care units (NICUs) was initiated in 1992 to promote a respectful response to individual family needs and support parental participation in care and decision-making for their infants. Although benefits of FCC have been reported, changes in the maternal experience in the NICU are unknown. The purpose of this study was to compare mothers' experiences in NICUs where FCC is the standard of care and to compare these with the experiences of mothers 2 decades ago.
AHRQ-funded; HS026370.
Citation: Neu M, Klawetter S, Greenfield JC .
Mothers' experiences in the NICU before family-centered care and in NICUs where it is the standard of care.
Adv Neonatal Care 2020 Feb;20(1):68-79. doi: 10.1097/anc.0000000000000671.
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Keywords: Newborns/Infants, Patient-Centered Healthcare, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Caregiving, Shared Decision Making, Patient Experience, Patient and Family Engagement
Profit J, Lee HC, Sharek PJ
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
The objectives of this study were to assess variation in safety and teamwork climate and in the neonatal intensive care unit (NICU) setting, and compare measurement of safety culture scales using two different instruments (Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSOPSC)). It concluded that large variation and opportunities for improvement in patient safety culture exist across NICUs. Important systematic differences exist between SAQ and HSOPSC.
AHRQ-funded; HS014246.
Citation: Profit J, Lee HC, Sharek PJ .
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
BMJ Qual Saf 2016 Dec;25(12):954-61. doi: 10.1136/bmjqs-2014-003924.
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Keywords: Hospitals, Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Safety, Teams
Quinn M, Gephart S
Evidence for implementation strategies to provide palliative care in the neonatal intensive care unit.
The authors sought to answer the clinical question: In neonatal intensive care, what evidence can be used to guide implementation of palliative care protocols? They found that successful team approaches included standardized order sets to initiate neonatal palliative care (NPC), NPC education for staff, and references to NPC guidelines or protocols.They recommended that barriers such as lack of interdisciplinary cooperation, lack of appropriate physical space, and lack of education be addressed during program development.
AHRQ-funded; HS022908.
Citation: Quinn M, Gephart S .
Evidence for implementation strategies to provide palliative care in the neonatal intensive care unit.
Adv Neonatal Care 2016 Dec;16(6):430-38. doi: 10.1097/anc.0000000000000354.
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Keywords: Evidence-Based Practice, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Palliative Care
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)
Freedman S
Capacity and utilization in health care: the effect of empty beds on neonatal intensive care admission.
In this paper, the author exploited short-term variation in Neonatal Intensive Care Unit (NICU) capacity that is unlikely to be correlated with unobserved demand determinants. He found that available NICU beds have little to no effect on NICU utilization for the sickest infants, but do increase utilization for those in the range of birth weights where admission decisions are likely to be more discretionary.
AHRQ-funded; HS018266.
Citation: Freedman S .
Capacity and utilization in health care: the effect of empty beds on neonatal intensive care admission.
Am Econ J Econ Policy 2016 May 1;8(2):154-85. doi: 10.1257/pol.20120393.
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Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Healthcare Utilization, Critical Care, Shared Decision Making
Garfield CF, Lee YS, Kim HN
Supporting parents of premature infants transitioning from the NICU to home: a pilot randomized control trial of a smartphone application.
This study determined whether parents of Very Low Birth Weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU) transitioning home with the NICU-2-Home smartphone application have greater parenting self-efficacy, are better prepared for discharge and have shorter length of stay (LOS) than control parents. It found that a smartphone application can improve parenting self-efficacy, discharge preparedness, and LOS with improved benefits based on usage.
AHRQ-funded; HS020316.
Citation: Garfield CF, Lee YS, Kim HN .
Supporting parents of premature infants transitioning from the NICU to home: a pilot randomized control trial of a smartphone application.
Internet Interv 2016 May;4(Pt 2):131-37. doi: 10.1016/j.invent.2016.05.004.
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Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Health Information Technology (HIT), Home Healthcare, Hospital Discharge
Farra S, Miller ET, Gneuhs M
Evacuation performance evaluation tool.
The authors described the development and implications of a disaster evacuation performance tool that measures one portion of the very complex process of evacuation. The tool was pilot tested with an administrative, medical, and nursing leadership group and then implemented with a group of healthcare workers during a disaster exercise. The authors found that the Delphi process based on the conceptual framework of DeVellis yielded a psychometrically sound evacuation performance evaluation tool for a neonatal intensive care unit.
AHRQ-funded; HS023149.
Citation: Farra S, Miller ET, Gneuhs M .
Evacuation performance evaluation tool.
Am J Disaster Med 2016 Spring;11(2):131-36. doi: 10.5055/ajdm.2016.0232.
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Keywords: Emergency Preparedness, Hospitals, Neonatal Intensive Care Unit (NICU), Children/Adolescents, Training