National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (3)
- Children/Adolescents (1)
- Clostridium difficile Infections (2)
- Communication (2)
- Comparative Effectiveness (1)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Critical Care (1)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (4)
- Guidelines (1)
- (-) Healthcare-Associated Infections (HAIs) (15)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (3)
- Kidney Disease and Health (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Nursing (1)
- Organizational Change (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (8)
- Policy (1)
- Pressure Ulcers (3)
- (-) Prevention (15)
- Quality Improvement (2)
- Risk (2)
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 15 of 15 Research Studies DisplayedChopra V, Saint S
Vascular catheter infections: time to get technical.
Combining technical and socioadaptive factors within a bundle of best practices has substantially reduced catheter-related bloodstream infections in the past decade, but which elements of this bundle are most responsible for reducing catheter infections? Although a key technical solution should become the standard of care to prevent vascular catheter infections, the authors recommended getting even more technical to prevent other health-care-associated infections.
AHRQ-funded; HS022835.
Citation: Chopra V, Saint S .
Vascular catheter infections: time to get technical.
Lancet 2015 Nov 21;386(10008):2034-36. doi: 10.1016/s0140-6736(15)00245-7.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Rangachari P, Madaio M, Rethemeyer RK
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
The authors investigated the challenge of consistent implementation of evidence-based infection prevention practices at the unit level. Their results showed that the interventions cumulatively had a significant desired impact on central catheter use and helped validate the theoretical literature and identify evidence-based management strategies for practice change at the unit level. Further, periodic top-down communications have the potential to modify interprofessional knowledge exchanges and enable practice change at the unit level, leading to significantly improved outcomes and reduced costs.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
Health Care Manage Rev 2015 Oct-Dec;40(4):324-36. doi: 10.1097/hmr.0000000000000038.
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Keywords: Communication, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Children/Adolescents, Prevention
Yanagizawa-Drott L, Kurland L, Schuur JD
Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey.
This study aimed to estimate the extent to which Swedish EDs have adopted evidence-based measures to prevent healthcare-associated infections (HAIs). It found that thirty-nine percent of EDs participate in a project to improve hand hygiene compliance. Staff hand hygiene compliance rates were audited at least monthly in 45 percent of EDs. Forty-three percent reported a compliance rate of 80 percent or more.
AHRQ-funded; HS021616; HS020013.
Citation: Yanagizawa-Drott L, Kurland L, Schuur JD .
Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey.
Eur J Emerg Med 2015 Oct;22(5):338-42. doi: 10.1097/mej.0000000000000159..
Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare-Associated Infections (HAIs), Prevention, Risk
Caya T, Musuuza J, Yanke E
Using a systems engineering initiative for patient safety to evaluate a hospital-wide daily chlorhexidine bathing intervention.
The researchers undertook a systems engineering approach to evaluate housewide implementation of daily chlorhexidine bathing. They performed direct observations of the bathing process and conducted provider and patient surveys. The main outcome was compliance with bathing using a checklist. Fifty-seven percent of baths had full compliance with the chlorhexidine bathing protocol. Additional time was the main barrier.
AHRQ-funded; HS024039.
Citation: Caya T, Musuuza J, Yanke E .
Using a systems engineering initiative for patient safety to evaluate a hospital-wide daily chlorhexidine bathing intervention.
J Nurs Care Qual 2015 Oct-Dec;30(4):337-44. doi: 10.1097/ncq.0000000000000129..
Keywords: Patient Safety, Prevention, Healthcare-Associated Infections (HAIs)
Milstone AM, Koontz DW, Voskertchian A
Treating parents to reduce NICU transmission of Staphylococcus aureus (TREAT PARENTS) trial: protocol of a multisite randomised, double-blind, placebo-controlled trial.
This study looks to measure the effect of treating parents with short course intranasal mupirocin and topical chlorhexidine antisepsis on acquisition of S. aureus colonisation and infection in neonates. The primary outcome will be neonatal acquisition of an S. aureus strain that is concordant to the parental baseline S. aureus strain.
AHRQ-funded; HS022872.
Citation: Milstone AM, Koontz DW, Voskertchian A .
Treating parents to reduce NICU transmission of Staphylococcus aureus (TREAT PARENTS) trial: protocol of a multisite randomised, double-blind, placebo-controlled trial.
BMJ Open 2015 Sep 09;5(9):e009274. doi: 10.1136/bmjopen-2015-009274.
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Keywords: Healthcare-Associated Infections (HAIs), Newborns/Infants, Antimicrobial Stewardship, Prevention, Neonatal Intensive Care Unit (NICU)
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
Slayton RB, Toth D, Lee BY
Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities - United States.
The researchers analyzed data from CDC's National Healthcare Safety Network and Emerging Infections Program to project the number of health care-associated infections (HAIs) from antibiotic-resistant bacteria or C. difficile both with and without a large scale national intervention that would include interrupting transmission and improved antibiotic stewardship. They found that, with effective action now, more than half a million antibiotic-resistant HAIs could be prevented over 5 years and that a coordinated approach to interrupting transmission is more effective than historical independent facility-based efforts.
AHRQ-funded; HS023317.
Citation: Slayton RB, Toth D, Lee BY .
Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities - United States.
MMWR Morb Mortal Wkly Rep 2015 Aug 7;64(30):826-31.
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Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Safdar N, Perencevich E
Crossing the quality chasm for Clostridium difficile infection prevention.
The author comments on a new population-based cohort study (Daneman, et al.) in the same journal issue on the association of hospital prevention processes and patient risk factors with the risk of Clostridium difficile infection. She concludes that the findings of the study are important and should serve as a wake-up call for institutions to participate actively in assessing and evaluating implementation of and adherence to CDI prevention practices.
AHRQ-funded; HS023791.
Citation: Safdar N, Perencevich E .
Crossing the quality chasm for Clostridium difficile infection prevention.
BMJ Qual Saf 2015 Jul;24(7):409-11. doi: 10.1136/bmjqs-2015-004344..
Keywords: Clostridium difficile Infections, Risk, Healthcare-Associated Infections (HAIs), Prevention
Padula WV, Valuck RJ, Makic MB
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced, the overall reduction of pressure ulcers (PUs). It found that several internal factors influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns and data sharing among peer institutions.
AHRQ-funded; HS023710.
Citation: Padula WV, Valuck RJ, Makic MB .
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
J Wound Ostomy Continence Nurs 2015 Jul-Aug;42(4):327-30. doi: 10.1097/won.0000000000000145..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Prevention
Chenoweth CE, Hines SC, Hall KK
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
The purpose of this study was to observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. The researchers found considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68 percent (range, 45 percent–92 percent) across all facilities.
AHRQ-authored; AHRQ-funded; 290200600022I.
Citation: Chenoweth CE, Hines SC, Hall KK .
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
Infect Control Hosp Epidemiol 2015 Jul;36(7):802-6. doi: 10.1017/ice.2015.55..
Keywords: Kidney Disease and Health, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Prevention
Padula WV, Makic MB, Mishra MK
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
This study was conducted to determine the comparative effectiveness of quality improvement interventions associated with reduced hospital-acquired pressure ulcer rates. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Mishra MK .
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):246-5..
Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Patient Safety, Pressure Ulcers, Prevention, Quality Improvement
Morgan DJ, Pineles L, Shardell M
Effect of chlorhexidine bathing and other infection control practices on the Benefits of Universal Glove and Gown (BUGG) trial: a subgroup analysis.
The researchers report the results of a subgroup analysis of the Benefits of Universal Glove and Gown trial. In 20 intensive care units, the reduction in acquisition of methicillin-resistant Staphylococcus aureus observed in this trial was observed in units also using chlorhexidine bathing and in those that previously performed active surveillance.
AHRQ-funded; HS018111; 290200600015.
Citation: Morgan DJ, Pineles L, Shardell M .
Effect of chlorhexidine bathing and other infection control practices on the Benefits of Universal Glove and Gown (BUGG) trial: a subgroup analysis.
Infect Control Hosp Epidemiol 2015 Jun;36(6):734-7. doi: 10.1017/ice.2015.33..
Keywords: Patient Safety, Prevention, Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs)
Padula WV, Makic MB, Wald HL
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
This study was conducted to define changes in hospital-acquired pressure ulcers (HAPU) incidence and variance since 2008. It found that HAPU incidence rates decreased significantly among 210 University HealthSystems Consortium academic medical centers after the enactment of the CMS nonpayment policy. This suggests that governmental policy was a significant driver of change in clinical practice for wound care and created incentives for preventive efforts on the part of hospitals.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Wald HL .
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):257-63..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Policy, Pressure Ulcers, Prevention, Quality Improvement
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
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