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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 4 of 4 Research Studies DisplayedFlannery DD, Zevallos Barboza A, Mukhopadhyay S
Antibiotic use among infants admitted to neonatal intensive care units.
The purpose of this cross-sectional study was to examine antibiotic exposure, days of therapy, types of antibiotics, and changes in use patterns among newborns in neonatal intensive care units (NICUs) across the U.S. Data for almost 1.4 million infants were taken from the Premier Healthcare Database. The most common antibiotics prescribed during the study period were ampicillin, gentamicin, vancomycin, and cefotaxime. Antibiotic use declined substantially over time, primarily because of reductions in ampicillin and gentamicin. The authors noted that these findings probably reflect the penetration of national calls for neonatal antibiotic stewardship efforts and refined early-onset infection risk-assessment strategies; shortage and subsequent discontinuation of cefotaxime may have played a role in the sharp decline in its use and the related increase in ceftazidime use.
AHRQ-funded; HS027468.
Citation: Flannery DD, Zevallos Barboza A, Mukhopadhyay S .
Antibiotic use among infants admitted to neonatal intensive care units.
JAMA Pediatr 2023 Dec; 177(12):1354-56. doi: 10.1001/jamapediatrics.2023.3664..
Keywords: Newborns/Infants, Antibiotics, Medication, Intensive Care Unit (ICU), Critical Care
Karvonen KL, Anunwah E, Chambers Butcher BD
Structural racism operationalized via adverse social events in a single-center neonatal intensive care unit.
The purpose of this retrospective cohort study was to assess structural racism in the neonatal intensive care unit (NICU) by establishing whether variations in adverse social events occur by racialized groups. The study included 3,290 infants hospitalized in a single center NICU in the Racial and Ethnic Justice in Outcomes in Neonatal Intensive Care (REJOICE) study, and researchers included demographics and adverse social events including infant urine toxicology screening, child protective services (CPS) referrals, behavioral contracts, and security emergency response calls were collected from electronic medical records. The study found that 6.2% of families experienced an adverse social event. Black families had a greater likelihood of having experienced a CPS referral and a urine toxicology screen. American Indian and Alaskan Native families also had a greater likelihood of experiencing CPS referrals and urine toxicology screens. Black families had a greater likelihood of experiencing behavioral contracts and security emergency response calls. Latinx families had a similar risk of adverse events, and Asian families were less likely to experience adverse events.
AHRQ-funded; HS028473; HS026383.
Citation: Karvonen KL, Anunwah E, Chambers Butcher BD .
Structural racism operationalized via adverse social events in a single-center neonatal intensive care unit.
J Pediatr 2023 Sep; 260:113499. doi: 10.1016/j.jpeds.2023.113499..
Keywords: Racial and Ethnic Minorities, Newborns/Infants, Intensive Care Unit (ICU), Critical Care
Herrick HM, O'Reilly M, Lee S
Providing Oxygen during Intubation in the NICU Trial (POINT): study protocol for a randomised controlled trial in the neonatal intensive care unit in the USA.
This article is a study protocol describing a pilot randomized controlled trial called Providing Oxygen during Intubation in the NICU Trial or POINT. This study’s objective will be to determine among infants ≥28 weeks' corrected gestational age (cGA) who undergo intubation in the neonatal intensive care unit (NICU) whether apnoeic oxygenation with a regular low-flow nasal cannula (NC), compared with standard of care (no additional respiratory support), reduces the magnitude of SpO(2) decline during intubation. This severe desaturation occurs in nearly half of neonatal intubations. This multicenter, prospective, unblinded, pilot randomized controlled trial recruited 120 infants, 10 in the run-in phase, and 110 in the randomization phase at two tertiary care hospitals in Pennsylvania. Patients will be randomized to 6 L NC 100% oxygen versus standard of care (no respiratory support) at time of intubation, with primary outcome the magnitude of oxygen desaturation during intubation. Secondary outcomes will include additional efficacy, safety, and feasibility outcomes.
AHRQ-funded; HS029029.
Citation: Herrick HM, O'Reilly M, Lee S .
Providing Oxygen during Intubation in the NICU Trial (POINT): study protocol for a randomised controlled trial in the neonatal intensive care unit in the USA.
BMJ Open 2023 Apr 13; 13(4):e073400. doi: 10.1136/bmjopen-2023-073400..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Critical Care
Doherty JR, Schaefer A, Goodman DC
Texas hospital's perspectives about NICU performance measures: a mixed-methods study.
This exploratory mixed-methods study was conducted to determine Texas hospital leaders’ perspectives about neonatal intensive care (NICU) performance measures. First a survey was sent along with a copy of the Dartmouth Atlas of Neonatal Intensive Care to clinical and administrative leaders of 150 NICUs in Texas. The authors asked respondents to review the chapter that reported Texas-specific results and respond to a variety of open and closed-ended questions about the overall usefulness of the report. Secondly, they conducted semistructured qualitative interviews with a subset of survey respondents to better understand their perspectives. There was a 50% survey response rate. Respondents generally found the report to be interesting and useful, and 87.7% of all respondents reported being in favor of receiving future reports with their own hospital's data benchmarked against other anonymous NICU peers. All measures in the Atlas were considered favorably. The respondents also felt that a report with performance data would serve as a mechanism to drive change by identifying opportunities for improvement.
AHRQ-funded; HS024075.
Citation: Doherty JR, Schaefer A, Goodman DC .
Texas hospital's perspectives about NICU performance measures: a mixed-methods study.
Qual Manag Health Care 2023 Jan-Mar;32(1):8-15. doi: 10.1097/qmh.0000000000000347..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Provider Performance, Hospitals