National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Blood Clots (1)
- Care Coordination (1)
- Care Management (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Communication (3)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Data (2)
- Education: Academic (1)
- Education: Continuing Medical Education (4)
- Electronic Health Records (EHRs) (4)
- Emergency Department (2)
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- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (7)
- Health Literacy (1)
- Health Services Research (HSR) (1)
- Home Healthcare (5)
- Hospital Discharge (1)
- Hospitalization (2)
- Hospitals (4)
- Human Immunodeficiency Virus (HIV) (1)
- Injuries and Wounds (1)
- Inpatient Care (4)
- Intensive Care Unit (ICU) (1)
- Labor and Delivery (2)
- Maternal Care (1)
- Medication (1)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (2)
- (-) Nursing (31)
- Outcomes (1)
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- Provider (5)
- Provider: Nurse (8)
- Quality Improvement (1)
- Quality of Care (3)
- Risk (1)
- Shared Decision Making (3)
- Surgery (1)
- Teams (1)
- TeamSTEPPS (1)
- Tools & Toolkits (1)
- Training (1)
- Transitions of Care (2)
- Women (1)
- Workflow (3)
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 31 Research Studies DisplayedKrein 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
Kreutzer L, Yang AD, Sansone C
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
This study analyzed barriers for administration of VTE chemoprophylaxis to hospitalized patients from nurses. Researchers conducted 14 focus group interviews with nurses from five inpatient units to assess their perceptions of barriers to administration of VTE chemoprophylaxis. Barriers included nurses’ misconceptions that patients did not require chemoprophylaxis, their uncertainty when counseling patients on the importance of chemoprophylaxis, and a lack of comparative data regarding specific refusal rates.
AHRQ-funded; HS024516.
Citation: Kreutzer L, Yang AD, Sansone C .
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
J Hosp Med 2019 Nov 1;14(10):668-72. doi: 10.12788/jhm.3290..
Keywords: Blood Clots, Patient Safety, Prevention, Inpatient Care, Care Management, Nursing
Hande K, Christenbery T, Phillippi J
Appreciative advising pilot study: an innovative approach to advising doctor of nursing practice students.
The purpose of this pilot study was to determine the feasibility of a doctor of nursing practice (DNP) appreciative advising model to advise students through the rigors of DNP education and improve student and faculty satisfaction. Faculty were provided with comprehensive guidebooks and received orientation on the model; qualitative responses were analyzed using content analysis. Results showed that the student and faculty participants reported satisfaction with the model and commented that the model allowed for early identification of needs and was helpful and worthwhile. These results suggest that the model may hold promise as a solution to assist students in adjusting to DNP education.
AHRQ-funded; HS024733.
Citation: Hande K, Christenbery T, Phillippi J .
Appreciative advising pilot study: an innovative approach to advising doctor of nursing practice students.
Nurse Educ 2019 Jul/Aug;44(4):187-91. doi: 10.1097/nne.0000000000000593..
Keywords: Provider: Nurse, Nursing, Education: Academic, Education: Continuing Medical Education
Wang J, Gephart SM, Mallow J
Models of collaboration and dissemination for nursing informatics innovations in the 21st century.
This study analyzed four nursing informatics projects to inform future informatics innovations. Four case studies were given a comparative cross-case analysis and were analyzed through the lens of the Informatics Research Organizing Model.
AHRQ-funded; HS022908.
Citation: Wang J, Gephart SM, Mallow J .
Models of collaboration and dissemination for nursing informatics innovations in the 21st century.
Nurs Outlook 2019 Jul - Aug;67(4):419-32. doi: 10.1016/j.outlook.2019.02.003..
Keywords: Health Information Technology (HIT), Nursing
Simpson KR, Lyndon A, Spetz J
Adaptation of the MISSCARE Survey to the maternity care setting.
This paper examines the feasibility of using the Missed Nursing Care (MISSCARE) Survey to study missed nursing care during labor and delivery. This survey has not been used to examine childbirth care although it is the most common reason for hospitalization in the United States. A modified version called the Perinatal Missed Care Survey appears to be the most feasible and promising instrument to evaluate missed nursing care during labor and delivery.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adaptation of the MISSCARE Survey to the maternity care setting.
J Obstet Gynecol Neonatal Nurs 2019 Jul;48(4):456-67. doi: 10.1016/j.jogn.2019.05.005..
Keywords: Labor and Delivery, Maternal Care, Nursing, Pregnancy, Women
Liu J, Larson E, Hessels A
Comparison of measures to predict mortality and length of stay in hospitalized patients.
This study compared performance of five measures in order to predict mortality and length of stay (LOS) in hospitalized adults using claims data; the measures included three comorbidity composite scores, 3 M risk of mortality, and 3 M severity of illness subclasses. Binary logistic and zero-truncated negative binomial regression models were applied to a 2-year retrospective dataset of adult inpatient admissions from a large hospital system in New York City. All five measures demonstrated a good to strong model fit for predicting in-hospital mortality. The authors conclude that these measures can guide nurse managers in assigning nursing care and coordinating patient services, as well as administrators in supporting optimal nursing care more effectively and efficiently.
AHRQ-funded; HS024915.
Citation: Liu J, Larson E, Hessels A .
Comparison of measures to predict mortality and length of stay in hospitalized patients.
Nurs Res 2019 May/Jun;68(3):200-09. doi: 10.1097/nnr.0000000000000350..
Keywords: Hospitalization, Mortality, Nursing, Patient Safety, Risk
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
Holmes E, Thompson D, Michell D
An inpatient HIV support nurse to promote engagement in outpatient HIV care.
In this paper, the investigators describe an inpatient HIV support nurse to promote engagement in outpatient HIV care. It provides two case reports and a discussion. The investigators indicate that their hospital has employed an RN specializing in HIV care coordination for more than a decade on their dedicated HIV unit and has recently created a position to extend this work to PLWH who have been admitted to the 42 other adult units in their hospital.
AHRQ-funded; R01 HS024079.
Citation: Holmes E, Thompson D, Michell D .
An inpatient HIV support nurse to promote engagement in outpatient HIV care.
J Assoc Nurses AIDS Care 2019 Mar-Apr;30(2):245-48. doi: 10.1097/jnc.0000000000000017..
Keywords: Human Immunodeficiency Virus (HIV), Patient and Family Engagement, Care Coordination, Nursing, Healthcare Delivery
Manojlovich M, Frankel RM, Harrod M
Formative evaluation of the video reflexive ethnography method, as applied to the physician-nurse dyad.
Poor communication between physicians and nurses continues to contributor to adverse events in the hospital setting. This article evaluates the use of video reflexive ethnography (VRE) as a means of improving communication and improving patient safety, and concludes that video-record communication between physicians and nurses during patient care rounds is feasible and acceptable.
AHRQ-funded; HS024760.
Citation: Manojlovich M, Frankel RM, Harrod M .
Formative evaluation of the video reflexive ethnography method, as applied to the physician-nurse dyad.
BMJ Qual Saf 2019 Feb;28(2):160-66. doi: 10.1136/bmjqs-2017-007728..
Keywords: Adverse Events, Communication, Hospitals, Nursing, Patient Safety
Jarrin OF, Pouladi FA, Madigan EA
International priorities for home care education, research, practice, and management: qualitative content analysis.
The purpose of this study was to articulate an international vision for the future of home care education, research, practice, and management shared by experienced home care nurses working in leadership roles. Four major themes emerged, in this qualitative study, reflecting international priorities for the future of home care education, research, practice, and management: 1) Build the evidence base for home care; 2) Design better systems of care; 3) Develop leaders at all levels; and 4) Address payment and policy issues.
AHRQ-funded; HS022406.
Citation: Jarrin OF, Pouladi FA, Madigan EA .
International priorities for home care education, research, practice, and management: qualitative content analysis.
Nurse Educ Today 2019 Feb;73:83-87. doi: 10.1016/j.nedt.2018.11.020..
Keywords: Education: Continuing Medical Education, Healthcare Delivery, Home Healthcare, Nursing, Provider
Kutney-Lee A, Sloane DM, Bowles KH
Electronic health record adoption and nurse reports of usability and quality of care: the role of work environment.
This study assessed the role of electronic health record (EHR) adoption and work environment for nurses. If the EHR system has positive usability ratings it impacts quality of care. Over 12,000 nurses in 353 hospitals were surveyed.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Sloane DM, Bowles KH .
Electronic health record adoption and nurse reports of usability and quality of care: the role of work environment.
Appl Clin Inform 2019 Jan;10(1):129-39. doi: 10.1055/s-0039-1678551..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing, Provider: Nurse, Quality of Care
de Cordova PB, Steck MBW, Vermeesch A
Health policy engagement among graduate nursing students in the United States.
This study researched the availability and requirements for graduate nursing students to take a dedicated health policy course. American Association of College of Nursing (AACN) member institution students were polled and over 75% reported taking a health policy course. There was an equal distribution between master’s and doctoral students.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Steck MBW, Vermeesch A .
Health policy engagement among graduate nursing students in the United States.
Nurs Forum 2019 Jan;54(1):38-44. doi: 10.1111/nuf.12295..
Keywords: Education: Continuing Medical Education, Nursing, Policy, Provider: Nurse
Yang Y, Bass EJ, Bowles KH
Impact of home care admission nurses' goals on electronic health record documentation strategies at the point of care.
The article reports on a study designed to investigate documentation strategies used by home care nurses with respect to entering electronic data during admission as well as the effect of nursing goals on the process. This was done to characterize admission nurses' practices at the point of care and to establish a basis for design recommendations for electronic health records (EHRs). Five nurses in rural Pennsylvania home care agencies were observed during the admission process. The results of the study lead the authors to recommend that EHR design and training should support the manner in which home care nurses document patient encounters.
AHRQ-funded; HS024537.
Citation: Yang Y, Bass EJ, Bowles KH .
Impact of home care admission nurses' goals on electronic health record documentation strategies at the point of care.
Comput Inform Nurs 2019 Jan;37(1):39-46. doi: 10.1097/cin.0000000000000468..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Home Healthcare, Nursing
Ricciardi R, Shofer M
AHRQ Author: Ricciardi R, Shofer M
Nurses and patients: Natural partners to advance patient safety.
In this Agency for Healthcare Research and Quality commentary, the authors discuss the nurse-patient partnership and its potential for enhancing communication and improving patient safety practices.
AHRQ-authored.
Citation: Ricciardi R, Shofer M .
Nurses and patients: Natural partners to advance patient safety.
J Nurs Care Qual 2019 Jan/Mar;34(1):1-3. doi: 10.1097/ncq.0000000000000377..
Keywords: Nursing, Provider: Nurse, Patient Safety
Dowding D, Merrill JA, Barron Y
Usability evaluation of a dashboard for home care nurses.
Usability tests were conducted on a creation of a dashboard prototype for home care nurses for their patients’ electronic health records (EHRs). The prototype was created by first observing and interviewing several nurses; getting feedback on paper versions of the dashboard; and then a usability evaluation of the electronic prototype. The dashboard was positively evaluated.
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill JA, Barron Y .
Usability evaluation of a dashboard for home care nurses.
Comput Inform Nurs 2019 Jan;37(1):11-19. doi: 10.1097/cin.0000000000000484..
Keywords: Health Information Technology (HIT), Home Healthcare, Nursing, Provider
Rosen MA, Dietz AS, Lee N
Sensor-based measurement of critical care nursing workload: Unobtrusive measures of nursing activity complement traditional task and patient level indicators of workload to predict perceived exertion.
The purpose of this study was to establish the validity of sensor-based measures of work processes for predicting perceived mental and physical exertion of critical care nurses. Environmental sensors worn by staff in a surgical intensive care unit captured work process data. Nurses rated their mental and physical exertion for each four-hour block, and recorded patient and staffing-level workload factors. Analysis of this data yielded highly predictive models of critical care nursing workload to generate insights into workflow and work design. The researchers conclude that sensor-based measures are a viable complement to traditional task demand measures of workload.
AHRQ-funded; HS023553.
Citation: Rosen MA, Dietz AS, Lee N .
Sensor-based measurement of critical care nursing workload: Unobtrusive measures of nursing activity complement traditional task and patient level indicators of workload to predict perceived exertion.
PLoS One 2018 Oct 12;13(10):e0204819. doi: 10.1371/journal.pone.0204819..
Keywords: Critical Care, Nursing, Provider: Nurse, Patient Safety, Workflow
Law AC, Stevens JP, Hohmann S
Patient outcomes after the introduction of statewide ICU nurse staffing regulations.
The objective of this study was to assess whether Massachusetts legislation directed at ICU nurse staffing was associated with improvements in patient outcomes. The investigators found that state regulation of patient-to-nurse staffing with the aid of patient complexity scores in intensive care was not associated with either increased nurse staffing or changes in patient outcomes.
AHRQ-funded; HS024288.
Citation: Law AC, Stevens JP, Hohmann S .
Patient outcomes after the introduction of statewide ICU nurse staffing regulations.
Crit Care Med 2018 Sep 4;46(10):1563-69. doi: 10.1097/ccm.0000000000003286..
Keywords: Intensive Care Unit (ICU), Policy, Nursing, Outcomes, Patient Safety
Auger KA, Simmons JM, Tubbs-Cooley HL
Postdischarge Nurse Home Visits and Reuse: the Hospital to Home Outcomes (H2O) Trial.
In this study, the investigators evaluated the effects of a pediatric transition intervention, specifically a single nurse home visit, on postdischarge outcomes in a randomized controlled trial. The investigators concluded that children randomly assigned to the intervention had higher rates of 30-day postdischarge unplanned health care reuse. They also noted that parents in the intervention group recalled more clinical warning signs 2 weeks after discharge.
AHRQ-funded; HS024735.
Citation: Auger KA, Simmons JM, Tubbs-Cooley HL .
Postdischarge Nurse Home Visits and Reuse: the Hospital to Home Outcomes (H2O) Trial.
Pediatrics 2018 Jul;142(1). doi: 10.1542/peds.2017-3919..
Keywords: Children/Adolescents, Home Healthcare, Hospital Discharge, Nursing, Transitions of Care
Al Danaf J, Chang BH, Shaear M
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
This paper reported on rounding interventions employed at high performing hospitals, and provided three case studies on how proactive nurse rounding was successfully implemented to improve patient-centredness. The investigators concluded that proactive rounding interventions are a feasible approach to help surface and address hospitalized patients' needs in a timely manner.
AHRQ-funded; HS021921.
Citation: Al Danaf J, Chang BH, Shaear M .
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
J Nurs Manag 2018 Jul;26(5):540-47. doi: 10.1111/jonm.12580..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitalization, Hospitals, Inpatient Care, Nursing, Patient-Centered Healthcare, Patient Experience, Quality Improvement
Bayramzadeh S, Joseph A, San D
The impact of operating room layout on circulating nurse's work patterns and flow disruptions: a behavioral mapping study.
The purpose of this study was to assess how the adjacencies of functionally different areas within operating rooms (ORs) can influence the circulating nurse's (CN) workflow patterns and disruptions. The investigators video recorded and thematically coded a convenience sample of 25 surgeries for CN's activities, locations, and flow disruptions. The investigators suggest that optimum adjacencies should be considered while designing ORs such that they are more efficient and safer.
AHRQ-funded; HS024380.
Citation: Bayramzadeh S, Joseph A, San D .
The impact of operating room layout on circulating nurse's work patterns and flow disruptions: a behavioral mapping study.
HERD 2018 Jul;11(3):124-38. doi: 10.1177/1937586717751124..
Keywords: Surgery, Workflow, Hospitals, Nursing, Provider: Nurse, Provider, Patient Safety
Sarkhel R, Socha JJ, Mount-Campbell A
HOW nurses identify hospitalized patients on their personal notes: findings from analyzing 'brains' headers with multiple raters.
Many nurses use handwritten notes in order to avoid using electronic health records to access information about patients. At the top of these notes are patient identifiers. By identifying aspects of good and suboptimal headers, the authors began to form a model of how to effectively support identifying patients during assessments and care activities. The primary finding was that nurses use room number as the primary patient identifier in the hospital setting, not the patient's last name.
AHRQ-funded; HS024379.
Citation: Sarkhel R, Socha JJ, Mount-Campbell A .
HOW nurses identify hospitalized patients on their personal notes: findings from analyzing 'brains' headers with multiple raters.
Proc Int Symp Hum Factors Ergon Healthc 2018 Jun;7(1):205-09. doi: 10.1177/2327857918071045..
Keywords: Electronic Health Records (EHRs), Health Services Research (HSR), Inpatient Care, Nursing
Mistry B, Stewart De Ramirez S, Kelen G
Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment.
This study assessed the accuracy and variability of triage score assignment by emergency department (ED) nurses using the Emergency Severity Index (ESI) in 3 countries. It found that the concordance of nurse-assigned ESI score with reference standard was universally poor and variability was high. Although the ESI is the most popular ED triage tool in the United States and is increasingly used worldwide, its findings point to a need for more reliable ED triage tools.
AHRQ-funded; HS023641.
Citation: Mistry B, Stewart De Ramirez S, Kelen G .
Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment.
Ann Emerg Med 2018 May;71(5):581-87.e3. doi: 10.1016/j.annemergmed.2017.09.036.
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Keywords: Shared Decision Making, Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT), Nursing
Patterson ES
Workarounds to intended use of health information technology: a narrative review of the human factors engineering literature.
This narrative review sought to integrate and synthesize insights from recent studies of workarounds to the intended use of health information technology (HIT) by health care professionals. It concluded that workarounds were employed to avoid changes to workflow, enable interdisciplinary communication, coordinate activities, and have real-time portable access to summarized and synthesized information.
AHRQ-funded; HS024379.
Citation: Patterson ES .
Workarounds to intended use of health information technology: a narrative review of the human factors engineering literature.
Hum Factors 2018 May;60(3):281-92. doi: 10.1177/0018720818762546.
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Keywords: Communication, Health Information Technology (HIT), Nursing, Patient Safety
Sockolow PS, Yang Y, Bass EJ
Data visualization of home care admission nurses' decision-making.
This study investigated nurses’ decision making regarding hospital to home care admissions. They conducted a focus group case study with six admitting home health nurses at a rural agency in Pennsylvania and analyzed the data using thematic analysis.
AHRQ-funded; HS024537.
Citation: Sockolow PS, Yang Y, Bass EJ .
Data visualization of home care admission nurses' decision-making.
AMIA Annu Symp Proc 2018 Apr 16;2017:1597-606..
Keywords: Data, Shared Decision Making, Home Healthcare, Nursing, Transitions of Care
Dudding KM, Gephart SM, Carrington JM
Neonatal nurses experience unintended consequences and risks to patient safety with electronic health records.
The purposes of this study were to describe unintended consequences of use of electronic health records for neonatal nurses and to explore relationships between the phenomena and characteristics of the nurse and the electronic health record. The most frequent unintended consequences of electronic health record use were due to interruptions, followed by a heavier workload due to the electronic health record.
AHRQ-funded; HS022908.
Citation: Dudding KM, Gephart SM, Carrington JM .
Neonatal nurses experience unintended consequences and risks to patient safety with electronic health records.
Comput Inform Nurs 2018 Apr;36(4):167-76. doi: 10.1097/cin.0000000000000406.
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Keywords: Electronic Health Records (EHRs), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Nursing, Patient Safety