National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (5)
- (-) Blood Clots (12)
- Brain Injury (1)
- Care Management (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
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- Comparative Effectiveness (1)
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- Elderly (1)
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- Quality Indicators (QIs) (1)
- Quality Measures (1)
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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 12 of 12 Research Studies DisplayedPatel 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
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
Leeds IL, DiBrito SR, Canner JK
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
This goal of this study was to assess the cost-effectiveness of extended prophylaxis in patients with Crohn's disease after abdominal surgery. A decision tree model was used to assess cost-effectiveness and cost-per-case averted with extended-duration venous thromboembolism prophylaxis following abdominal surgery. Results showed that extended prophylaxis in patients with Crohn's disease postoperatively is not cost-effective when the cumulative incidence of posthospital thrombosis remains less than 4.9%. These findings are driven by the low absolute risk of thrombosis in this population and the considerable cost of universal treatment.
AHRQ-funded; HS024547.
Citation: Leeds IL, DiBrito SR, Canner JK .
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
Dis Colon Rectum 2019 Nov;62(11):1371-80. doi: 10.1097/dcr.0000000000001461..
Keywords: Prevention, Digestive Disease and Health, Surgery, Healthcare Costs, Adverse Events, Patient Safety, Blood Clots, Shared Decision Making, Medication
Hoonakker PLT, Carayon P, Salwei ME
The design of PE Dx, a CDS to support pulmonary embolism diagnosis in the ED.
One possible explanation for user resistance to clinical decision support (CDS) procedures may be poor CDS design. This study describes the design of PE Dx, a CDS built to aid in the diagnosis of pulmonary embolism in the emergency department using human factors methods.
AHRQ-funded; HS022086.
Citation: Hoonakker PLT, Carayon P, Salwei ME .
The design of PE Dx, a CDS to support pulmonary embolism diagnosis in the ED.
Stud Health Technol Inform 2019 Aug 9;265:134-40. doi: 10.3233/shti190152..
Keywords: Blood Clots, Clinical Decision Support (CDS), Shared Decision Making, Diagnostic Safety and Quality, Emergency Department, Respiratory Conditions
Simon E, Miake-Lye IM, Smith SW
An evaluation of guideline-discordant ordering behavior for CT pulmonary angiography in the emergency department.
The aim of this study was to determine rates of and possible reasons for guideline-discordant ordering of CT pulmonary angiography for the evaluation of suspected pulmonary embolism (PE) in the emergency department. The investigators concluded that many of the guideline-discordant orders were placed for patients who presented with evidence-based risk factors for PE that are not included in the risk stratification scores. They suggest that guideline-discordant ordering may indicate that in the presence of these factors, the assessment of risk made by current scoring systems may not align with clinical suspicion.
AHRQ-funded; HS024376.
Citation: Simon E, Miake-Lye IM, Smith SW .
An evaluation of guideline-discordant ordering behavior for CT pulmonary angiography in the emergency department.
J Am Coll Radiol 2019 Aug;16(8):1064-72. doi: 10.1016/j.jacr.2018.12.015..
Keywords: Respiratory Conditions, Emergency Department, Guidelines, Evidence-Based Practice, Blood Clots
Glass NE, Vadlamani A, Hwang F
Bleeding and thromboembolism after traumatic brain injury in the elderly: a real conundrum.
The objectives of this study were to evaluate the incidence of bleeding, recurrent traumatic brain injury (TBI), and thromboembolic (TE) events after an initial TBI in older adults and to identify which factors contribute to this risk. The researchers found that, among Medicare patients hospitalized with TBI, the incidence of TE events was significantly higher than that of bleeding or recurrent TBI. They identified specific risk factors of bleeding and TE events, which may guide care of older adults after TBI.
AHRQ-funded; HS024560.
Citation: Glass NE, Vadlamani A, Hwang F .
Bleeding and thromboembolism after traumatic brain injury in the elderly: a real conundrum.
J Surg Res 2019 Mar;235:615-20. doi: 10.1016/j.jss.2018.10.021..
Keywords: Brain Injury, Blood Clots, Elderly, Trauma, Injuries and Wounds, Risk, Adverse Events
Blay E, Huang R, Chung JW
Evaluating the impact of the venous thromboembolism outcome measure on the PSI 90 composite quality metric.
Patient Safety Indicator (PSI) 90 is a composite measure widely used in federal pay-for-performance and public reporting programs. A component metric of PSI 90, venous thromboembolism (VTE) rate, has been shown to be subject to surveillance bias and not a valid measure for hospital quality comparisons. A study was conducted to examine how hospital PSI 90 scores would change if the VTE measure were removed from calculation of this composite measure.
AHRQ-funded; HS021857.
Citation: Blay E, Huang R, Chung JW .
Evaluating the impact of the venous thromboembolism outcome measure on the PSI 90 composite quality metric.
Jt Comm J Qual Patient Saf 2019 Mar;45(3):148-55. doi: 10.1016/j.jcjq.2018.08.009..
Keywords: Blood Clots, Patient Safety, Quality Measures, Quality Indicators (QIs), Quality of Care
Admon AJ, Seymour CW, Gershengorn HB
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
The researchers examined the relationship between intensive care unit (ICU) use for patients with pulmonary embolism (PE) and cost, mortality, readmission, and procedure use in 263 hospitals. They found wide variations in ICU admission rates for acute PE without a detectable impact on mortality, cost, or readmission.
AHRQ-funded; HS020672
Citation: Admon AJ, Seymour CW, Gershengorn HB .
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
Chest. 2014 Dec;146(6):1452-61. doi: 10.1378/chest.14-0059..
Keywords: Blood Clots, Care Management, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU)
Ju MH, Chung JW, Kinnier CV
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
This study assessed the presence and extent of venous thromboembolism (VTE) surveillance bias using high-quality clinical data from 208 hospitals. It concluded that hospitals may be unfairly deemed poor performers for the outcome VTE measure if they have increased vigilance for VTE by performing more VTE imaging studies that result in higher VTE event rates.
AHRQ-funded; HS021857
Citation: Ju MH, Chung JW, Kinnier CV .
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
Ann Surg. 2014 Sep; 260(3):558-64; discussion 64-6. doi: 10.1097/sla.0000000000000897..
Keywords: Blood Clots, Public Reporting, Adverse Events, Outcomes, Quality of Care
Chopra V, Ratz D, Kuhn L
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
This study was designed to determine patient, provider, and device outcome of deep vein thrombosis (DVT) associated with peripherally inserted central catheters (PICCs). Larger PICC gauge, especially in the use of recently diagnosed cancer patients, increases the likelihood of DVT.
AHRQ-funded; HS022835
Citation: Chopra V, Ratz D, Kuhn L .
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
J Thromb Haemost 2014 Jun;12(6):847-54. doi: 10.1111/jth.12549..
Keywords: Adverse Events, Blood Clots, Patient Safety, Risk
Streiff MB, Brady JP, Grant AM
AHRQ Author: Brady JP
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
Approximately half of new venous thromboembolism (VTE) cases occur during a hospital stay or within 90 days of an inpatient admission or surgical procedure, and many are not diagnosed until after discharge. Prevention of VTE can be complicated as physicians must balance the risk for thrombosis with the risk for bleeding from anticoagulants. A collaborative, team-based approach to care is needed for significant and sustained improvement, and it also offers efficiency and capacity to tackle other patient safety problems.
AHRQ-authored.
Citation: Streiff MB, Brady JP, Grant AM .
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
MMWR Morb Mortal Wkly Rep 2014 Mar 7;63(9):190-3.
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Keywords: Blood Clots, Healthcare-Associated Infections (HAIs), Hospitalization, Prevention, Teams
Lau BD, Haut ER
Practices to prevent venous thromboembolism: a brief review.
The purpose of this review is to provide an update on the most effective interventions aimed at improving adherence to guidelines on the use of venous thromboembolism (VTE) prevention strategies. After reviewing sixteen studies, the researchers concluded that the greatest and most sustained improvements were those that combined education with computerised tools.
AHRQ-funded; 290200710.
Citation: Lau BD, Haut ER .
Practices to prevent venous thromboembolism: a brief review.
BMJ Qual Saf 2014 Mar;23(3):187-95. doi: 10.1136/bmjqs-2012-001782..
Keywords: Comparative Effectiveness, Blood Clots, Prevention, Shared Decision Making, Guidelines