National Healthcare Quality and Disparities Report
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- Adverse Events (1)
- Antibiotics (2)
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- (-) Sepsis (9)
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 9 of 9 Research Studies DisplayedPrescott HC, Seelye S, Wang XQ
Temporal trends in antimicrobial prescribing during hospitalization for potential infection and sepsis.
This study examined whether the push to administer antimicrobials to prevent sepsis has increased antimicrobial use in general. This observational cohort study of hospitalized patients at 152 hospitals in 2 health care systems during 2013 to 2018 looked at almost 1.6 million patients (81% male), admitted via the emergency department with 2 or more systemic inflammatory response syndrome (SIRS) criteria. From 2013 to 2018 first antimicrobial administration to patients with sepsis decreased by 37 minutes. At the same time, antimicrobial use within 48 hours, days of antimicrobial therapy, and receipt of broad-spectrum coverage decreased among the broader cohort of patients with systemic inflammatory response syndrome (SIRS). This may have caused a decrease in in-hospital mortality, 30-day mortality, length of hospitalization, new MDR culture positivity, and new MDR blood culture positivity over the study period among both patients with sepsis and those with SIRS. For the overall hospital population there was no evidence that increasing antimicrobial timing for sepsis was associated with increasing antimicrobial use or impaired antimicrobial stewardship.
AHRQ-funded; HS026725.
Citation: Prescott HC, Seelye S, Wang XQ .
Temporal trends in antimicrobial prescribing during hospitalization for potential infection and sepsis.
JAMA Intern Med 2022 Aug;182(8):805-13. doi: 10.1001/jamainternmed.2022.2291..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Sepsis, Inpatient Care, Hospitals
Lasater KB, Sloane DM, McHugh MD
Evaluation of hospital nurse-to-patient staffing ratios and sepsis bundles on patient outcomes.
Despite nurses' responsibilities in recognition and treatment of sepsis, little evidence documents whether patient-to-nurse staffing ratios are associated with clinical outcomes for patients with sepsis. Using linked data sources from 2017 including MEDPAR patient claims, Hospital Compare, American Hospital Association, and a large survey of nurses, the investigators estimated the effect of hospital patient-to-nurse staffing ratios and adherence to the Early Management Bundle for patients with Severe Sepsis/Septic Shock SEP-1 sepsis bundles on patients' odds of in-hospital and 60-day mortality, readmission, and length of stay.
AHRQ-funded; HS026232.
Citation: Lasater KB, Sloane DM, McHugh MD .
Evaluation of hospital nurse-to-patient staffing ratios and sepsis bundles on patient outcomes.
Am J Infect Control 2021 Jul;49(7):868-73. doi: 10.1016/j.ajic.2020.12.002..
Keywords: Sepsis, Nursing, Provider: Nurse, Inpatient Care, Hospitals
Masonbrink AR, Harris M, Hall M
Safety events in children's hospitals during the COVID-19 pandemic.
The coronavirus disease 2019 (COVID-19) pandemic has impacted hospitals, potentially affecting quality and safety. The objective of this study was to compare pediatric hospitalization safety events during the pandemic versus previous years. The investigators concluded that postoperative sepsis rates increased among children hospitalized during COVID-19. They suggest that efforts are needed to improve safety of postoperative care for hospitalized children.
AHRQ-funded; HS024554; HS024592.
Citation: Masonbrink AR, Harris M, Hall M .
Safety events in children's hospitals during the COVID-19 pandemic.
Hosp Pediatr 2021 Jun;11(6):e95-e100. doi: 10.1542/hpeds.2020-004937..
Keywords: Children/Adolescents, COVID-19, Patient Safety, Sepsis, Adverse Events, Hospitalization, Hospitals, Inpatient Care, Infectious Diseases, Public Health
Mohr NM, Zebrowski AM, Gaieski DF
Inpatient hospital performance is associated with post-discharge sepsis mortality.
The objective of this study was to test the hypothesis that hospitals with high risk-adjusted inpatient sepsis mortality also have high post-discharge mortality, readmissions, and discharge to nursing homes. Sepsis hospitalization survivors among age-qualifying Medicare beneficiaries were followed for 180 days post-discharge; mortality, readmissions, and new admission to skilled nursing facilities were measured. Findings showed that hospitals with the highest risk-adjusted sepsis inpatient mortality also had higher post-discharge mortality and increased readmissions, suggesting that post-discharge complications were a modifiable risk that may be affected during inpatient care. Recommendations for future work include seeking to elucidate inpatient and healthcare practices that can reduce sepsis post-discharge complications.
AHRQ-funded; HS023614; HS025753.
Citation: Mohr NM, Zebrowski AM, Gaieski DF .
Inpatient hospital performance is associated with post-discharge sepsis mortality.
Crit Care 2020 Oct 27;24(1):626. doi: 10.1186/s13054-020-03341-3..
Keywords: Sepsis, Mortality, Hospital Discharge, Hospitals, Provider Performance, Quality of Care, Inpatient Care, Hospital Readmissions
Trent SA, Jarou ZJ, Havranek EP
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Evidence-based clinical practice guidelines (CPGs) for the treatment of pneumonia and sepsis have existed for many years with multiple studies suggesting improved patient outcomes. Despite their importance, little is known about variation in emergency department (ED) adherence to these CPGs. The objectives of this study were to estimate variation in ED adherence across CPGs for pneumonia and sepsis and identify patient, provider, and environmental factors associated with adherence.
AHRQ-funded; HS022400.
Citation: Trent SA, Jarou ZJ, Havranek EP .
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Acad Emerg Med 2019 Aug;26(8):908-20. doi: 10.1111/acem.13639.
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Keywords: Emergency Department, Evidence-Based Practice, Guidelines, Inpatient Care, Pneumonia, Sepsis
Trent SA, Havranek EP, Ginde AA
Effect of audit and feedback on physician adherence to clinical practice guidelines for pneumonia and sepsis.
This study examined the effect of feedback with blinded peer comparison on emergency physician adherence to guidelines for appropriate antibiotic administration for inpatient pneumonia and completion of the 3-hour Surviving Sepsis Bundle for patients with severe sepsis. A quasi-experiment was conducted with attending physicians randomized into 6 clusters at a single urban safety net hospital. Feedback with blinded peer comparison significantly improved guideline adherence from 52% to 65% with feedback.
AHRQ-funded; HS022400.
Citation: Trent SA, Havranek EP, Ginde AA .
Effect of audit and feedback on physician adherence to clinical practice guidelines for pneumonia and sepsis.
Am J Med Qual 2019 May/Jun;34(3):217-25. doi: 10.1177/1062860618796947..
Keywords: Antibiotics, Emergency Department, Guidelines, Infectious Diseases, Inpatient Care, Medication, Pneumonia, Provider, Provider: Physician, Sepsis
Kempker JA, Kramer MR, Waller LA
State-level hospital compliance with and performance in the Centers for Medicaid & Medicare Services' Early Management Severe Sepsis and Septic Shock Bundle.
This research letter discusses a study that measured state-level hospital compliance and performance in the Centers for Medicaid & Medicare Services’(CMS) Early Management Severe Sepsis and Septic Shock Bundle (SEP-1) inpatient quality measure. There was a wide range of compliance from 97% (New Jersey) to North Dakota (15.9%). There was a state average of 48%.
AHRQ-funded; HS025240.
Citation: Kempker JA, Kramer MR, Waller LA .
State-level hospital compliance with and performance in the Centers for Medicaid & Medicare Services' Early Management Severe Sepsis and Septic Shock Bundle.
Crit Care 2019 Mar 18;23(1):92. doi: 10.1186/s13054-019-2382-0..
Keywords: Hospitals, Inpatient Care, Quality of Care, Quality Measures, Sepsis
Rhee C, Jones TM, Hamad Y
Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals.
The purpose of this study was to estimate the prevalence, underlying causes, and preventability of sepsis-associated mortality in acute care hospitals. A retrospective medical record review was conducted of 568 randomly selected adults admitted to six US academic and community hospitals who died in the hospital or were discharged to hospice and not readmitted. Medical records were reviewed. Sepsis was found to be the most common immediate cause of death; however, most underlying causes were related to severe chronic comorbidities. Most sepsis-associated deaths were unlikely to be preventable through better hospital-based care. The authors conclude that further innovations in the prevention and care of underlying conditions may be necessary before a significant reduction in sepsis-associated deaths can be achieved.
AHRQ-funded; HS025008.
Citation: Rhee C, Jones TM, Hamad Y .
Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals.
JAMA Netw Open 2019 Feb;2(2):e187571. doi: 10.1001/jamanetworkopen.2018.7571..
Keywords: Mortality, Sepsis, Hospitals, Inpatient Care
Cooke CR, Iwashyna TJ
Sepsis mandates: improving inpatient care while advancing quality improvement.
In light of improvements in the care of the acutely ill hospitalized patients and changes in the epidemiology of hospital care, the authors recommend new quality mandates focused on sepsis. These mandates should: (1) address the reality that sepsis is frequently underdiagnosed, (2) focus on catalyzing and aggregating local efforts for quality improvements, and (3) plan for a phased implementation, improving measures in select sites prior to national roll-out.
AHRQ-funded; HS020672
Citation: Cooke CR, Iwashyna TJ .
Sepsis mandates: improving inpatient care while advancing quality improvement.
JAMA. 2014 Oct 8;312(14):1397-8. doi: 10.1001/jama.2014.11350..
Keywords: Quality of Care, Hospitalization, Inpatient Care, Critical Care, Sepsis