National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Blood Pressure (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children/Adolescents (5)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (3)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Data (1)
- Diabetes (1)
- Disabilities (1)
- Disparities (2)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
- Home Healthcare (2)
- Hospitals (5)
- Implementation (1)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (3)
- Long-Term Care (1)
- (-) Nursing (22)
- Organizational Change (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Patient Safety (5)
- Patient Self-Management (1)
- Prevention (2)
- Primary Care (2)
- Provider (2)
- Provider: Nurse (5)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (4)
- Quality of Life (1)
- Risk (1)
- Sepsis (1)
- Shared Decision Making (1)
- Surgery (1)
- Teams (1)
- Telehealth (1)
- Transitions of Care (1)
- Urinary Tract Infection (UTI) (1)
- Vulnerable Populations (1)
- Workflow (2)
- Workforce (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 22 of 22 Research Studies DisplayedJohnson KD, Schumacher D, Lee RC
Identifying strategies for the management of interruptions for novice triage nurses using an online modified Delphi method.
This study’s purpose was to use the Delphi Method to identify strategies used by triage nurses to effectively manage interrupts that can be taught to novice nurses. A panel of nine triage, education, and operational management experts were selected. The panel participated in three Delphi rounds. Results were synthesized and summaries returned to the participants. A final consensus was reached regarding recommendations for successful strategies to address triage interruptions. Eight strategies to mitigate the impact of interruptions were identified. Six of those strategies were identified as best being taught using simulation.
AHRQ-funded; HS025844.
Citation: Johnson KD, Schumacher D, Lee RC .
Identifying strategies for the management of interruptions for novice triage nurses using an online modified Delphi method.
J Nurs Scholarsh 2021 Nov;53(6):718-26. doi: 10.1111/jnu.12683..
Keywords: Nursing, Workflow
Bender M, Williams M, Cruz MF
A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader care model in improving quality and safety outcomes.
The authors discuss the Clinical Nurse Leader care model, a Hybrid Type II Implementation-Effectiveness study to evaluate the effect of the care model on standardized quality and safety outcomes and to identify implementation characteristics that are sufficient and necessary to achieve outcomes. Findings are expected to elucidate Registered Nurse's mechanisms of action as organized into frontline models of care and link actions to improved care quality and safety.
AHRQ-funded; HS027181.
Citation: Bender M, Williams M, Cruz MF .
A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader care model in improving quality and safety outcomes.
Nurs Open 2021 Nov;8(6):3688-96. doi: 10.1002/nop2.910..
Keywords: Implementation, Quality Improvement, Quality of Care, Patient Safety, Nursing, Evidence-Based Practice
Kutney-Lee A, Brooks Carthon M, Sloane DM
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Researchers examined associations between electronic health record (EHR) usability and nurse job and surgical patient outcomes. Data from the American Hospital Association, state patient discharges, and nurse surveys were linked in a cross-sectional analysis. The researchers found that employing EHR systems with suboptimal usability was associated with higher odds of adverse nurse job outcomes and surgical patient mortality and readmission.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Brooks Carthon M, Sloane DM .
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Med Care 2021 Jul;59(7):625-31. doi: 10.1097/mlr.0000000000001536..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Outcomes, Nursing, Provider: Nurse
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
Rasooly IR, Kern-Goldberger AS, Xiao Rasooly IR, Kern-Goldberger AS, Xiao R
Physiologic monitor alarm burden and nurses' subjective workload in a children's hospital.
Physiologic monitor alarms occur at high rates in children's hospitals; ≤1% are actionable. The burden of alarms has implications for patient safety and is challenging to measure directly. Nurse workload, measured by using a version of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) validated among nurses, is a useful indicator of work burden that has been associated with patient outcomes. The objective of this study was to measure the relationship between alarm count and nurse workload by using the NASA-TLX.
AHRQ-funded; R18 HS026620.
Citation: Rasooly IR, Kern-Goldberger AS, Xiao Rasooly IR, Kern-Goldberger AS, Xiao R .
Physiologic monitor alarm burden and nurses' subjective workload in a children's hospital.
Hosp Pediatr 2021 Jul;11(7):703-10. doi: 10.1542/hpeds.2020-003509..
Keywords: Children/Adolescents, Nursing, Inpatient Care, Patient Safety
McDonald MV, Brickner C, Russell D
Observation of hand hygiene practices in home health care.
The purpose of this observational study was to describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits. The investigators concluded that hand hygiene adherence in HHC was suboptimal, with rates mirroring those reported in hospital and outpatient settings.
AHRQ-funded; HS024723.
Citation: McDonald MV, Brickner C, Russell D .
Observation of hand hygiene practices in home health care.
J Am Med Dir Assoc 2021 May;22(5):1029-34. doi: 10.1016/j.jamda.2020.07.031..
Keywords: Home Healthcare, Nursing, Provider: Nurse, Provider, Prevention, Healthcare-Associated Infections (HAIs), Guidelines
Woods-Hill CZ, Papili K, Nelson E
Harnessing implementation science to optimize harm prevention in critically ill children: a pilot study of bedside nurse CLABSI bundle performance in the pediatric intensive care unit.
Central-line associated bloodstream infection (CLABSI) is associated with increased mortality, morbidity, and cost in hospitalized children. An evidence-based bundle of care can decrease CLABSI, but bundle compliance is imperfect. In this study, the investigators explored factors impacting bundle performance in the pediatric intensive care unit (PICU) by bedside nurses. The investigators concluded that PICU nurses were knowledgeable and motivated to prevent CLABSI, but faced challenges from competing clinical tasks, limited resources, and complex family interactions. Physician engagement was specifically noted to impact nurse motivation to complete the bundle.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Papili K, Nelson E .
Harnessing implementation science to optimize harm prevention in critically ill children: a pilot study of bedside nurse CLABSI bundle performance in the pediatric intensive care unit.
Am J Infect Control 2021 Mar;49(3):345-51. doi: 10.1016/j.ajic.2020.08.019..
Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Intensive Care Unit (ICU), Nursing, Patient Safety
Dowding D, Russell D, McDonald MV
"A catalyst for action": factors for implementing clinical risk prediction models of infection in home care settings.
This study looked at how a clinical risk prediction model for identifying patients at risk of infection is perceived by home care nurses. It was a qualitative study using semi-structured interviews with 50 home care nurses. The interviews were audio-taped and transcribed with data evaluation using thematic analysis. Findings indicated that the nurses would find a clinical risk prediction model useful, as long as it provided both context around the reasons why a patient was deemed to be high risk and provided some guidance for action.
AHRQ-funded; HS024723.
Citation: Dowding D, Russell D, McDonald MV .
"A catalyst for action": factors for implementing clinical risk prediction models of infection in home care settings.
J Am Med Inform Assoc 2021 Feb 15;28(2):334-41. doi: 10.1093/jamia/ocaa267..
Keywords: Home Healthcare, Nursing, Risk, Healthcare-Associated Infections (HAIs), Prevention, Provider: Nurse, Provider
Howland C, Despins L, Sindt J
Primary care clinic nurse activities with a telehealth monitoring system.
The purpose of this study was to evaluate differences in the types of nursing activities and communication processes reported in a primary care clinic between patients using a home-based monitoring system to electronically communicate self-monitored blood glucose and blood pressure values and those assuming usual care. Significant differences were identified for the direct care nursing activities of providing lifestyle and health education, medication adjustments, and patient follow-up, providing evidence of greater nursing activity reported in a primary care clinic in patients who utilized a home-based monitoring system.
AHRQ-funded; HS017035.
Citation: Howland C, Despins L, Sindt J .
Primary care clinic nurse activities with a telehealth monitoring system.
West J Nurs Res 2021 Jan;43(1):5-12. doi: 10.1177/0193945920923082..
Keywords: Telehealth, Health Information Technology (HIT), Blood Pressure, Primary Care, Clinician-Patient Communication, Communication, Patient Self-Management, Nursing, Patient-Centered Healthcare, Diabetes
Bakken S, Reame N
http://www.ingentaconnect.com/content/springer/arnr/2016/00000034/00000001/art00013
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
The purposes of this chapter are to (a) briefly summarize the current drivers for the use of big data in research; (b) describe the promise of big data and associated data science methods for advancing symptom management research; and (c) explicate the potential perils of big data and data science from the perspective of the ethical principles of autonomy, beneficence, and justice.
AHRQ-funded; HS022961
Citation: Bakken S, Reame N .
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
Annu Rev Nurs Res 2016;34:247-60. doi: 10.1891/0739-6686.34.247..
Keywords: Data, Disparities, Nursing, Patient-Centered Outcomes Research
Martsolf GR, Gibson TB, Benevent R
AHRQ Author: Jiang HJ, Stocks C
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
The researchers studied the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. After controlling for unobserved hospital characteristics, they found that the positive influences of increased nurse staffing levels and skill mix were relatively small in size and limited to a few measures of patients' inpatient experience.
AHRQ-authored.
Citation: Martsolf GR, Gibson TB, Benevent R .
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
Health Serv Res 2016 Dec;51(6):2221-41. doi: 10.1111/1475-6773.12462.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Nursing, Patient Experience, Patient Experience, Healthcare Cost and Utilization Project (HCUP)
Harrod M, Montoya A, Mody L
Challenges for nurses caring for individuals with peripherally inserted central catheters in skilled nursing facilities.
The researchers sought to understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. They noted differences between resident self-reported PICC concerns (quality of life) and those described by frontline nurses.
AHRQ-funded; HS019979; HS022835.
Citation: Harrod M, Montoya A, Mody L .
Challenges for nurses caring for individuals with peripherally inserted central catheters in skilled nursing facilities.
J Am Geriatr Soc 2016 Oct;64(10):2059-64. doi: 10.1111/jgs.14341.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Nursing, Quality of Life, Transitions of Care
Grundy Q
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
The author analyzed the ways that committee members constructed and evaluated a case for a product's value, concluding that purchasing committees need unique support that emphasizes local contexts and expertise, while maintaining rigor and minimizing bias. Grundy proposed a guiding framework to support this decision-making.
AHRQ-funded; HS022383.
Citation: Grundy Q .
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
Soc Sci Med 2016 Sep;165:82-91. doi: 10.1016/j.socscimed.2016.07.042.
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Keywords: Shared Decision Making, Healthcare Costs, Hospitals, Nursing
Connor JA, Larson C, Baird J
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
The authors aimed to identify and develop standardized measures representative of pediatric nursing care of the cardiovascular patient for benchmarking within freestanding children's hospitals. The Consortium of Congenital Cardiac Care-Measurement of Nursing Practice members developed quality measures within working groups and then individually critiqued all drafted measures. The process resulted in 10 measures eligible for testing. The Consortium will continue with implementation and testing of each measure, supporting the development of benchmarks and the evaluation of the association of the measures with patient outcomes.
AHRQ-funded; HS000063.
Citation: Connor JA, Larson C, Baird J .
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
J Pediatr Nurs 2016 Sep-Oct;31(5):471-7. doi: 10.1016/j.pedn.2016.04.010.
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Keywords: Children/Adolescents, Cardiovascular Conditions, Nursing, Quality Measures, Hospitals
Poghosyan L, Liu J
Nurse practitioner autonomy and relationships with leadership affect teamwork in primary care practices: a cross-sectional survey.
The authors investigated whether nurse practitioner (NP) autonomy within primary care practices and the relationships they have with leadership affect teamwork between NPs and physicians. They concluded that NP autonomy and favorable relationships with leadership improve teamwork, and they recommended that policy and organizational change focus on promoting NP autonomy and improving the relationship between NPs and leadership to improve teamwork and consequently improve patient care and outcomes.
AHRQ-funded; HS020999.
Citation: Poghosyan L, Liu J .
Nurse practitioner autonomy and relationships with leadership affect teamwork in primary care practices: a cross-sectional survey.
J Gen Intern Med 2016 Jul;31(7):771-7. doi: 10.1007/s11606-016-3652-z.
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Keywords: Nursing, Organizational Change, Primary Care, Teams
Silber JH, Rosenbaum PR, McHugh MD
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
This study tested whether hospitals with better nursing work environments displayed better value than those with worse nursing. It found that hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients.
AHRQ-funded; HS018338.
Citation: Silber JH, Rosenbaum PR, McHugh MD .
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
JAMA Surg 2016 Jun;151(6):527-36. doi: 10.1001/jamasurg.2015.4908.
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Keywords: Healthcare Costs, Quality of Care, Nursing, Workforce
Navarra AM, Schlau R, Murray M
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
The researchers designed and tested the Nursing-Kids Intensity of Care Survey (N-KICS) tool and describe intensity of nursing care for children with complex medical conditions. Their psychometric evaluation confirmed an acceptable standard for reliability and validity and feasibility. Intensity scores were highest for nursing care related to infection control, medication administration, nutrition, diaper changes, hygiene, neurological and respiratory support, and standing program.
AHRQ-funded; HS021470.
Citation: Navarra AM, Schlau R, Murray M .
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
J Pediatr Nurs 2016 May-Jun;31(3):299-310. doi: 10.1016/j.pedn.2015.11.012.
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Keywords: Children/Adolescents, Chronic Conditions, Disabilities, Long-Term Care, Nursing, Vulnerable Populations
Baird J, Rehm RS, Hinds PS
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
The objective of this analysis was to explore the delivery of continuity of nursing care in the pediatric intensive care unit (PICU), from the perspective of both parents and nurses. Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child's care regimen.
AHRQ-funded; HS000063.
Citation: Baird J, Rehm RS, Hinds PS .
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
Nurs Res 2016 Mar-Apr;65(2):142-50. doi: 10.1097/nnr.0000000000000135.
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Keywords: Care Management, Children/Adolescents, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU), Nursing
Schondelmeyer AC, Brady PW, Landrigan CP
Alarm fatigue: clearing the air.
The authors discuss an article in the same issue of the Journal of Hospital Medicine by Paine and colleagues that sets out to review the small but growing body of literature addressing physiologic monitor alarms and interventions that have tried to address alarm fatigue. They conclude that the review demonstrates that the great majority of alarms do not help clinicians and likely contribute to alarm fatigue.
AHRQ-funded; HS023827.
Citation: Schondelmeyer AC, Brady PW, Landrigan CP .
Alarm fatigue: clearing the air.
J Hosp Med 2016 Feb;11(2):153-4. doi: 10.1002/jhm.2521.
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Keywords: Patient Safety, Nursing, Adverse Events, Hospitals
Abraham J, Kannampallil T, Brenner C
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
This paper describes Sequential Conversational Analysis (SCA) - a mixed-method approach integrating qualitative conversational analysis with quantitative sequential pattern analysis. This approach allows characterization of the nature of nurse handoff communication, highlighting the relationships underlying verbal content. The authors also discuss how SCA can help in understanding the dynamics of communication in other settings.
AHRQ-funded; HS017586.
Citation: Abraham J, Kannampallil T, Brenner C .
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
J Biomed Inform 2016 Feb;59:76-88. doi: 10.1016/j.jbi.2015.11.009.
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Keywords: Communication, Quality of Care, Intensive Care Unit (ICU), Nursing, Workflow
Jones K, Sibai J, Battjes R
How and when nurses collect urine cultures on catheterized patients: a survey of 5 hospitals.
Obtaining a specimen for urine culture is a key element in evaluating for catheter-associated urinary tract infections (CAUTIs). Nurses at 5 hospitals completed a survey regarding their knowledge, training, and practices of appropriate reasons for obtaining urine cultures. The researchers concluded that important opportunities exist for nurses to optimize the decisions to obtain urine cultures and the process for obtaining them.
AHRQ-funded; 290201000025I; 29032001T.
Citation: Jones K, Sibai J, Battjes R .
How and when nurses collect urine cultures on catheterized patients: a survey of 5 hospitals.
Am J Infect Control 2016 Feb;44(2):173-6. doi: 10.1016/j.ajic.2015.09.003.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Hospitals, Nursing, Provider: Nurse, Urinary Tract Infection (UTI)
Ricciardi R, Moy E, Wilson NJ
AHRQ Author: Ricciardi R and Moy E
Finding the true north: lessons from the National Healthcare Quality and Disparities Report.
The authors delineate important features and findings of the 2014 report. For example, it shows that one measure of patient safety improved quickly. The rate of central line–associated bloodstream infection per 1000 medical and surgical discharges (age 18+ years or obstetric admissions) improved at an annual rate of change of more than 10 percent. This success reflects the direct impact that nurses can have in making care safer for their patients.
AHRQ authors Ricciardi and Moy
Citation: Ricciardi R, Moy E, Wilson NJ .
Finding the true north: lessons from the National Healthcare Quality and Disparities Report.
J Nurs Care Qual 2016 Jan-Mar;31(1):9-12. doi: 10.1097/ncq.0000000000000164..
Keywords: Quality of Care, Disparities, Patient Safety, Nursing, Central Line-Associated Bloodstream Infections (CLABSI)