National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (9)
- Antibiotics (1)
- Arthritis (2)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (3)
- Central Line-Associated Bloodstream Infections (CLABSI) (4)
- Children/Adolescents (2)
- Clostridium difficile Infections (2)
- Communication (1)
- Comparative Effectiveness (2)
- Critical Care (2)
- Data (2)
- Diagnostic Safety and Quality (1)
- Evidence-Based Practice (2)
- Genetics (1)
- Guidelines (1)
- (-) Healthcare-Associated Infections (HAIs) (36)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Hospital Discharge (1)
- Hospitals (3)
- Injuries and Wounds (7)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (4)
- Long-Term Care (2)
- Medicare (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (3)
- Nursing (1)
- Nursing Homes (2)
- Organizational Change (1)
- Orthopedics (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- (-) Patient Safety (36)
- Policy (1)
- Pressure Ulcers (4)
- Prevention (8)
- Provider Performance (1)
- Quality Improvement (2)
- Quality of Care (5)
- Risk (4)
- Screening (1)
- Shared Decision Making (1)
- Surgery (6)
- Urinary Tract Infection (UTI) (2)
- Women (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 25 of 36 Research Studies DisplayedMurray MT, Neu N, Cohen B
Developing case definitions for health care-associated infections for pediatric long-term care facilities.
The researchers performed a pilot study to assess the utility of the Society for Healthcare Epidemiology of America/CDC surveillance case definitions for children in pediatric long-term care facilities (pLTCFs). They concluded that the current surveillance definitions for healthcare-acquired infections in adult long-term care appear to have limited utility for the pLTC population.
AHRQ-funded; HS021470.
Citation: Murray MT, Neu N, Cohen B .
Developing case definitions for health care-associated infections for pediatric long-term care facilities.
Clin Pediatr 2015 Dec;54(14):1380-2. doi: 10.1177/0009922815599379..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Patient Safety, Children/Adolescents
Dicks KV, Baker AW, Durkin MJ
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
The purpose of this paper was to determine the association between shorter operative duration and surgical site infection (SSI) and also between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties. The researchers concluded that short operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in their analysis.
AHRQ-funded; HS023866.
Citation: Dicks KV, Baker AW, Durkin MJ .
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
Infect Control Hosp Epidemiol 2015 Dec;36(12):1431-6. doi: 10.1017/ice.2015.222.
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Keywords: Healthcare-Associated Infections (HAIs), Orthopedics, Patient Safety, Adverse Events, Surgery, Injuries and Wounds
Chopra 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
Han JH, Sullivan N, Leas BF
Cleaning hospital room surfaces to prevent health care-associated infections: a technical brief.
The authors review the evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness. Their review of the literature indicates an increased interest in environmental cleaning and disinfecting for the prevention of HAIs. However, there are many limitations in the current evidence base.
AHRQ-funded; 290201200011I.
Citation: Han JH, Sullivan N, Leas BF .
Cleaning hospital room surfaces to prevent health care-associated infections: a technical brief.
Ann Intern Med 2015 Oct 20;163(8):598-607. doi: 10.7326/m15-1192..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Healthcare-Associated Infections (HAIs), Patient Safety
Wiseman JT, Fernandes-Taylor S, Barnes ML
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
This study explored the factors that lead to postdischarge surgical site infections (SSI), investigated the differences between risk factors for in-hospital vs postdischarge SSI, and developed a scoring system to identify patients who might benefit from postdischarge monitoring of their wounds. In a comparative analysis, it found that comorbidities were the primary driver of postdischarge SSI, whereas in-hospital factors (operative time, emergency case status) and complications predicted in-hospital SSI.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
J Vasc Surg 2015 Oct;62(4):1023-31.e5. doi: 10.1016/j.jvs.2015.04.453..
Keywords: Surgery, Hospital Discharge, Healthcare-Associated Infections (HAIs), Patient Safety, Injuries and Wounds, Adverse Events
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)
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
Durkin MJ, Dicks KV, Baker AW
Seasonal variation of common surgical site infections: does season matter?
The researchers evaluated seasonal variation in the rate of surgical site infections (SSI) following commonly performed surgical procedures. Using data from the Duke Infection Control Outreach Network, they found that the rate of SSI following commonly performed surgical procedures was higher during the summer compared with the remainder of the year.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Seasonal variation of common surgical site infections: does season matter?
Infect Control Hosp Epidemiol 2015 Sep;36(9):1011-6. doi: 10.1017/ice.2015.121.
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Keywords: Adverse Events, Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Injuries and Wounds
van Mourik MS, van Duijn PJ, Moons KG
Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review.
The researchers conducted a systematic review evaluating the diagnostic accuracy of administrative data for the detection of HAI. They concluded that administrative data had limited and highly variable accuracy for the detection of HAI, and their judicious use for internal surveillance efforts and external quality assessment is recommended.
AHRQ-funded; HS018414.
Citation: van Mourik MS, van Duijn PJ, Moons KG .
Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review.
BMJ Open 2015 Aug 27;5(8):e008424. doi: 10.1136/bmjopen-2015-008424..
Keywords: Healthcare-Associated Infections (HAIs), Data, Patient Safety, Quality of Care
Croft LD, Harris AD, Pineles L
The effect of universal glove and gown use on adverse events in intensive care unit patients.
The researchers assessed if wearing gloves and gowns during all patient contact in the intensive care unit (ICU) changes adverse event rates. They found that in ICUs where healthcare workers donned gloves and gowns for all patient contact, patients were no more likely to experience adverse events than in control ICUs. Concerns of adverse events resulting from universal glove and gown use were not supported.
AHRQ-funded; 29020060001.
Citation: Croft LD, Harris AD, Pineles L .
The effect of universal glove and gown use on adverse events in intensive care unit patients.
Clin Infect Dis 2015 Aug 15;61(4):545-53. doi: 10.1093/cid/civ315..
Keywords: Patient Safety, Intensive Care Unit (ICU), Adverse Events, Healthcare-Associated Infections (HAIs), Critical Care
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
Pierce RA, Lessler J, Milstone AM
Expanding the statistical toolbox: analytic approaches for cohort studies with healthcare-associated infectious outcomes.
This review intends to convey the scope of available statistical methodology to better understand the process of pathogen acquisition or HAI development. It determined that despite the range of methods available, logistic regression remains the dominant statistical approach in use. Poisson regression, survival methods, and mechanistic (mathematical) models remain underutilized.
AHRQ-funded; HS022872.
Citation: Pierce RA, Lessler J, Milstone AM .
Expanding the statistical toolbox: analytic approaches for cohort studies with healthcare-associated infectious outcomes.
Curr Opin Infect Dis 2015 Aug;28(4):384-91. doi: 10.1097/qco.0000000000000179..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Outcomes, Patient Safety
Rajaram R, Chung JW, Kinnier CV
Hospital characteristics associated with penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program.
The purpose of this study was to examine the characteristics of hospitals penalized by the Hospital-Acquired Condition (HAC) Reduction Program. It found that among hospitals participating in the HAC Reduction Program, hospitals that were penalized more frequently had more quality accreditations, and had better performance on other process and outcome measure.
AHRQ-funded; HS000078.
Citation: Rajaram R, Chung JW, Kinnier CV .
Hospital characteristics associated with penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program.
JAMA 2015 Jul 28;314(4):375-83. doi: 10.1001/jama.2015.8609..
Keywords: Hospitals, Healthcare-Associated Infections (HAIs), Patient Safety, Provider Performance
Mody L, Meddings J, Edson BS
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
The authors describe a new initiative based on lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent catheter-associated urinary tract infections in over 950 acute care hospitals. This initiative will now be implemented in nearly 500 nursing homes through a project funded by AHRQ. It will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship.
AHRQ-funded; 2902010000251; HS019979; HS019767.
Citation: Mody L, Meddings J, Edson BS .
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
Clin Infect Dis 2015 Jul 1;61(1):86-94. doi: 10.1093/cid/civ236..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Inpatient Care
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
Murray MT, Pavia M, Jackson O
Health care-associated infection outbreaks in pediatric long-term care facilities.
The researchers performed a retrospective study from January 2010- December 2013 at 3 pediatric long-term care facilities to describe HAI outbreaks and associated infection control interventions. They found that there were 62 outbreaks involving 700 cases in residents and 250 cases in staff. The most common interventions were isolation precautions and education and in-services.
AHRQ-funded; HS021470.
Citation: Murray MT, Pavia M, Jackson O .
Health care-associated infection outbreaks in pediatric long-term care facilities.
Am J Infect Control 2015 Jul;43(7):756-8. doi: 10.1016/j.ajic.2015.03.010..
Keywords: Healthcare-Associated Infections (HAIs), Long-Term Care, Children/Adolescents, Children/Adolescents, Patient Safety
Rock C, Harris AD, Johnson JK
Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients.
The researchers, by using a validated air sampling method, found Acinetobacter baumannii in the air surrounding only 1 of 12 patients known to be colonized or infected with A. baumannii. Patients’ closed-circuit ventilator status, frequent air exchanges in patient rooms, and short sampling time may have contributed to this low burden.
AHRQ-funded; HS022291.
Citation: Rock C, Harris AD, Johnson JK .
Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients.
Infect Control Hosp Epidemiol 2015 Jul;36(7):830-2. doi: 10.1017/ice.2015.68..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU)
Pakyz AL, Patterson JA, Motzkus-Feagans C
Performance of the present-on-admission indicator for Clostridium difficile infection.
The researchers compared performance of a hospital- and community-onset Clostridium difficile infection definition using administrative data to a present on- admission indicator with definitions using clinical surveillance. For hospital-onset C. difficile infection, there was moderate sensitivity (68 percent) and high specificity (93 percent); for community-onset, sensitivity and specificity were high (both 85 percent).
AHRQ-funded; HS018578.
Citation: Pakyz AL, Patterson JA, Motzkus-Feagans C .
Performance of the present-on-admission indicator for Clostridium difficile infection.
Infect Control Hosp Epidemiol 2015 Jul;36(7):838-40. doi: 10.1017/ice.2015.63..
Keywords: Clostridium difficile Infections, Patient Safety, Healthcare-Associated Infections (HAIs), Data
Durkin MJ, Dicks KV, Baker AW
Postoperative infection in spine surgery: does the month matter?
The authors evaluated for seasonal variation of surgical site infection (SSI) following spine surgery in a network of nonteaching community hospitals. They found that the rate of SSI following fusion or spinal laminectomy/laminoplasty was higher during the summer in this network of community hospitals, most likely due to S. aureus rather than the July effect.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Postoperative infection in spine surgery: does the month matter?
J Neurosurg Spine 2015 Jul;23(1):128-34. doi: 10.3171/2014.10.spine14559.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Hospitals, Outcomes, Quality of Care
Meddings J, Reichert H, Rogers MA
Under pressure: Financial effect of the hospital-acquired conditions initiative-a statewide analysis of pressure ulcer development and payment.
This study assessed the financial effect of the 2008 Hospital-Acquired Conditions Initiative (HACI) pressure ulcer payment changes on Medicare, other payers, and hospitals. It found that the total financial effect of the 2008 payment changes for pressure ulcers was negligible. Most payment decreases occurred by removal of comorbidity payments for present-on-admission pressure ulcers other than Stages III and IV.
AHRQ-funded; HS019767; HS018334.
Citation: Meddings J, Reichert H, Rogers MA .
Under pressure: Financial effect of the hospital-acquired conditions initiative-a statewide analysis of pressure ulcer development and payment.
J Am Geriatr Soc 2015 Jul;63(7):1407-12. doi: 10.1111/jgs.13475..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare-Associated Infections (HAIs), Pressure Ulcers, Patient Safety, Healthcare-Associated Infections (HAIs)
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
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)
Yun H, Xie F, Delzell E
Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.
The researchers compare the subsequent risk of hospitalized infections associated with specific biologic agents among RA patients previously hospitalized for infection while receiving anti-tumor necrosis factor (anti-TNF) therapy. They found that among rheumatoid arthritis patients who experienced a hospitalized infection while on anti-TNF therapy, abatacept and etanercept were associated with the lowest risk of a subsequent infection compared to other biologic therapies.
AHRQ-funded; HS021694; HS023009; HS018517.
Citation: Yun H, Xie F, Delzell E .
Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.
Ann Rheum Dis 2015 Jun;74(6):1065-71. doi: 10.1136/annrheumdis-2013-204011..
Keywords: Arthritis, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Patient Safety