National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (21)
- Ambulatory Care and Surgery (5)
- Antibiotics (6)
- Antimicrobial Stewardship (3)
- Blood Clots (1)
- Cancer (1)
- Cardiovascular Conditions (5)
- Catheter-Associated Urinary Tract Infection (CAUTI) (17)
- Central Line-Associated Bloodstream Infections (CLABSI) (20)
- Children/Adolescents (12)
- Clinical Decision Support (CDS) (2)
- Clostridium difficile Infections (14)
- Communication (3)
- Community-Acquired Infections (1)
- Comparative Effectiveness (4)
- Comprehensive Unit-based Safety Program (CUSP) (3)
- Critical Care (6)
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- Decision Making (2)
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- (-) Healthcare-Associated Infections (HAIs) (123)
- Healthcare Cost and Utilization Project (HCUP) (1)
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- Injuries and Wounds (9)
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- Maternal Care (1)
- Medical Devices (2)
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- Medication: Safety (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (16)
- Mortality (2)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (2)
- Nursing (3)
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- Patient-Centered Healthcare (2)
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- Payment (1)
- Pneumonia (4)
- Policy (1)
- Practice Patterns (3)
- Pregnancy (1)
- Prevention (36)
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- Quality Improvement (12)
- Quality Measures (1)
- Quality of Care (27)
- Racial and Ethnic Minorities (2)
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- Research Methodologies (1)
- Respiratory Conditions (1)
- Risk (12)
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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 123 Research Studies DisplayedRacila AM, O'Shea AMJ, Nair R
Using nasal povidone-iodine to prevent bloodstream infections and transmission of Staphylococcus aureus among haemodialysis
This article describes a planned study; the objective is to determine the clinical efficacy and effectiveness of a novel intervention using nasal povidone-iodine to prevent bloodstream infections among patients in hemodialysis units. Findings will be presented at international meetings, and the study team will publish findings in peer-reviewed journals, making each accepted peer-reviewed manuscript publicly available.
AHRQ-funded; HS026724.
Citation: Racila AM, O'Shea AMJ, Nair R .
Using nasal povidone-iodine to prevent bloodstream infections and transmission of Staphylococcus aureus among haemodialysis
BMJ Open 2021 Dec 3;11(12):e048830. doi: 10.1136/bmjopen-2021-048830..
Keywords: Healthcare-Associated Infections (HAIs), Kidney Disease and Health, Prevention
Ford WJH, Bundy DG, Oyeku S
Central venous catheter salvage in ambulatory central line-associated bloodstream infections.
In this study, researchers evaluated central venous catheters (CVCs) salvage in pediatric patients with ambulatory CLABSI and associated risk factors for treatment failure. They found that underlying diagnosis, CVC type, number of lumens, and absence of candidemia were associated with successful salvage. In patients with malignancy, neutropenia within 30 days before CLABSI was significantly associated with both attempted salvage and successful salvage.
AHRQ-funded; HS024432.
Citation: Ford WJH, Bundy DG, Oyeku S .
Central venous catheter salvage in ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Dec 1;148(6). doi: 10.1542/peds.2020-042069..
Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Pienta M, Shore S, Pagani FD
Rates and types of infections in left ventricular assist device recipients: a scoping review.
This scoping review examined rates and types of infections in left ventricular assist device (LVAD) recipients. A comprehensive literature search was done from January 2006 to February 2019. After screening 9680 titles and abstracts, 132 full text articles were included for data extraction. The most commonly studied LVAD-specific infections were driveline infections followed by pocket and pump or cannula infections. Driveline infection rates ranged from 5-56% within the first 6 months, 7-71% after the first year, and 7-65% at 2 years. Bloodstream infections were the most commonly studied LVAD-related infections with rates in the first month ranging from 2.6% to 10%, 13-20% within the first 6 months of implant, and 3-27% within 1 year of implant. Pocket infection incidence was reported in 20 studies with fairly low rates for all time periods. The authors found a substantial proportion of studies did not report according to Strengthening the Reporting of Observation Studies in Epidemiology guidelines, including demographic information of follow-up time. They also did not adhere to minimum reporting criteria and did not use standardized definitions of infections. This has implications for future investigations.
AHRQ-funded; HS026003.
Citation: Pienta M, Shore S, Pagani FD .
Rates and types of infections in left ventricular assist device recipients: a scoping review.
JTCVS Open 2021 Dec;8:405-11. doi: 10.1016/j.xjon.2021.08.005..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare-Associated Infections (HAIs)
Ernest EC, Hellar A, Varallo J
Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention.
This study evaluated the impact of a multicomponent safe surgery intervention in Tanzania to reduce surgical site infection (SSI) rates and mortality after caesarean sections (CS). The authors used the WHO Surgical Safety Checklist (SSC) to measure WHO SSC utilization, SSI rates, and CS-related perioperative mortality rates (POMRs) before and 18 months after implementation. The SSC utilization rate for CS increased from 3.7% to 95.1%, which decreased the proportion of women with SSI after CS from 14% during baseline to 1%. CS-related POMR decreased by 38.5% after implementation of safe surgery interventions as well.
AHRQ-funded; HS024235.
Citation: Ernest EC, Hellar A, Varallo J .
Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention.
BMJ Glob Health 2021 Dec;6(12). doi: 10.1136/bmjgh-2021-006788..
Keywords: Maternal Care, Pregnancy, Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Adverse Events, Patient Safety
Alrawashdeh M, Rhee C, Hsu H
Assessment of federal value-based incentive programs and in-hospital Clostridioides difficile infection rates.
The authors sought to examine the association between value-based incentive program (VBIP) implementation and health care facility-onset Clostridioides difficile infection (HO-CDI) rates. Their study evaluated HO-CDI rates among adults hospitalized at acute-care hospitals from January 2013 to March 2019. They found that, in this study, VBIP implementation was associated with improvements in HO-CDI rates, independent of CDI testing method. They recommended that future research focus on elucidating the specific processes that contributed to improvement in HO-CDI rates to inform the design of future VBIP interventions.
AHRQ-funded; HS018414; HS025008.
Citation: Alrawashdeh M, Rhee C, Hsu H .
Assessment of federal value-based incentive programs and in-hospital Clostridioides difficile infection rates.
JAMA Netw Open 2021 Oct;4(10):e2132114. doi: 10.1001/jamanetworkopen.2021.32114..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Quality of Care
Arntson E, Dimick JB, Nuliyalu U
Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.
This study evaluated changes in Hospital-Acquired Conditions (HACs) and 30-day mortality after the announcement of the Centers for Medicare and Medicare Services’ Hospital-Acquired Condition Reduction Program (HACRP) in August 2013. The authors evaluated models to test for changes in HACs and 30-day mortality before and after the Affordable Care Act (ACA), and after the HACRP. Fee-for-service Medicare claims from 2009 to 2015 were used. The HAC rate declined after the ACA was passed and declined further after the HACRP announcement. However, 30-day mortality rates were unchanged.
AHRQ-funded; HS026244.
Citation: Arntson E, Dimick JB, Nuliyalu U .
Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.
Ann Surg 2021 Oct 1;274(4):e301-e07. doi: 10.1097/sla.0000000000003641..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Mortality, Medicare, Payment, Prevention, Patient Safety
Page B, Klompas M, Chan C
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
US hospitals are required by the Centers for Medicare and Medicaid Services to publicly report central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), Clostridioidesdiffficile, methicillin-resistant Staphylococcus aureus bacteremia, and selected surgical site infections for benchmarking and pay-for-performance programs. In this study the investigators retrospectively assessed the overlap between HO-ASEs and reportable HAIs among adults hospitalized between June 2015-June 2018 in 3 hospitals.
AHRQ-funded; HS025008.
Citation: Page B, Klompas M, Chan C .
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
Clin Infect Dis 2021 Sep 15;73(6):1013-19. doi: 10.1093/cid/ciab217..
Keywords: Sepsis, Healthcare-Associated Infections (HAIs), Hospitals, Clostridium difficile Infections, Catheter-Associated Urinary Tract Infection (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI)
Bucher BT, Yang M, Arndorfer J
Changes in the accuracy of administrative data for the detection of surgical site infections.
The authors performed a retrospective analysis of the changes in accuracy of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes for colectomy and hysterectomy surgical site infection surveillance. They found no significant change in the accuracy of these codes following the transition from ICD-CM ninth edition to tenth edition codes.
AHRQ-funded; HS025776.
Citation: Bucher BT, Yang M, Arndorfer J .
Changes in the accuracy of administrative data for the detection of surgical site infections.
Infect Control Hosp Epidemiol 2021 Sep;42(9):1128-30. doi: 10.1017/ice.2020.1346..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Diagnostic Safety and Quality
Pakyz AL, Wang H, Ozcan YA
Leapfrog Hospital Safety Score, magnet designation, and healthcare-associated infections in United States hospitals.
The goal of this study was to determine whether Magnet designation and hospitals with better Leapfrog Hospital Safety Scores have fewer healthcare-associated infections (HAIs). Findings showed that “A” hospitals performed better on clostridium difficile infection (CDI) but not methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, while Magnet designation was associated with fewer than expected MRSA infections but more than expected CDIs. These mixed results show that hospital global assessments of safety and workplace quality differentially and imperfectly predict its level of HAIs.
AHRQ-funded; HS018578.
Citation: Pakyz AL, Wang H, Ozcan YA .
Leapfrog Hospital Safety Score, magnet designation, and healthcare-associated infections in United States hospitals.
J Patient Saf 2021 Sep 1;17(6):445-50. doi: 10.1097/pts.0000000000000378..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety
Bartsch SM, Wong KF, Mueller LE
Modeling interventions to reduce the spread of multidrug-resistant organisms between health care facilities in a region.
The objective of this study was to identify a group of target facilities and to assess which multidrug-resistant organism (MDRO) intervention would be best to implement in the Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, a large regional public health collaborative in Orange County, California. Findings suggested that decolonization would be the best strategy for the Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County.
AHRQ-funded; HS023317; HS028165.
Citation: Bartsch SM, Wong KF, Mueller LE .
Modeling interventions to reduce the spread of multidrug-resistant organisms between health care facilities in a region.
JAMA Netw Open 2021 Aug 2;4(8):e2119212. doi: 10.1001/jamanetworkopen.2021.19212..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Public Health
Cabral SM, Goodman KE, Blanco N
Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.
This study’s objective was to determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Adult patients admitted to 3 hospitals in Maryland from 2016 to 2018 were included. Patients with comorbid conditions were assigned using the Elixhauser comorbidity index. Standardized infection rates (SIRs) were computed using current CDC risk adjustment methodology and included the addition of Elixhauser score and individual comorbidities. Hospital 1 had 314 (0.65%) of patients with a HO-CDI, Hospital 2 had 41 (0.47%) with a HO-CDI, and Hospital 3 had 75 (0.26%) with a HO-CDI. Elixhauser score in multivariable regression was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic user, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospitals 1 and 2. Including the Elixhauser score in the risk adjustment model was statistically significant.
AHRQ-funded; HS022291.
Citation: Cabral SM, Goodman KE, Blanco N .
Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.
Infect Control Hosp Epidemiol 2021 Aug;42(8):955-61. doi: 10.1017/ice.2020.1344..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Risk
Hewage SCN, Cao LTT, Jones RM
Factors associated with environmental service worker cleaning practices in health care settings: a systematic review of the literature.
The objective of this systematic literature review was to identify factors associated with the disinfection practices of environmental service workers in health care settings. Findings showed that, when education/training was combined with performance evaluation/feedback, significant improvement in environmental service worker disinfection practices was reported. The long-term commitment of an organization was also found to be essential for continuous improvement in disinfection outcomes.
AHRQ-funded; HS025987.
Citation: Hewage SCN, Cao LTT, Jones RM .
Factors associated with environmental service worker cleaning practices in health care settings: a systematic review of the literature.
Am J Infect Control 2021 Jul;49(7):919-27. doi: 10.1016/j.ajic.2021.01.001..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety
Safdar N, Parmasad V, Brown R
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interventions are effective in CDI control, but there is little evidence regarding the most effective AS interventions. In this paper the investigators describe their multisite, stepped-wedge, cluster, effectiveness-implementation clinical trial.
AHRQ-funded; R01 HS026226.
Citation: Safdar N, Parmasad V, Brown R .
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
BMJ Open 2021 Jun 29;11(6):e046480. doi: 10.1136/bmjopen-2020-046480..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Antimicrobial Stewardship, Antibiotics, Medication, Prevention
Golob JL, Rao K
Signal versus noise: how to analyze the microbiome and make progress on antimicrobial resistance.
This paper’s objective is to: 1) review the current thought on risk from antibiotic-resistant organization (ARO) acquisition; 2) review the current understanding on the gut microbiome’s ability to resist colonization with AROs; 3) describe how experimental model systems can test these global initial, global insights to arrive at more granular, mechanistic ones; and 4) suggest a path forward to make further progress in the field. This review is informed from experiences and successes with understanding of the role of the microbiome in mediating risk of Clostridioides difficile infection.
AHRQ-funded; HS027431.
Citation: Golob JL, Rao K .
Signal versus noise: how to analyze the microbiome and make progress on antimicrobial resistance.
J Infect Dis 2021 Jun 16;223(Suppl 3):S214-S21. doi: 10.1093/infdis/jiab184..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Genetics
Zhu Y, Simon GJ, Wick EC
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
Surgical complications have tremendous consequences and costs. Complication detection is important for quality improvement, but traditional manual chart review is burdensome. Automated mechanisms are needed to make this more efficient. The purpose of the study was to understand the generalizability of a machine learning algorithm between sites; automated surgical site infection (SSI) detection algorithms developed at one center were tested at another distinct center.
AHRQ-funded; HS024532.
Citation: Zhu Y, Simon GJ, Wick EC .
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
J Am Coll Surg 2021 Jun;232(6):963-71.e1. doi: 10.1016/j.jamcollsurg.2021.03.026..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Schuetz CR, Hogan PG, Reich PJ
Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates.
The purpose of this case-control study was to identify factors associated with development of symptomatic infection in infants colonized with methicillin-resistant Staphylococcus aureus (MRSA) in the Neonatal Intensive Care Unit (NICU). The investigators concluded that progression from MRSA colonization to symptomatic infection was associated with increased morbidity and may be mitigated through decolonization.
AHRQ-funded; HS021736; HS024269.
Citation: Schuetz CR, Hogan PG, Reich PJ .
Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates.
J Perinatol 2021 Jun;41(6):1285-92. doi: 10.1038/s41372-021-00944-8..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Critical Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs)
Brajcic BC, Ko CY, Liu JB
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
This paper describes the protocol for an upcoming multicenter randomized surgical trial to evaluate choice of prophylactic antibiotics for pancreaticoduodenectomy. The rationale and methodology of the trial evaluating piperacillin-tazobactam compared to cefoxitin for surgical site infection prevention is described. The study will utilize a clinical registry for data collection.
AHRQ-funded; HS000078.
Citation: Brajcic BC, Ko CY, Liu JB .
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
J Surg Oncol 2021 May;123(6):1387-94. doi: 10.1002/jso.26402..
Keywords: Cancer, Antibiotics, Medication, Prevention, Surgery, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Evidence-Based Practice
Sick-Samuels AC, Linz M, Bergmann J
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
This study describes the development and impact of a clinical decision support algorithm to standardize the use of endotracheal aspirate cultures (EACs) from ventilated PICU patients in the evaluation of suspected ventilator-associated infections. Bacterial growth in EACs does not distinguish bacterial colonization from infection and may lead to overtreatment with antibiotics. The rate of EACs was compared pre- and postintervention. In the preintervention year there were 557 EACs over 5092 ventilator days. After introduction of the algorithm the rate went down to 234 EACs over 3654 ventilator days. There was a 41% decrease in the monthly rate of EACs. This intervention did not affect mortality, readmissions, or length of stay in ventilated PICU patients.
AHRQ-funded; HS025642.
Citation: Sick-Samuels AC, Linz M, Bergmann J .
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-1634..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Clinical Decision Support (CDS), Decision Making, Healthcare-Associated Infections (HAIs), Diagnostic Safety and Quality
McAlearney AS, Gaughan AA, DePuccio MJ
Management practices for leaders to promote infection prevention: lessons from a qualitative study.
This study looked at the management practices around prevention of catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSI) that hospital leaders can take to promote healthcare associated infection (HAI) prevention efforts. Interviews were conducted with 420 managers and frontline staff in 18 hospitals across the United States. The three management practices characterized as important facilitators of HAI prevention were 1) engagement of executive leadership; 2) information sharing; and 3) manager coaching.
AHRQ-funded; HS024958.
Citation: McAlearney AS, Gaughan AA, DePuccio MJ .
Management practices for leaders to promote infection prevention: lessons from a qualitative study.
Am J Infect Control 2021 May;49(5):536-41. doi: 10.1016/j.ajic.2020.09.001..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Prevention, Communication
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
Deshpande A, Richter SS, Haessler S
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
This study assessed antibiotic de-escalation practices across hospitals and their associations with outcomes in hospitalized patients diagnosed with pneumonia with negative cultures. The authors included 14,170 adults admitted with pneumonia in 2010-2015 to 164 US hospitals if they had negative blood and/or respiratory cultures and received both anti-MRSA and antipseudomonal agents other than quinolones. If empiric drugs were stopped on day 4 while continuing another antibiotic it was defined at de-escalation. Patients were propensity adjusted for de-escalation and compared on in-hospital 14-day mortality, late deterioration with ICU transfer, length-of-stay (LOS) and costs. Thirteen percent (1924 patients) had both initial empiric drugs stopped by hospital day 4. De-escalation rates at hospitals ranged from 2-35% and the established rate quartiles were not significantly associated with outcomes. Even at hospitals in the top quartile of de-escalation, the de-escalation rates were lower than 50%.
AHRQ-funded; HS025026; HS024277.
Citation: Deshpande A, Richter SS, Haessler S .
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
Clin Infect Dis 2021 Apr 26;72(8):1314-22. doi: 10.1093/cid/ciaa212..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Pneumonia, Respiratory Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Inpatient Care
Milstone AM, Rosenberg C, Yenokyan G
Alcohol-impregnated caps and ambulatory central-line-associated bloodstream infections (CLABSIs): a randomized clinical trial.
The purpose of this study was to evaluate the effect of 70% isopropyl alcohol-impregnated central venous catheter caps on ambulatory central-line-associated bloodstream infections (CLABSIs) in pediatric hematology-oncology patients. Findings showed that isopropyl alcohol-impregnated central-line caps did not lead to a statistically significant reduction in CLABSI rates in ambulatory hematology-oncology patients. In the per-protocol analysis, there was a statistically significant decrease in positive blood cultures.
AHRQ-funded; HS022870.
Citation: Milstone AM, Rosenberg C, Yenokyan G .
Alcohol-impregnated caps and ambulatory central-line-associated bloodstream infections (CLABSIs): a randomized clinical trial.
Infect Control Hosp Epidemiol 2021 Apr;42(4):431-39. doi: 10.1017/ice.2020.467..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Sepsis, Children/Adolescents, Prevention
O'Hara NN, Mullins CD, Slobogean GP
Association of postoperative infections after fractures with long-term income among adults.
This retrospective cohort study evaluated the association between postoperative infection in patients with surgically treated fractures and long-term income loss. Out of 11,673 adults who underwent surgery to treat fractures of the extremities or pelvis from 2003-2016, a total of 3.5% had a postoperative infection. These infections were associated with a $6080 annual decrease in household income in the 6 years after injury. There was a 6.6% increase in the risk of catastrophic wage loss within 2 years of the fracture and a 45% increase in the odds of receiving Social Security benefits. However, postoperative infections were not associated with an increase in the value of the Social Security benefits received.
AHRQ-funded; HS027218.
Citation: O'Hara NN, Mullins CD, Slobogean GP .
Association of postoperative infections after fractures with long-term income among adults.
JAMA Netw Open 2021 Apr;4(4):e216673. doi: 10.1001/jamanetworkopen.2021.6673..
Keywords: Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Adverse Events, Healthcare Costs
Lydecker AD, Osei PA, Pineles L
Targeted gown and glove use to prevent Staphylococcus aureus acquisition in community-based nursing homes: a pilot study.
This study tested the feasibility of targeted gown and glove use by healthcare personnel caring for high-risk nursing home residents to present Staphylococcus aureus transmission in short-stay residents. The study included 322 residents in 2 community-based Maryland nursing homes on mixed short- and long-stay units. During a 2-month baseline period, all residents had nose and inguinal fold swabs taken to estimate S. aureus presence. MRSA acquisition rate decreased from 11.9% during the baseline period to 3.6% during the intervention period among short-stay residents. MRSA acquisition rate also decreased from 9.1% during the baseline period to 3.6% during the intervention period for longer-term care residents. Resident-to-resident transmission rate also decreased from 5.9% during the baseline period to 0.8% during the intervention period.
AHRQ-funded; HS025451.
Citation: Lydecker AD, Osei PA, Pineles L .
Targeted gown and glove use to prevent Staphylococcus aureus acquisition in community-based nursing homes: a pilot study.
Infect Control Hosp Epidemiol 2021 Apr;42(4):448-54. doi: 10.1017/ice.2020.1219..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), 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