National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (4)
- Ambulatory Care and Surgery (2)
- (-) Catheter-Associated Urinary Tract Infection (CAUTI) (13)
- Central Line-Associated Bloodstream Infections (CLABSI) (5)
- Children/Adolescents (3)
- Clostridium difficile Infections (1)
- Communication (1)
- Community-Acquired Infections (1)
- Critical Care (2)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (13)
- Healthcare Costs (1)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospitals (3)
- Infectious Diseases (2)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (2)
- Medicare (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (8)
- Prevention (1)
- Provider (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Provider Performance (1)
- Quality Measures (1)
- Quality of Care (1)
- Risk (1)
- Surgery (2)
- Urinary Tract Infection (UTI) (12)
- Workflow (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 DisplayedHsu HE, Mathew R, Wang R
Health care-associated infections among critically ill children in the US, 2013-2018.
The purpose of this study was to examine changes over time in CLABSI and CAUTI rates between 2013 and 2018 in neonatal intensive care units (NICUs) and pediatric intensive care units (PICUs) using prospective surveillance data from community hospitals, children's hospitals, and pediatric units within general hospitals. The investigators concluded that recent trends in CLABSI rates noted in this study among critically ill neonates and children in a large cohort of US hospitals indicated that past gains have held, without evidence of further improvements, suggesting novel approaches for CLABSI prevention are needed.
AHRQ-funded; HS025008; HS018414.
Citation: Hsu HE, Mathew R, Wang R .
Health care-associated infections among critically ill children in the US, 2013-2018.
https://www.pubmed.ncbi.nlm.nih.gov/33017011
JAMA Pediatr 2020 Dec;174(12):1176-83. doi: 10.1001/jamapediatrics.2020.3223..
JAMA Pediatr 2020 Dec;174(12):1176-83. doi: 10.1001/jamapediatrics.2020.3223..
Keywords: Children/Adolescents, Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU)
Rinke ML, Oyeku SO, Ford WJH
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This retrospective case control study estimated additional costs associated with pediatric ambulatory central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery. The authors concluded that ambulatory HAI in pediatric patients were associated with significant additional costs.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Ford WJH .
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Infect Control Hosp Epidemiol 2020 Nov;41(11):1292-97. doi: 10.1017/ice.2020.305..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Ambulatory Care and Surgery, Healthcare Costs, Surgery
De Roo AC, Hendren S, Ameling JM
Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.
Researchers applied Michigan Appropriate Perioperative criteria to statewide registry data to identify improvement targets for urinary catheter use. They found that perioperative urinary catheter use was appropriate for most simple abdominal procedures, but duration of use varied in all categories.
AHRQ-funded; HS019767; HS024385; HS018334; HS000053.
Citation: De Roo AC, Hendren S, Ameling JM .
Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.
Am J Surg 2020 Sep;220(3):706-13. doi: 10.1016/j.amjsurg.2020.01.008..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Patient Safety, Surgery, Prevention, Adverse Events
Rinke ML, Oyeku SO, Heo M
Pediatric ambulatory catheter-associated urinary tract infections (CAUTIs): incidence, risk factors, and patient outcomes.
Catheter-associated urinary tract infections (CAUTIs) occur frequently in pediatric inpatients, and they are associated with increased morbidity and cost. Few studies have investigated ambulatory CAUTIs, despite at-risk children utilizing home urinary catheterization. This retrospective cohort and case-control study determined incidence, risk factors, and outcomes of pediatric patients with ambulatory CAUTI. The investigators concluded that pediatric ambulatory CAUTIs occurred in 18% of patients with catheters; they were associated with morbidity and healthcare utilization. Ambulatory indwelling catheter CAUTI incidence exceeded national inpatient incidence.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Heo M .
Pediatric ambulatory catheter-associated urinary tract infections (CAUTIs): incidence, risk factors, and patient outcomes.
Infect Control Hosp Epidemiol 2020 Aug;41(8):891-99. doi: 10.1017/ice.2020.204..
Keywords: Children/Adolescents, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Risk, Ambulatory Care and Surgery, Adverse Events
Hsu HE, Wang R, Broadwell C
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
The authors assessed the association of Hospital-Acquired Condition Reduction Program (HACRP) and Hospital Value-Based Purchasing (HVBP) implementation with changes in rates of targeted health care-associated infections and disparities in rates among safety-net and non-safety-net hospitals. They found that HACRP and HVBP implementation was not associated with any improvements in targeted health care-associated infections among safety-net or non-safety-net hospitals or with changes in disparities in infection rates. They concluded that, given the persistent health care-associated infection rate disparities, these programs appear to function as a disproportionate penalty system for safety-net hospitals that offer no measurable benefits for patients.
AHRQ-funded; HS018414.
Citation: Hsu HE, Wang R, Broadwell C .
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
JAMA Netw Open 2020 Jul;3(7):e209700. doi: 10.1001/jamanetworkopen.2020.9700..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Medicare, Patient Safety
Luzum M, Sebolt J, Chopra V
Catheter-associated urinary tract infection, Clostridioides difficile colitis, central line-associated bloodstream infection, and methicillin-resistant Staphylococcus aureus.
This article provides summaries of the background, epidemiology, diagnosis, and treatment of central line-associated bloodstream infection, catheter-associated urinary tract infection, Clostridioides difficile, and methicillin-resistant Staphylococcus aureus colonization and infections. Additional prevention strategies, including those related to recent national interventions, are also reviewed.
AHRQ-funded; HS022835.
Citation: Luzum M, Sebolt J, Chopra V .
Catheter-associated urinary tract infection, Clostridioides difficile colitis, central line-associated bloodstream infection, and methicillin-resistant Staphylococcus aureus.
Med Clin North Am 2020 Jul;104(4):663-79. doi: 10.1016/j.mcna.2020.02.004..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Clostridium difficile Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases
Meddings J, Greene MT, Ratz D
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
AHRQ’s Safety Program for ICUs aimed to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in intensive care units with elevated rates. Included hospitals had at least one adult intensive care unit with elevated CLABSI or CAUTI rates. The investigators targeted intensive care units with elevated catheter infection rates but yielded no statistically significant reduction in CLABSI, CAUTI or catheter utilization in the first two of six planned cohorts. Improvements in the interventions based on lessons learned from these initial cohorts are being applied to subsequent cohorts.
AHRQ-funded; 233201500016I.
Citation: Meddings J, Greene MT, Ratz D .
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
BMJ Qual Saf 2020 May;29(5):418-29. doi: 10.1136/bmjqs-2019-009330..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Urinary Tract Infection (UTI), Intensive Care Unit (ICU), Hospitals, Evidence-Based Practice, Patient-Centered Outcomes Research, Inpatient Care, Critical Care
Quinn M, Ameling JM, Forman J
Persistent barriers to timely catheter removal identified from clinical observations and interviews.
Indwelling urinary and vascular catheters are valuable devices in patient care, but prolonged or unnecessary use increases the risk of infectious and noninfectious catheter harms. To understand persistent barriers to detecting and removing unnecessary catheters, the researchers conducted a multimethod qualitative study that included observations and in-person interviews with clinicians working on a progressive care unit of a large hospital.
AHRQ-funded; HS024385; HS019767.
Citation: Quinn M, Ameling JM, Forman J .
Persistent barriers to timely catheter removal identified from clinical observations and interviews.
Jt Comm J Qual Patient Saf 2020 Feb;46(2):99-108. doi: 10.1016/j.jcjq.2019.10.004..
Keywords: Patient Safety, Quality of Care, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI)
Hsu HE, Wang R, Jentzsch MS
The impact of measurement changes on evaluating hospital performance: the case of catheter-associated urinary tract infections.
Researchers observed that catheter-associated urinary tract infections in 592 hospitals immediately declined after federal value-based incentive program implementation, but found that this was fully attributable to a concurrent surveillance case definition revision. They found that post revision, more hospitals had favorable standardized infection ratios, likely leading to artificial inflation of their performance scores unrelated to changes in patient safety.
AHRQ-funded; HS000063; HS025008; HS018414.
Citation: Hsu HE, Wang R, Jentzsch MS .
The impact of measurement changes on evaluating hospital performance: the case of catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2019 Nov;40(11):1269-71. doi: 10.1017/ice.2019.240..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Provider Performance, Quality Measures, Urinary Tract Infection (UTI)
Manojlovich M, Ameling JM, Forman J
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
This study identified contextual barriers to communication between physicians and nurses that contribute to inappropriate use of catheters and increased risk of health care-associated infections. The researchers conducted individual and small-group semistructured interviewed with physicians and nurses in a progressive care unit of an academic hospital. Common barriers included workflow misalignment between clinicians, issues with electronic medical records and pagers, and strained relationships between clinicians.
AHRQ-funded; HS024385.
Citation: Manojlovich M, Ameling JM, Forman J .
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
Am J Crit Care 2019 Jul;28(4):290-98. doi: 10.4037/ajcc2019372..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Healthcare-Associated Infections (HAIs), Patient Safety, Provider, Provider: Nurse, Provider: Physician, Urinary Tract Infection (UTI), Workflow
Elman MR, Williams CD, Bearden DT
Healthcare-associated urinary tract infections with onset post hospital discharge.
The objective of this study was to measure the incidence of potentially healthcare-associated (HA), community-onset (CO) urinary tract infection (UTI) in a retrospective cohort of hospitalized patients. Among 3,273 patients at risk for potentially HA-CO UTI, results found that the incidence of HA-CO UTI in the 30 days post discharge was 29.8 per 1,000 patients; independent risk factors included paraplegia, quadriplegia, indwelling catheter during index hospitalization, prior piperacillin-tazobactam prescription, prior penicillin class prescription, and private insurance. The authors conclude that HA-CO UTI may be common within 30 days following hospital discharge, and that their data suggests that surveillance efforts may need to be expanded to capture the full burden to patients and to better inform antibiotic prescribing decisions for patients with a history of hospitalization.
AHRQ-funded; HS020970.
Citation: Elman MR, Williams CD, Bearden DT .
Healthcare-associated urinary tract infections with onset post hospital discharge.
Infect Control Hosp Epidemiol 2019 Aug;40(8):863-71. doi: 10.1017/ice.2019.148..
Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Hospital Discharge, Hospitalization, Urinary Tract Infection (UTI)
Hsu HE, Wang R, Jentzsch MS
Association between value-based incentive programs and catheter-associated urinary tract infection rates in the critical care setting.
This letter discussed a study which was done on value-based incentive programs to reduce the number of catheter-associated urinary tract infections (CAUTI) in intensive care units (ICUs). The study used data from 592 hospitals in the District of Columbia and 49 states. Researchers found these incentive programs did not significantly reduce CAUTI.
AHRQ-funded; HS000063; HS025008; HS018414.
Citation: Hsu HE, Wang R, Jentzsch MS .
Association between value-based incentive programs and catheter-associated urinary tract infection rates in the critical care setting.
JAMA 2019 Feb 5;321(5):509-11. doi: 10.1001/jama.2018.18997.
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Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Critical Care, Healthcare-Associated Infections (HAIs), Inpatient Care, Patient Safety, Urinary Tract Infection (UTI)
Meddings J, Skolarus TA, Fowler KE
Michigan Appropriate Perioperative (MAP) criteria for urinary catheter use in common general and orthopaedic surgeries: results obtained using the RAND/UCLA Appropriateness Method.
Using the RAND Corporation/University of California Los Angeles (RAND/UCLA) Appropriateness Method, the authors assessed the appropriateness of indwelling urinary catheter placement and different timings of catheter removal for routine general and orthopaedic surgery procedures. The investigators found that appropriateness of catheter use varied by procedure, accounting for procedure-specific risks as well as expected procedure time and intravenous fluids. Procedural appropriateness ratings for catheters were summarised for clinical use into three groups, described in detail in the paper.
AHRQ-funded; 2902010000251; 29032001T; HS19767.
Citation: Meddings J, Skolarus TA, Fowler KE .
Michigan Appropriate Perioperative (MAP) criteria for urinary catheter use in common general and orthopaedic surgeries: results obtained using the RAND/UCLA Appropriateness Method.
BMJ Qual Saf 2019 Jan;28(1):56-66. doi: 10.1136/bmjqs-2018-008025..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Urinary Tract Infection (UTI)