National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (17)
- Ambulatory Care and Surgery (4)
- Antibiotics (4)
- Antimicrobial Stewardship (1)
- Blood Clots (1)
- Cardiovascular Conditions (4)
- Catheter-Associated Urinary Tract Infection (CAUTI) (15)
- Central Line-Associated Bloodstream Infections (CLABSI) (18)
- Children/Adolescents (9)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (12)
- Communication (2)
- Community-Acquired Infections (2)
- Comparative Effectiveness (3)
- Comprehensive Unit-based Safety Program (CUSP) (3)
- Critical Care (5)
- Data (1)
- Digestive Disease and Health (1)
- Disparities (2)
- Elderly (5)
- Electronic Health Records (EHRs) (3)
- Evidence-Based Practice (7)
- Guidelines (4)
- (-) Healthcare-Associated Infections (HAIs) (105)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (4)
- Health Information Technology (HIT) (3)
- Heart Disease and Health (1)
- Home Healthcare (3)
- Hospital Discharge (2)
- Hospitalization (2)
- Hospital Readmissions (1)
- Hospitals (20)
- Infectious Diseases (21)
- Injuries and Wounds (7)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (10)
- Long-Term Care (5)
- Medical Devices (3)
- Medicare (4)
- Medication (5)
- Medication: Safety (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (11)
- Mortality (1)
- Newborns/Infants (1)
- Nursing (1)
- Nursing Homes (6)
- Orthopedics (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (5)
- Patient Safety (58)
- Patient Self-Management (1)
- Pneumonia (5)
- Practice Patterns (3)
- Pressure Ulcers (1)
- Prevention (29)
- Provider: Health Personnel (1)
- Provider Performance (1)
- Public Health (3)
- Quality Improvement (8)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (24)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Risk (10)
- Sepsis (2)
- Shared Decision Making (1)
- Surgery (24)
- Teams (3)
- Telehealth (1)
- Treatments (1)
- Urinary Tract Infection (UTI) (14)
- 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 105 Research Studies DisplayedMiller LG, McKinnell JA, Singh RD
Decolonization in nursing homes to prevent infection and hospitalization.
Researchers conducted a cluster-randomized trial of universal decolonization as compared with routine-care bathing in nursing homes. Data were obtained from 28 nursing homes. The results indicated that universal decolonization with chlorhexidine and nasal iodophor led to a significantly lower risk of transfer to a hospital due to infection than routine care.
AHRQ-funded; HS024286.
Citation: Miller LG, McKinnell JA, Singh RD .
Decolonization in nursing homes to prevent infection and hospitalization.
N Engl J Med 2023 Nov 9; 389(19):1766-77. doi: 10.1056/NEJMoa2215254..
Keywords: Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs)
Keller SC, Hannum SM, Weems K
Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition.
Researchers tested the validity of a home-infusion central-line-associated bloodstream infection (CLABSI) surveillance definition and the feasibility and acceptability of its implementation. Their study was conducted in large home-infusion agencies in a CLABSI prevention collaborative in 14 states and the District of Columbia and included semistructured interviews with staff performing home-infusion CLABSI surveillance. The results showed that the home-infusion CLABSI surveillance definition was valid and would be feasible to implement.
AHRQ-funded; HS027819.
Citation: Keller SC, Hannum SM, Weems K .
Implementing and validating a home-infusion central-line-associated bloodstream infection surveillance definition.
Infect Control Hosp Epidemiol 2023 Nov; 44(11):1748-59. doi: 10.1017/ice.2023.70..
Keywords: Home Healthcare, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Thom KA, Rock C, Robinson GL
Direct gloving vs hand hygiene before donning gloves in adherence to hospital infection control practices: a cluster randomized clinical trial.
The purpose of this study was to assess the effectiveness of a direct-gloving policy on adherence to infection prevention control practices in a hospital setting. In this study, hospital units were randomly assigned to either the intervention (hand hygiene not required before putting on gloves) or to usual care (hand hygiene required prior to before putting on nonsterile gloves). The primary study outcome was adherence to the expected practice upon room entry and room exit. Thirteen hospital units participated in the trial, and 3,790 health care personnel (HCP) were observed. The study found that adherence to expected practice was higher in the 6 units with the direct-gloving intervention than in the 7 usual care units even when controlling for baseline hand hygiene rates, unit type, and universal gloving policies. The intervention had no effect on hand hygiene adherence measured at entry to non-contact precautions rooms or at room exit. The intervention was related with increased total bacteria colony counts and increased detection of pathogenic bacteria on gloves in the ED and reduced colony counts in pediatrics units, with no change in either total colony count for adult intensive care unit or presence of pathogenic bacteria for adult intensive care unit.
AHRQ-funded; HS024108.
Citation: Thom KA, Rock C, Robinson GL .
Direct gloving vs hand hygiene before donning gloves in adherence to hospital infection control practices: a cluster randomized clinical trial.
JAMA Netw Open 2023 Oct 2; 6(10):e2336758. doi: 10.1001/jamanetworkopen.2023.36758..
Keywords: Hospitals, Patient Safety, Guidelines, Healthcare-Associated Infections (HAIs)
Ojala F, Sater MRA, Miller LG
Bayesian modeling of the impact of antibiotic resistance on the efficiency of MRSA decolonization.
The authors analyzed how the persistence of methicillin-resistant Staphylococcus aureus (MRSA) colonization correlates with the genomic presence of antibiotic resistance genes. Using a Bayesian mixed effects survival model, they found that genetic determinants of high-level resistance to mupirocin was strongly associated with failure of the decolonization protocol, but they did not find a similar effect with genetic resistance to chlorhexidine or other antibiotics. They concluded that these results highlight the need to consider the properties of the colonizing MRSA strain when deciding which treatments to include in the decolonization protocol.
AHRQ-funded; HS019388.
Citation: Ojala F, Sater MRA, Miller LG .
Bayesian modeling of the impact of antibiotic resistance on the efficiency of MRSA decolonization.
PLoS Comput Biol 2023 Oct; 19(10):e1010898. doi: 10.1371/journal.pcbi.1010898..
Keywords: Antibiotics, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication
Metersky ML, Wang Y, Klompas M
Temporal trends in postoperative and ventilator-associated pneumonia in the United States.
The purpose of this retrospective cohort study was to assess change in rates of postoperative pneumonia and ventilator-associated pneumonia among patients hospitalized in the United States during 2009-2019. The study found that among 58,618 patients undergoing major surgical procedures between 2009 and 2019, the observed rate of postoperative pneumonia from 2009-2011 was 1.9% and decreased to 1.3% during 2017-2019. The adjusted annual risk each year, compared to the prior year, was 0.94. Among 4,007 patients hospitalized for any of the 4 conditions at risk for ventilator-associated pneumonia during 2009-2019, the researchers did not detect a significant change in observed or adjusted rates. Observed rates clustered around 10%, and adjusted annual risk compared to the prior year was 0.99.
AHRQ-funded; 290201800005C.
Citation: Metersky ML, Wang Y, Klompas M .
Temporal trends in postoperative and ventilator-associated pneumonia in the United States.
Infect Control Hosp Epidemiol 2023 Aug; 44(8):1247-54. doi: 10.1017/ice.2022.264..
Keywords: Pneumonia, Respiratory Conditions, Healthcare-Associated Infections (HAIs), Healthcare Cost and Utilization Project (HCUP)
Kamineni M, Ötleş Meng E, Oh J
Prospective evaluation of data-driven models to predict daily risk of Clostridioides difficile infection at 2 large academic health centers.
The purpose of this prospective study was to assess a data-driven approach for Clostridioides difficile infection (CDI) risk prediction that had previously demonstrated a high performance in retrospective evaluations at 2 large academic health centers. The final retrospective cohort included 18,030 admissions (138 CDI cases) at Massachusetts General Hospital (MGH) and 25,341admissions (158 CDI cases) at Michigan Medicine. The prospective cohort included 13,712 admissions (119 CDI cases) at MGH and 26,864 admissions (190 CDI cases) at MM. At MGH, the model achieved area under the receiver operator characteristic curve (AUROC). AUROCs of 0.744 in the retrospective cohort and 0.748 in the prospective cohort. At MM, the model achieved AUROCs of 0.778 in the retrospective cohort and 0.767 in the prospective cohort. The AUROCs for predicting CDI risk on both retrospective and prospective cohorts were similar each month and did not exhibit significant monthly variation throughout either assessment period.
AHRQ-funded; HS027431.
Citation: Kamineni M, Ötleş Meng E, Oh J .
Prospective evaluation of data-driven models to predict daily risk of Clostridioides difficile infection at 2 large academic health centers.
Infect Control Hosp Epidemiol 2023 Jul; 44(7):1163-66. doi: 10.1017/ice.2022.218..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Risk
MacEwan SR, Gaughan AA, Beal EW
Concerns and frustrations about the public reporting of device-related healthcare-associated infections: perspectives of hospital leaders and staff.
The purpose of this study was to explore the specific concerns of hospital leaders and staff regarding the identification and public reporting of healthcare-associated infections (HAIs). Between 2017 and 2019 the researchers conducted interviews with 471 participants including hospitals leaders and hospital staff across 18 United States hospitals. The study found that interviewees discussed concerns about public reporting of HAI data, including a lack of trust in the data and unintended consequences of its public reporting, as well as particular frustrations with the identification and accountability for publicly-reported HAIs.
AHRQ-funded; HS024958.
Citation: MacEwan SR, Gaughan AA, Beal EW .
Concerns and frustrations about the public reporting of device-related healthcare-associated infections: perspectives of hospital leaders and staff.
Am J Infect Control 2023 Jun; 51(6):633-37. doi: 10.1016/j.ajic.2022.08.003..
Keywords: Medical Devices, Healthcare-Associated Infections (HAIs), Hospitals, Provider: Health Personnel
Ye S, Li D, Yu T
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Researchers investigated the effect of surgical volume on the accuracy of identifying poorly performing hospitals. Their research was based on the standardized infection ratio, and they applied their proposed method to data from HCA Healthcare from 2014-2016 on surgical site infections in colon surgery patients. They concluded that minimum surgical volumes and predicted events criteria are required to make hospital evaluation reliable, and that these criteria may vary by overall prevalence and between-hospital variability.
AHRQ-funded; HS027791.
Citation: Ye S, Li D, Yu T .
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Sci Rep 2023 May 10; 13(1):7624. doi: 10.1038/s41598-023-33937-y..
Keywords: Hospitals, Surgery, Healthcare-Associated Infections (HAIs), Provider Performance, Quality of Care
Oladapo-Shittu O, Hannum SM, Salinas AB
The need to expand the infection prevention workforce in home infusion therapy.
This study looked at the prevalence of formal surveillance and infection prevention training for home infusion staff. The authors interviewed home infusion staff who perform surveillance activities about barriers to and facilitators for central line-associated bloodstream infection (CLABSI) surveillance and identified barriers to training in CLABSI surveillance. Their findings showed a lack of formal surveillance training which can be addressed by by adapting existing training resources to the home infusion setting.
AHRQ-funded; HS027819.
Citation: Oladapo-Shittu O, Hannum SM, Salinas AB .
The need to expand the infection prevention workforce in home infusion therapy.
Am J Infect Control 2023 May; 51(5):594-96. doi: 10.1016/j.ajic.2022.11.008.AHRQ-funded; HS027819..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Home Healthcare, Central Line-Associated Bloodstream Infections (CLABSI)
Sanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z .
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
Morgan DJ, Dubberke ER, Hink T
The impact of universal glove and gown use on Clostridioides difficile acquisition: a cluster-randomized trial.
This article described a secondary analysis of a cluster-randomized trial in medical and surgical intensive care units (ICUs) in 20 US hospitals to assess whether universal gown and glove use decreases Clostridioides difficile infection. ICUs were randomized to standard practice for glove and gown use versus all healthcare workers required to wear gloves and gowns for all patient contact or when entering a patient room. The results showed no significant difference in the rate of toxigenic C. difficile with universal gown and glove use.
AHRQ-funded; HS025456.
Citation: Morgan DJ, Dubberke ER, Hink T .
The impact of universal glove and gown use on Clostridioides difficile acquisition: a cluster-randomized trial.
Clin Infect Dis 2023 Feb 8; 76(3):e1202-e07. doi: 10.1093/cid/ciac519..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Prevention
Gregory ME, MacEwan SR, Sova LN
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
The objective of this study was to investigate the role of interprofessional teamwork in the prevention of health care-associated infections (HAIs), focusing on central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) prevention. The authors interviewed participating physicians, nurses, and other staff from 18 hospitals about interprofessional collaboration, and proposed an Input-Mediator-Output-Input (IMOI) model as well as strategies to support teamwork for the prevention of HAIs.
AHRQ-funded; HS024958.
Citation: Gregory ME, MacEwan SR, Sova LN .
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
Med Care Res Rev 2023 Feb;80(1):30-42. doi: 10.1177/10775587221103973..
Keywords: Teams, Prevention, Healthcare-Associated Infections (HAIs)
McNeil JC, Sommer LM, Vallejo JG
Going back in time: Increasing penicillin susceptibility among methicillin-susceptible staphylococcus aureus osteoarticular infections in children.
Researchers investigated the prevalence of penicillin susceptibility (PSSA) among pediatric methicillin susceptible S. aureus (MSSA) acute hematogenous osteoarticular infection (OAI) isolates; the isolates were obtained through surveillance studies at Texas Children's and St. Louis Children's Hospitals. Overall, PSSA isolates were found to be associated with a similar clinical presentation as penicillin-resistant isolates. The researchers concluded that potential for use of penicillin treatment in PSSA OAI merits further study.
AHRQ-funded; HS026896'HS021736' HS024269.
Citation: McNeil JC, Sommer LM, Vallejo JG .
Going back in time: Increasing penicillin susceptibility among methicillin-susceptible staphylococcus aureus osteoarticular infections in children.
Antimicrob Agents Chemother 2023 Jan 24; 67(1):e0119622. doi: 10.1128/aac.01196-22..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication, Prevention
Goto M, Hasegawa S, Balkenende EC
Effectiveness of ultraviolet-c disinfection on hospital-onset gram-negative rod bloodstream infection: a nationwide stepped-wedge time-series analysis.
This study evaluated the effectiveness of enhanced terminal room cleaning with ultraviolet C (UV-C) disinfection in reducing gram-negative rod (GNR) infections. The authors used information regarding UV-C use and the timing of implementation through a survey of all Veterans Health Administration (VHA) hospitals providing inpatient acute care from January 2010 and December 2018. Among 128 Veterans Health Administration hospitals, 120 provided complete survey responses with 40 reporting implementations of UV-C systems. UV-C use was associated with a 19% lower incident of hospital-onset (HO) GNR bloodstream infection (BSI).
AHRQ-funded; HS027472.
Citation: Goto M, Hasegawa S, Balkenende EC .
Effectiveness of ultraviolet-c disinfection on hospital-onset gram-negative rod bloodstream infection: a nationwide stepped-wedge time-series analysis.
Clin Infect Dis 2023 Jan 13; 76(2):291-98. doi: 10.1093/cid/ciac776..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Prevention, Sepsis
Patel P, Deshpande A, Yu PC
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
The purpose of this study was to explore the relationships between the antibiotic regimens of empiric therapy with a respiratory fluoroquinolone or cephalosporin plus macrolide combination and the development of hospital-onset Clostridioides difficile infection (CDI). The researchers used data from 638 United States hospitals and included adults admitted with pneumonia and discharged from July 2010 through June 2015 with a pneumonia diagnosis code who received 3 or more days of either antibiotic regimen. The study sample included 58,060 patients treated with either cephalosporin plus macrolide (36,796 patients) or a fluoroquinolone alone (21,264 patients). 0.35% of patients who received cephalosporin plus macrolide and 0.31% who received a fluoroquinolone developed CDI, making CDI risks similar for fluoroquinolones versus cephalosporin plus macrolide.
AHRQ-funded; HS024277.
Citation: Patel P, Deshpande A, Yu PC .
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
Infect Control Hosp Epidemiol 2023 Jan; 44(1):47-54. doi: 10.1017/ice.2022.60..
Keywords: Pneumonia, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Infectious Diseases, Community-Acquired Infections
Kim JJ, Johnson JK, Stucke EM
Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves.
Transmission of Staphylococcus aureus (S. aureus) to health care workers (HCWs) on gowns and gloves has been an issue in nursing homes. This study evaluated the effect of the burden in 13 community-based nursing homes in Maryland and Michigan. Residents were cultured for S. aureus at the perianal skin and the anterior nares areas. A total of 403 residents were enrolled, with 169 colonized with methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA). Transmission to HCW gowns and gloves was greater from those colonized with greater quantities of S. aureus on the perianal skin. These findings inform future infection control practices for both MRSA and MSSA in nursing homes.
AHRQ-funded; HS019979; HS025451.
Citation: Kim JJ, Johnson JK, Stucke EM .
Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves.
Infect Control Hosp Epidemiol 2020 Dec;41(12):1396-401. doi: 10.1017/ice.2020.336..
Keywords: Elderly, Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs), Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention
Hsu 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)
McKinnell JA, Miller LG, Singh RD
High prevalence of multidrug-resistant organism colonization in 28 nursing homes: an "iceberg effect."
The objective of this study was to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), extended-spectrum beta-lactamase producing organisms (ESBLs), and carbapenem-resistant Enterobacteriaceae (CRE) among residents and in the environment of nursing homes (NHs). The investigators concluded that in more than half of the NHs, more than 50% of residents were colonized with MDROs of clinical and public health significance, most commonly MRSA and ESBL. Additionally, the vast majority of resident rooms and common areas were MDRO contaminated.
AHRQ-funded; HS024286.
Citation: McKinnell JA, Miller LG, Singh RD .
High prevalence of multidrug-resistant organism colonization in 28 nursing homes: an "iceberg effect."
J Am Med Dir Assoc 2020 Dec;21(12):1937-43.e2. doi: 10.1016/j.jamda.2020.04.007..
Keywords: Nursing Homes, Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs)
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
Reeder B, Makic MBF, Morrow C
AHRQ Author: Rodrick D
Design and evaluation of low-fidelity visual display prototypes for multiple hospital-acquired conditions.
Hospital-acquired conditions such as catheter-associated urinary tract infection, stage 3 or 4 hospital-acquired pressure injury, and falls with injury are common, costly, and largely preventable. This study used participatory design methods to design and evaluate low-fidelity prototypes of clinical dashboards to inform high-fidelity prototype designs to visualize integrated risks based on patient profiles.
AHRQ-authored; AHRQ-funded; 233201500025I; 23337003T.
Citation: Reeder B, Makic MBF, Morrow C .
Design and evaluation of low-fidelity visual display prototypes for multiple hospital-acquired conditions.
Comput Inform Nurs 2020 Nov;38(11):562-71. doi: 10.1097/cin.0000000000000668..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Risk, Hospitals, Prevention
Thate JA, Couture B, Schnock KO
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
It is clear that interdisciplinary communication and collaboration have the potential to mitigate healthcare-associated harm, yet there is limited research on how communication through documentation in the patient record can support collaborative decision making. Understanding what information is needed to support collaborative decision making is necessary to design electronic health information systems that facilitate effective communication and, ultimately, safe care. To explore this issue, the investigators focused on information needs related to central venous catheter management and the prevention of central line-associated blood stream infections.
AHRQ-funded; HS0235335.
Citation: Thate JA, Couture B, Schnock KO .
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
Comput Inform Nurs 2020 Nov 2;39(4):208-14. doi: 10.1097/cin.0000000000000683..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Shared Decision Making, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Anderson DJ, Ilieş I, Foy K
Early recognition and response to increases in surgical site infections using optimized statistical process control charts-the Early 2RIS Trial: a multicenter cluster randomized controlled trial with stepped wedge design.
This paper discusses the study protocol that was used to conduct the Early 2RIS Trial, which was a multicenter cluster randomized controlled trial from 2016 to 2020 to reduce surgical site infection (SSI) rates. The trial was performed in 29 hospitals in the Duke Infection Control Outreach Network (DICON) and 105 clusters over 4 years. All patients who underwent one of 13 targeted procedures at study hospitals were included. Six clusters were identified: cardiac, orthopedic, gastrointestinal, OB-GYN, vascular, and spinal. Clusters were randomized to intervention, and also underwent surveillance and feedback using optimized SPC charts. Surveillance data feedback was provided to all clusters, regardless of allocation or type of surveillance. The goal was to lower SSI through SPC intervention compared to traditional surveillance and feedback alone.
AHRQ-funded; HS023821.
Citation: Anderson DJ, Ilieş I, Foy K .
Early recognition and response to increases in surgical site infections using optimized statistical process control charts-the Early 2RIS Trial: a multicenter cluster randomized controlled trial with stepped wedge design.
Trials 2020 Oct 28;21(1):894. doi: 10.1186/s13063-020-04802-4..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety
Vaughn VM, O'Malley M, Flanders SA
Association of infectious disease physician approval of peripherally inserted central catheter with appropriateness and complications.
The purpose of this study was to evaluate whether infectious disease physician approval prior to PICC placement for intravenous antimicrobials was associated with more appropriate device use and fewer complications. The authors concluded that this cohort study suggested that, when PICCs were placed for intravenous antimicrobial therapy, infectious disease physician approval of PICC insertion was associated with more appropriate device use and fewer complications.
AHRQ-funded; HS026530; HS025891.
Citation: Vaughn VM, O'Malley M, Flanders SA .
Association of infectious disease physician approval of peripherally inserted central catheter with appropriateness and complications.
JAMA Netw Open 2020 Oct;3(10):e2017659. doi: 10.1001/jamanetworkopen.2020.17659..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases, Adverse Events
Bucher BT, Shi J, Ferraro JP
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
The authors presented the development and validation of a portable natural language processing (NLP) approach for automated surveillance of surgical site infections (SSIs). Patient clinical text notes from EHRs following surgical procedures from two independent healthcare systems were abstracted. The authors found that automated surveillance of SSIs can be achieved using NLP of clinical notes with high sensitivity and specificity.
AHRQ-funded; HS025776.
Citation: Bucher BT, Shi J, Ferraro JP .
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
Ann Surg 2020 Oct;272(4):629-36. doi: 10.1097/sla.0000000000004133..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Gall E, Long A, Hall KK
Chlorhexidine bathing strategies for multidrug-resistant organisms: a summary of recent evidence.
This systematic literature review investigated the latest evidence for patient bathing with a 2%-4% chlorhexidine gluconate solution to reduce multidrug-resistant organism (MDRO) transmission and infection. Three databases were searched for articles from 2008 through 2018, as well as any key articles published after 2018. Findings focused on health care-associated infections (HAIs) and 3 categories of MDROs: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and carbapenem-resistant Enterobacteriaceae (CRE). Chlorhexidine reduced MRSA acquisition and carriage, but no studies found significant reductions in infections. Several studies found that chlorhexidine bathing reduced VRE acquisition and carriage. Two very large studies found bathing significantly reduced HAIs, but these reductions may be smaller when HAIs are already controlled with other anti-infection measures.
AHRQ-funded; HHSP233201500013I.
Citation: Gall E, Long A, Hall KK .
Chlorhexidine bathing strategies for multidrug-resistant organisms: a summary of recent evidence.
J Patient Saf 2020 Sep;16(3S Suppl 1):S16-s22. doi: 10.1097/pts.0000000000000743..
Keywords: Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety, Infectious Diseases