National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- (-) Central Line-Associated Bloodstream Infections (CLABSI) (13)
- Children/Adolescents (1)
- Communication (1)
- Comprehensive Unit-based Safety Program (CUSP) (2)
- Critical Care (1)
- Data (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (11)
- Hospitals (3)
- Intensive Care Unit (ICU) (2)
- Medicare (1)
- Nursing Homes (1)
- Organizational Change (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (10)
- Prevention (4)
- Provider Performance (2)
- Quality Improvement (1)
- Quality of Care (1)
- Risk (3)
- Shared Decision Making (1)
- Social Media (1)
- Surgery (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 13 of 13 Research Studies DisplayedHerc E, Patel P, Washer LL
A model to predict central-line-associated bloodstream infection among patients with peripherally inserted central catheters: the MPC Score.
Peripherally inserted central catheters (PICCs) are associated with central-line-associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed. The purpose of this study is to operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate an individual's risk of PICC-CLABSI prior to device placement.
AHRQ-funded; HS022835.
Citation: Herc E, Patel P, Washer LL .
A model to predict central-line-associated bloodstream infection among patients with peripherally inserted central catheters: the MPC Score.
Infect Control Hosp Epidemiol 2017 Oct;38(10):1155-66. doi: 10.1017/ice.2017.167..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Shared Decision Making, Healthcare-Associated Infections (HAIs), Patient Safety
Jackson SS, Leekha S, Magder LS
The effect of adding comorbidities to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology.
The authors of this study hypothesized that risk adjustment would be improved by including patient demographics and comorbidities from electronically available hospital discharge codes to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology. They concluded that their risk-adjustment model for CLABSI using electronically available comorbidities demonstrated better discrimination than did the CDC model.
AHRQ-funded; HS022291.
Citation: Jackson SS, Leekha S, Magder LS .
The effect of adding comorbidities to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1019-24. doi: 10.1017/ice.2017.129..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Risk
Smith SN, Reichert HA, Ameling JM
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Voluntary Leapfrog Safe Practices Score (SPS) measures were among the first public reports of hospital performance. Recently, Medicare's Hospital Compare website has reported compulsory measures. Leapfrog's Hospital Safety Score (HSS) grades incorporate SPS and Medicare measures. The researchers evaluated associations between Leapfrog SPS and Medicare measures. They found that voluntary Leapfrog SPS measures skew toward positive self-report and bear little association with compulsory Medicare outcomes and penalties.
AHRQ-funded; HS019767; HS024385; HS018334.
Citation: Smith SN, Reichert HA, Ameling JM .
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Med Care 2017 Jun;55(6):606-14. doi: 10.1097/mlr.0000000000000716.
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Keywords: Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Provider Performance
Harris AD, Pineles L, Anderson D
Which comorbid conditions should we be analyzing as risk factors for healthcare-associated infections?
This study sought to determine which comorbid conditions are considered causally related to central-line associated bloodstream infection (CLABSI) and surgical-site infection (SSI) based on expert consensus. Its results have produced a list of comorbid conditions that should be analyzed as risk factors for and further explored for risk adjustment of CLABSI and SSI.
AHRQ-funded; HS022291.
Citation: Harris AD, Pineles L, Anderson D .
Which comorbid conditions should we be analyzing as risk factors for healthcare-associated infections?
Infect Control Hosp Epidemiol 2017 Apr;38(4):449-54. doi: 10.1017/ice.2016.314.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Risk, Surgery
Meddings J, Reichert H, Greene MT
Evaluation of the association between Hospital Survey on Patient Safety Culture (HSOPS) measures and catheter-associated infections: results of two national collaboratives.
This study examined the association between hospital units' results for the Hospital Survey on Patient Safety Culture (HSOPS) and catheter-associated infection rates. It found no association between results of the HSOPS and catheter-associated infection rates when measured at baseline and postintervention in two successful large national collaboratives focused on prevention of central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI).
AHRQ-funded; 290201000025I; 29032001T; HS019767.
Citation: Meddings J, Reichert H, Greene MT .
Evaluation of the association between Hospital Survey on Patient Safety Culture (HSOPS) measures and catheter-associated infections: results of two national collaboratives.
BMJ Qual Saf 2017 Mar;26(3):226-35. doi: 10.1136/bmjqs-2015-005012.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Prevention
Govindan S, Chopra V, Iwashyna TJ
Do clinicians understand quality metric data? An evaluation in a Twitter-derived sample.
The researchers assessed clinician comprehension of central line-associated blood stream infection (CLABSI) quality metric data. It found that the mean percentage of correct answers was 61 percent. Overall, doctor performance was better than performance by nurses and other respondents. In basic numeracy, mean percent correct was 82 percent. For risk-adjustment numeracy, the mean percent correct was 70 percent.
AHRQ-funded; HS022835.
Citation: Govindan S, Chopra V, Iwashyna TJ .
Do clinicians understand quality metric data? An evaluation in a Twitter-derived sample.
J Hosp Med 2017 Jan;12(1):18-22.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Data, Quality of Care, Provider Performance, Social Media
Theodoro D, Olsen MA, Warren DK
Emergency department central line-associated bloodstream infections (CLABSI) incidence in the era of prevention practices.
The incidence of central line–associated bloodstream infections (CLABSI) attributed to central venous catheters (CVCs) inserted in the emergency department (ED) is not widely reported. The goal of this study was to report the incidence of ED CLABSI. It concluded that the CLABSI rates in this academic medical center ED were in the range of those reported by the ICU.
AHRQ-funded; HS018092; HS019455.
Citation: Theodoro D, Olsen MA, Warren DK .
Emergency department central line-associated bloodstream infections (CLABSI) incidence in the era of prevention practices.
Acad Emerg Med 2015 Sep;22(9):1048-55. doi: 10.1111/acem.12744..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Emergency Department, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Prevention
Chopra V, Montoya A, Joshi D
Peripherally inserted central catheter use in skilled nursing facilities: a pilot study.
The purpose of this study was to describe patterns of use, care practices, and outcomes related to peripherally inserted central catheter (PICC) use in skilled nursing facilities (SNFs). The most common indication for PICC use was intravenous antibiotic delivery. The average PICC dwell time was 43 days, and most devices were single-lumen PICCs. Major and minor complications were common and occurred in 11 (20 percent) and 18 (32 percent) participants, respectively.
AHRQ-funded; HS022835; HS019979.
Citation: Chopra V, Montoya A, Joshi D .
Peripherally inserted central catheter use in skilled nursing facilities: a pilot study.
J Am Geriatr Soc 2015 Sep;63(9):1894-9. doi: 10.1111/jgs.13600..
Keywords: Adverse Events, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Nursing Homes, Patient Safety
Vaz LE, Kleinman KP, Kawai AT
Impact of Medicare's hospital-acquired condition policy on infections in safety net and non-safety net hospitals.
The researchers sought to determine whether the 2008 Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in safety net compared with non–safety net hospitals. They found that this policy did not have an impact, either positive or negative, on already declining rates of central line–associated bloodstream infection in safety net or non–safety net hospitals.
AHRQ-funded; HS018414.
Citation: Vaz LE, Kleinman KP, Kawai AT .
Impact of Medicare's hospital-acquired condition policy on infections in safety net and non-safety net hospitals.
Infect Control Hosp Epidemiol 2015 Jun;36(6):649-55. doi: 10.1017/ice.2015.38..
Keywords: Patient Safety, Medicare, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Scheck McAlearney A, Hefner J, Robbins J
AHRQ Author: Harrison MI
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
This study identified factors that may explain hospital-level differences in outcomes of programs to prevent central line–associated bloodstream infections. A main theme that differentiated higher- from lower-performing hospitals was a distinctive framing of the goal of “getting to zero” infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition.
AHRQ-authored; AHRQ-funded; 290200600022.
Citation: Scheck McAlearney A, Hefner J, Robbins J .
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
Infect Control Hosp Epidemiol 2015 May;36(5):557-63. doi: 10.1017/ice.2015.27..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Prevention
Rinke ML, Chen AR, Milstone AM
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
The researchers investigated (1) the extent to which best-practice central line maintenance practices were employed in the homes of pediatric oncology patients and by whom, (2) caregiver beliefs about central line care and central line-associated blood stream infection (CLABSI) risk, (3) barriers to optimal central line care by families, and (4) educational experiences and preferences regarding central line care. They concluded that interventions aimed at reducing ambulatory CLABSIs should target appropriate educational experiences for adult caregivers and patients and identify ways to improve compliance with best-practice care.
AHRQ-funded; HS021282.
Citation: Rinke ML, Chen AR, Milstone AM .
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
Jt Comm J Qual Patient Saf 2015 Apr;41(4):177-85.
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Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Ambulatory Care and Surgery, Quality Improvement
Pepin CS, Thom KA, Sorkin JD
Risk factors for central-line-associated bloodstream infections: a focus on comorbid conditions.
This cohort study explored risk factors for CLABSI using 2 comorbidity classification schemes, the Charlson Comorbidity Index (CCI) and the Chronic Disease Score (CDS). It found that individual comorbid conditions obtained electronically by ICD-9 codes and admission medications can be used to identify factors for increased risk for CLABSI. The composite CDS and CCI scores were not risk factors.
AHRQ-funded; HS022291.
Citation: Pepin CS, Thom KA, Sorkin JD .
Risk factors for central-line-associated bloodstream infections: a focus on comorbid conditions.
Infect Control Hosp Epidemiol 2015 Apr;36(4):479-81. doi: 10.1017/ice.2014.81..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Rangachari P, Madaio M, Rethemeyer RK
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
There are gaps in understanding the mechanisms by which top-down communications enable practice change. The authors sought to address these gaps in order to help identify evidence-based management strategies for successful practice change at the unit level. They found that both intensive care units studied experienced substantially improved outcomes and indicated a statistically significant increase in proactive communications. Early in the study, champions emerged within each unit to initiate process improvements. The authors concluded that the study helped to identify evidence-based management strategies for successful practice change at the unit level.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
Health Care Manage Rev 2015 Jan-Mar;40(1):65-78. doi: 10.1097/hmr.0000000000000001.
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Keywords: Intensive Care Unit (ICU), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Critical Care, Communication, Evidence-Based Practice, Organizational Change, Prevention, Patient Safety