National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (10)
- Ambulatory Care and Surgery (3)
- Antibiotics (8)
- Antimicrobial Stewardship (4)
- Blood Clots (1)
- Burnout (1)
- Cancer (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (5)
- Central Line-Associated Bloodstream Infections (CLABSI) (10)
- Children/Adolescents (7)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (8)
- Communication (1)
- Community-Acquired Infections (3)
- Critical Care (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Electronic Health Records (EHRs) (2)
- Emergency Department (1)
- Evidence-Based Practice (3)
- Guidelines (3)
- (-) Healthcare-Associated Infections (HAIs) (69)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (4)
- Health Insurance (1)
- Home Healthcare (4)
- Hospital Discharge (2)
- Hospitalization (4)
- Hospitals (17)
- Implementation (1)
- Infectious Diseases (23)
- Influenza (1)
- Injuries and Wounds (5)
- Inpatient Care (2)
- Kidney Disease and Health (1)
- Long-Term Care (5)
- Medical Devices (1)
- Medicare (1)
- Medication (10)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (9)
- Newborns/Infants (1)
- Nursing (2)
- Nursing Homes (5)
- Orthopedics (1)
- Outcomes (1)
- Patient Safety (32)
- Payment (2)
- Pneumonia (3)
- Policy (1)
- Practice Patterns (2)
- Pressure Ulcers (1)
- Prevention (15)
- Primary Care (1)
- Provider (3)
- Provider: Health Personnel (1)
- Provider: Nurse (3)
- Provider: Physician (1)
- Provider Performance (4)
- Public Health (4)
- Public Reporting (1)
- Quality Improvement (4)
- Quality Indicators (QIs) (2)
- Quality Measures (2)
- Quality of Care (6)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (4)
- Risk (9)
- Sepsis (1)
- Shared Decision Making (1)
- Skin Conditions (1)
- Social Determinants of Health (1)
- Surgery (9)
- Teams (2)
- Urinary Tract Infection (UTI) (5)
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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 25 of 69 Research Studies DisplayedMiller LG, McKinnell JA, Singh RD
Decolonization in nursing homes to prevent infection and hospitalization.
Researchers conducted a cluster-randomized trial of universal decolonization as compared with routine-care bathing in nursing homes. Data were obtained from 28 nursing homes. The results indicated that universal decolonization with chlorhexidine and nasal iodophor led to a significantly lower risk of transfer to a hospital due to infection than routine care.
AHRQ-funded; HS024286.
Citation: Miller LG, McKinnell JA, Singh RD .
Decolonization in nursing homes to prevent infection and hospitalization.
N Engl J Med 2023 Nov 9; 389(19):1766-77. doi: 10.1056/NEJMoa2215254..
Keywords: Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs)
Keller SC, Hannum SM, Weems K
Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition.
Researchers tested the validity of a home-infusion central-line-associated bloodstream infection (CLABSI) surveillance definition and the feasibility and acceptability of its implementation. Their study was conducted in large home-infusion agencies in a CLABSI prevention collaborative in 14 states and the District of Columbia and included semistructured interviews with staff performing home-infusion CLABSI surveillance. The results showed that the home-infusion CLABSI surveillance definition was valid and would be feasible to implement.
AHRQ-funded; HS027819.
Citation: Keller SC, Hannum SM, Weems K .
Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition.
Infect Control Hosp Epidemiol 2023 Nov; 44(11):1748-59. doi: 10.1017/ice.2023.70..
Keywords: Home Healthcare, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Thom KA, Rock C, Robinson GL
Direct gloving vs hand hygiene before donning gloves in adherence to hospital infection control practices: a cluster randomized clinical trial.
The purpose of this study was to assess the effectiveness of a direct-gloving policy on adherence to infection prevention control practices in a hospital setting. In this study, hospital units were randomly assigned to either the intervention (hand hygiene not required before putting on gloves) or to usual care (hand hygiene required prior to before putting on nonsterile gloves). The primary study outcome was adherence to the expected practice upon room entry and room exit. Thirteen hospital units participated in the trial, and 3,790 health care personnel (HCP) were observed. The study found that adherence to expected practice was higher in the 6 units with the direct-gloving intervention than in the 7 usual care units even when controlling for baseline hand hygiene rates, unit type, and universal gloving policies. The intervention had no effect on hand hygiene adherence measured at entry to non-contact precautions rooms or at room exit. The intervention was related with increased total bacteria colony counts and increased detection of pathogenic bacteria on gloves in the ED and reduced colony counts in pediatrics units, with no change in either total colony count for adult intensive care unit or presence of pathogenic bacteria for adult intensive care unit.
AHRQ-funded; HS024108.
Citation: Thom KA, Rock C, Robinson GL .
Direct gloving vs hand hygiene before donning gloves in adherence to hospital infection control practices: a cluster randomized clinical trial.
JAMA Netw Open 2023 Oct 2; 6(10):e2336758. doi: 10.1001/jamanetworkopen.2023.36758..
Keywords: Hospitals, Patient Safety, Guidelines, Healthcare-Associated Infections (HAIs)
Ojala F, Sater MRA, Miller LG
Bayesian modeling of the impact of antibiotic resistance on the efficiency of MRSA decolonization.
The authors analyzed how the persistence of methicillin-resistant Staphylococcus aureus (MRSA) colonization correlates with the genomic presence of antibiotic resistance genes. Using a Bayesian mixed effects survival model, they found that genetic determinants of high-level resistance to mupirocin was strongly associated with failure of the decolonization protocol, but they did not find a similar effect with genetic resistance to chlorhexidine or other antibiotics. They concluded that these results highlight the need to consider the properties of the colonizing MRSA strain when deciding which treatments to include in the decolonization protocol.
AHRQ-funded; HS019388.
Citation: Ojala F, Sater MRA, Miller LG .
Bayesian modeling of the impact of antibiotic resistance on the efficiency of MRSA decolonization.
PLoS Comput Biol 2023 Oct; 19(10):e1010898. doi: 10.1371/journal.pcbi.1010898..
Keywords: Antibiotics, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication
Metersky ML, Wang Y, Klompas M
Temporal trends in postoperative and ventilator-associated pneumonia in the United States.
The purpose of this retrospective cohort study was to assess change in rates of postoperative pneumonia and ventilator-associated pneumonia among patients hospitalized in the United States during 2009-2019. The study found that among 58,618 patients undergoing major surgical procedures between 2009 and 2019, the observed rate of postoperative pneumonia from 2009-2011 was 1.9% and decreased to 1.3% during 2017-2019. The adjusted annual risk each year, compared to the prior year, was 0.94. Among 4,007 patients hospitalized for any of the 4 conditions at risk for ventilator-associated pneumonia during 2009-2019, the researchers did not detect a significant change in observed or adjusted rates. Observed rates clustered around 10%, and adjusted annual risk compared to the prior year was 0.99.
AHRQ-funded; 290201800005C.
Citation: Metersky ML, Wang Y, Klompas M .
Temporal trends in postoperative and ventilator-associated pneumonia in the United States.
Infect Control Hosp Epidemiol 2023 Aug; 44(8):1247-54. doi: 10.1017/ice.2022.264..
Keywords: Pneumonia, Respiratory Conditions, Healthcare-Associated Infections (HAIs), Healthcare Cost and Utilization Project (HCUP)
Kamineni M, Ötleş Meng E, Oh J
Prospective evaluation of data-driven models to predict daily risk of Clostridioides difficile infection at 2 large academic health centers.
The purpose of this prospective study was to assess a data-driven approach for Clostridioides difficile infection (CDI) risk prediction that had previously demonstrated a high performance in retrospective evaluations at 2 large academic health centers. The final retrospective cohort included 18,030 admissions (138 CDI cases) at Massachusetts General Hospital (MGH) and 25,341admissions (158 CDI cases) at Michigan Medicine. The prospective cohort included 13,712 admissions (119 CDI cases) at MGH and 26,864 admissions (190 CDI cases) at MM. At MGH, the model achieved area under the receiver operator characteristic curve (AUROC). AUROCs of 0.744 in the retrospective cohort and 0.748 in the prospective cohort. At MM, the model achieved AUROCs of 0.778 in the retrospective cohort and 0.767 in the prospective cohort. The AUROCs for predicting CDI risk on both retrospective and prospective cohorts were similar each month and did not exhibit significant monthly variation throughout either assessment period.
AHRQ-funded; HS027431.
Citation: Kamineni M, Ötleş Meng E, Oh J .
Prospective evaluation of data-driven models to predict daily risk of Clostridioides difficile infection at 2 large academic health centers.
Infect Control Hosp Epidemiol 2023 Jul; 44(7):1163-66. doi: 10.1017/ice.2022.218..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Risk
MacEwan SR, Gaughan AA, Beal EW
Concerns and frustrations about the public reporting of device-related healthcare-associated infections: perspectives of hospital leaders and staff.
The purpose of this study was to explore the specific concerns of hospital leaders and staff regarding the identification and public reporting of healthcare-associated infections (HAIs). Between 2017 and 2019 the researchers conducted interviews with 471 participants including hospitals leaders and hospital staff across 18 United States hospitals. The study found that interviewees discussed concerns about public reporting of HAI data, including a lack of trust in the data and unintended consequences of its public reporting, as well as particular frustrations with the identification and accountability for publicly-reported HAIs.
AHRQ-funded; HS024958.
Citation: MacEwan SR, Gaughan AA, Beal EW .
Concerns and frustrations about the public reporting of device-related healthcare-associated infections: perspectives of hospital leaders and staff.
Am J Infect Control 2023 Jun; 51(6):633-37. doi: 10.1016/j.ajic.2022.08.003..
Keywords: Medical Devices, Healthcare-Associated Infections (HAIs), Hospitals, Provider: Health Personnel
Ye S, Li D, Yu T
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Researchers investigated the effect of surgical volume on the accuracy of identifying poorly performing hospitals. Their research was based on the standardized infection ratio, and they applied their proposed method to data from HCA Healthcare from 2014-2016 on surgical site infections in colon surgery patients. They concluded that minimum surgical volumes and predicted events criteria are required to make hospital evaluation reliable, and that these criteria may vary by overall prevalence and between-hospital variability.
AHRQ-funded; HS027791.
Citation: Ye S, Li D, Yu T .
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Sci Rep 2023 May 10; 13(1):7624. doi: 10.1038/s41598-023-33937-y..
Keywords: Hospitals, Surgery, Healthcare-Associated Infections (HAIs), Provider Performance, Quality of Care
Oladapo-Shittu O, Hannum SM, Salinas AB
The need to expand the infection prevention workforce in home infusion therapy.
This study looked at the prevalence of formal surveillance and infection prevention training for home infusion staff. The authors interviewed home infusion staff who perform surveillance activities about barriers to and facilitators for central line-associated bloodstream infection (CLABSI) surveillance and identified barriers to training in CLABSI surveillance. Their findings showed a lack of formal surveillance training which can be addressed by by adapting existing training resources to the home infusion setting.
AHRQ-funded; HS027819.
Citation: Oladapo-Shittu O, Hannum SM, Salinas AB .
The need to expand the infection prevention workforce in home infusion therapy.
Am J Infect Control 2023 May; 51(5):594-96. doi: 10.1016/j.ajic.2022.11.008.AHRQ-funded; HS027819..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Home Healthcare, Central Line-Associated Bloodstream Infections (CLABSI)
Sanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z .
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
Morgan DJ, Dubberke ER, Hink T
The impact of universal glove and gown use on Clostridioides difficile acquisition: a cluster-randomized trial.
This article described a secondary analysis of a cluster-randomized trial in medical and surgical intensive care units (ICUs) in 20 US hospitals to assess whether universal gown and glove use decreases Clostridioides difficile infection. ICUs were randomized to standard practice for glove and gown use versus all healthcare workers required to wear gloves and gowns for all patient contact or when entering a patient room. The results showed no significant difference in the rate of toxigenic C. difficile with universal gown and glove use.
AHRQ-funded; HS025456.
Citation: Morgan DJ, Dubberke ER, Hink T .
The impact of universal glove and gown use on Clostridioides difficile acquisition: a cluster-randomized trial.
Clin Infect Dis 2023 Feb 8; 76(3):e1202-e07. doi: 10.1093/cid/ciac519..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Prevention
Gregory ME, MacEwan SR, Sova LN
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
The objective of this study was to investigate the role of interprofessional teamwork in the prevention of health care-associated infections (HAIs), focusing on central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) prevention. The authors interviewed participating physicians, nurses, and other staff from 18 hospitals about interprofessional collaboration, and proposed an Input-Mediator-Output-Input (IMOI) model as well as strategies to support teamwork for the prevention of HAIs.
AHRQ-funded; HS024958.
Citation: Gregory ME, MacEwan SR, Sova LN .
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
Med Care Res Rev 2023 Feb;80(1):30-42. doi: 10.1177/10775587221103973..
Keywords: Teams, Prevention, Healthcare-Associated Infections (HAIs)
McNeil JC, Sommer LM, Vallejo JG
Going back in time: Increasing penicillin susceptibility among methicillin-susceptible staphylococcus aureus osteoarticular infections in children.
Researchers investigated the prevalence of penicillin susceptibility (PSSA) among pediatric methicillin susceptible S. aureus (MSSA) acute hematogenous osteoarticular infection (OAI) isolates; the isolates were obtained through surveillance studies at Texas Children's and St. Louis Children's Hospitals. Overall, PSSA isolates were found to be associated with a similar clinical presentation as penicillin-resistant isolates. The researchers concluded that potential for use of penicillin treatment in PSSA OAI merits further study.
AHRQ-funded; HS026896'HS021736' HS024269.
Citation: McNeil JC, Sommer LM, Vallejo JG .
Going back in time: Increasing penicillin susceptibility among methicillin-susceptible staphylococcus aureus osteoarticular infections in children.
Antimicrob Agents Chemother 2023 Jan 24; 67(1):e0119622. doi: 10.1128/aac.01196-22..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication, Prevention
Goto M, Hasegawa S, Balkenende EC
Effectiveness of ultraviolet-c disinfection on hospital-onset gram-negative rod bloodstream infection: a nationwide stepped-wedge time-series analysis.
This study evaluated the effectiveness of enhanced terminal room cleaning with ultraviolet C (UV-C) disinfection in reducing gram-negative rod (GNR) infections. The authors used information regarding UV-C use and the timing of implementation through a survey of all Veterans Health Administration (VHA) hospitals providing inpatient acute care from January 2010 and December 2018. Among 128 Veterans Health Administration hospitals, 120 provided complete survey responses with 40 reporting implementations of UV-C systems. UV-C use was associated with a 19% lower incident of hospital-onset (HO) GNR bloodstream infection (BSI).
AHRQ-funded; HS027472.
Citation: Goto M, Hasegawa S, Balkenende EC .
Effectiveness of ultraviolet-c disinfection on hospital-onset gram-negative rod bloodstream infection: a nationwide stepped-wedge time-series analysis.
Clin Infect Dis 2023 Jan 13; 76(2):291-98. doi: 10.1093/cid/ciac776..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Prevention, Sepsis
Patel P, Deshpande A, Yu PC
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
The purpose of this study was to explore the relationships between the antibiotic regimens of empiric therapy with a respiratory fluoroquinolone or cephalosporin plus macrolide combination and the development of hospital-onset Clostridioides difficile infection (CDI). The researchers used data from 638 United States hospitals and included adults admitted with pneumonia and discharged from July 2010 through June 2015 with a pneumonia diagnosis code who received 3 or more days of either antibiotic regimen. The study sample included 58,060 patients treated with either cephalosporin plus macrolide (36,796 patients) or a fluoroquinolone alone (21,264 patients). 0.35% of patients who received cephalosporin plus macrolide and 0.31% who received a fluoroquinolone developed CDI, making CDI risks similar for fluoroquinolones versus cephalosporin plus macrolide.
AHRQ-funded; HS024277.
Citation: Patel P, Deshpande A, Yu PC .
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
Infect Control Hosp Epidemiol 2023 Jan; 44(1):47-54. doi: 10.1017/ice.2022.60..
Keywords: Pneumonia, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Infectious Diseases, Community-Acquired Infections
Flores EJ, Jue JJ, Giradi G
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
In this pilot study, findings from the 2016 AHRQ EPC report on Clostridioides difficile infection were translated into a treatment pathway and disseminated via a cloud-based platform and electronic health record (EHR). Results indicated that pathways can be an approach for disseminating AHRQ EPC report findings within health care systems, with reports including guideline and pathway syntheses. Embedding hyperlinks to pathway content within the EHR may be a viable and low-effort solution for promoting awareness of evidence-based resources.
AHRQ-funded.
Citation: Flores EJ, Jue JJ, Giradi G .
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
Jt Comm J Qual Patient Saf 2019 Dec;45(12):822-28. doi: 10.1016/j.jcjq.2019.10.002..
Keywords: Implementation, Evidence-Based Practice, Infectious Diseases, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Patel SA, Araujo T, Rodriguez LP
Long peripheral catheters: a retrospective review of major complications.
The risk of infectious and noninfectious complications associated with long peripheral catheters (LPCs) is unknown. In this retrospective study of 539 catheters, the investigators did a retrospective review of major complications. Among other discoveries, they found LPCs were often placed for the indications of difficult access and long-term antibiotics.
AHRQ-funded; HS025891.
Citation: Patel SA, Araujo T, Rodriguez LP .
Long peripheral catheters: a retrospective review of major complications.
J Hosp Med 2019 Dec;14(12):758-60. doi: 10.12788/jhm.3313..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Blood Clots, Infectious Diseases, Risk
Krein SL, Kuhn L, Ratz D
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
The authors identified the prevalence of and factors associated with having a designated nurse peripherally inserted central catheter (PICC) team among U.S. acute care hospitals. They found that nurse PICC teams inserted PICCs in more than 60% of U.S. hospitals during the study period. Moreover, certain practices to prevent central line-associated bloodstream infection, including maximum sterile barrier precautions, chlorhexidine gluconate for insertion site antisepsis, and facility-wide insertion checklists were regularly used by a higher percentage of hospitals with nurse PICC teams compared with those without. They concluded that nurse PICC teams play an integral role in PICC use at many hospitals and that use of such teams may promote key practices to prevent complications.
AHRQ-funded; HS022835.
Citation: Krein SL, Kuhn L, Ratz D .
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
J Patient Saf 2019 Dec;15(4):293-95. doi: 10.1097/pts.0000000000000246..
Keywords: Nursing, Teams, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Inpatient Care, Hospitals, Patient Safety, Prevention, Provider: Nurse, Provider
Chiotos K, Rock C, Schweizer ML
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
This survey compares results with a similar 2013 survey that characterizes contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities. There was decreased frequency of active surveillance for MRSA, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
AHRQ-funded; HS026393.
Citation: Chiotos K, Rock C, Schweizer ML .
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
Infect Control Hosp Epidemiol 2019 Sep;40(9):1046-49. doi: 10.1017/ice.2019.172.
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Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Practice Patterns
Yang H, Tourani R, Zhu Y
Strategies for building robust prediction models using data unavailable at prediction time.
Risk prediction models based on pre- and intraoperative data have been proposed to assess the risk of HAIs at the end of the surgery, but the performance of these models lag behind HAI detection models based on postoperative data. Postoperative data are more predictive than pre- or interoperative data but it is unavailable when the risk models are applied (end of surgery). The objective of this study was to examine whether such data can be used to improve the performance of the risk model.
AHRQ-funded; HS024532.
Citation: Yang H, Tourani R, Zhu Y .
Strategies for building robust prediction models using data unavailable at prediction time.
J Am Med Inform Assoc 2021 Dec 28;29(1):72-79. doi: 10.1093/jamia/ocab229..
Keywords: Healthcare-Associated Infections (HAIs), Risk, Health Information Technology (HIT)
McKinnell JA, Singh RD, Miller LG
The SHIELD Orange County project: multidrug-resistant organism prevalence in 21 nursing homes and long-term acute care facilities in Southern California.
The authors reported baseline multidrug-resistant organism (MDRO) prevalence in 21 nursing homes (NHs) and long-term acute care facilities (LTACs). They found that prevalence of MDROs was 65% in NHs and 80% in LTACs. They concluded that the majority of NH residents and LTAC patients harbor MDROs, and that MDRO status is frequently unknown to the facility. The high MDRO prevalence highlights the need for prevention efforts in NHs/LTACs as part of regional efforts to control MDRO spread.
AHRQ-funded; HS023317.
Citation: McKinnell JA, Singh RD, Miller LG .
The SHIELD Orange County project: multidrug-resistant organism prevalence in 21 nursing homes and long-term acute care facilities in Southern California.
Clin Infect Dis 2019 Oct 15;69(9):1566-73. doi: 10.1093/cid/ciz119.
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Keywords: Nursing Homes, Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Patient Safety
Sheetz KH, Dimick JB, Englesbe MJ
Hospital-acquired condition reduction program is not associated with additional patient safety improvement.
In 2013 the Centers for Medicare and Medicaid Services announced that it would begin levying penalties against hospitals with the highest rates of hospital-acquired conditions through the Hospital-Acquired Condition Reduction Program. This study evaluates whether the program has been successful in improving patient safety or not. The investigators concluded that the program did not improve patient safety in Michigan beyond existing trends.
AHRQ-funded; HS000053; HS026244.
Citation: Sheetz KH, Dimick JB, Englesbe MJ .
Hospital-acquired condition reduction program is not associated with additional patient safety improvement.
Health Aff 2019 Nov;38(11):1858-65. doi: 10.1377/hlthaff.2018.05504..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Provider Performance, Quality Improvement, Quality of Care, Infectious Diseases, Payment
Hsu HE, Wang R, Jentzsch MS
The impact of measurement changes on evaluating hospital performance: the case of catheter-associated urinary tract infections.
Researchers observed that catheter-associated urinary tract infections in 592 hospitals immediately declined after federal value-based incentive program implementation, but found that this was fully attributable to a concurrent surveillance case definition revision. They found that post revision, more hospitals had favorable standardized infection ratios, likely leading to artificial inflation of their performance scores unrelated to changes in patient safety.
AHRQ-funded; HS000063; HS025008; HS018414.
Citation: Hsu HE, Wang R, Jentzsch MS .
The impact of measurement changes on evaluating hospital performance: the case of catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2019 Nov;40(11):1269-71. doi: 10.1017/ice.2019.240..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Provider Performance, Quality Measures, Urinary Tract Infection (UTI)
Caroff DA, Chan C, Kleinman K
Association of open approach vs laparoscopic approach with risk of surgical site infection after colon surgery.
The authors assessed whether laparoscopic colon surgery is associated with a lower surgical site infection rate than open-approach laparoscopy. They found that policy changes that promote surgical education and resources for laparoscopy, especially at low-adoption hospitals, may be associated with reduced colon surgical site infection rates. They recommend support of the development of innovative educational policies to help achieve improvement in patient outcomes and decreased health care use in colon surgery.
AHRQ-funded; HS021424.
Citation: Caroff DA, Chan C, Kleinman K .
Association of open approach vs laparoscopic approach with risk of surgical site infection after colon surgery.
JAMA Netw Open 2019 Oct 2;2(10):e1913570. doi: 10.1001/jamanetworkopen.2019.13570..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Patient Safety, Risk
Qi AC, Peacock K, Luke AA
Associations between social risk factors and surgical site infections after colectomy and abdominal hysterectomy.
The purpose of this study was to determine whether social risk factors, including race/ethnicity, insurance status, and neighborhood income, were associated with higher rates of surgical site infections (SSI) after colectomy or abdominal hysterectomy, 2 surgical procedures for which SSI rates are publicly reported and included in pay-for-performance programs by Medicare and other groups. The investigators report that inconsistent associations between social risk factors and SSIs were found.
AHRQ-funded; HS019455.
Citation: Qi AC, Peacock K, Luke AA .
Associations between social risk factors and surgical site infections after colectomy and abdominal hysterectomy.
JAMA Netw Open 2019 Oct 2;2(10):e1912339. doi: 10.1001/jamanetworkopen.2019.12339..
Keywords: Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Social Determinants of Health