National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (16)
- Ambulatory Care and Surgery (1)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (3)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (2)
- Clostridium difficile Infections (1)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- (-) Healthcare-Associated Infections (HAIs) (23)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Hospital Discharge (1)
- Hospitals (5)
- Infectious Diseases (4)
- Injuries and Wounds (11)
- Medical Devices (2)
- Orthopedics (2)
- Outcomes (1)
- Patient Safety (12)
- Pneumonia (1)
- Prevention (4)
- Public Health (1)
- Quality Improvement (3)
- Quality Measures (1)
- Quality of Care (4)
- Registries (1)
- Risk (5)
- (-) Surgery (23)
- Transplantation (1)
- Urinary Tract Infection (UTI) (2)
- Women (2)
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 23 of 23 Research Studies DisplayedRinke 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
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
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
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
De Roo AC, Hendren S, Ameling JM
Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.
Researchers applied Michigan Appropriate Perioperative criteria to statewide registry data to identify improvement targets for urinary catheter use. They found that perioperative urinary catheter use was appropriate for most simple abdominal procedures, but duration of use varied in all categories.
AHRQ-funded; HS019767; HS024385; HS018334; HS000053.
Citation: De Roo AC, Hendren S, Ameling JM .
Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.
Am J Surg 2020 Sep;220(3):706-13. doi: 10.1016/j.amjsurg.2020.01.008..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Patient Safety, Surgery, Prevention, Adverse Events
Sheetz KH, Ryan A
Accuracy of quality measurement for the hospital acquired conditions reduction program.
Accuracy of quality measurement for the hospital acquired conditions reduction program.
AHRQ-funded; HS026244; HS000053.
Citation: Sheetz KH, Ryan A .
Accuracy of quality measurement for the hospital acquired conditions reduction program.
BMJ Qual Saf 2020 Jul;29(7):605-07. doi: 10.1136/bmjqs-2019-009747..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Quality Measures, Quality Improvement, Quality of Care, Surgery, Infectious Diseases
Ilieş I, Anderson DJ, Salem J
Large-scale empirical optimisation of statistical control charts to detect clinically relevant increases in surgical site infection rates.
Researchers sought to determine which statistical process control chart types and design parameters maximized the detection of clinically relevant surgical site infection (SSI) rate increases while minimizing false alarms. Statistically significant SSI rate increases (signals) at individual hospitals were identified using 50 different statistical process control chart variations; blinded epidemiologists evaluated the clinical significance of 2709 representative signals of potential outbreaks and rated them as requiring action or no action. The researchers concluded that an optimized combination of two moving average charts had the best performance for identifying clinically relevant small but sustained above-network SSI rates and large short-term individual hospital increases.
AHRQ-funded; HS023821.
Citation: Ilieş I, Anderson DJ, Salem J .
Large-scale empirical optimisation of statistical control charts to detect clinically relevant increases in surgical site infection rates.
BMJ Qual Saf 2020 Jun;29(6):472-81. doi: 10.1136/bmjqs-2018-008976..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Patient Safety
Baker AW, Nehls N, Ilies I
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
This study analyzed the use of optimized dual statistical process control (SPC) charts to predict surgical site infection (SSI) outbreaks. The researchers retrospectively applied an optimized pair of moving average (MA) SPC charts to all 30 SSI outbreaks previously identified and investigated from 2007 to 2015 in the Duke Infection Control Outreach Network (DICON), which is a network of more than 50 community hospitals. The dual MA SPC chart approach detected all 30 outbreaks at a median of 16 months prior to traditional surveillance detection.
AHRQ-funded; HS23821.
Citation: Baker AW, Nehls N, Ilies I .
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
BMJ Qual Saf 2020 Jun;29(6):517-20. doi: 10.1136/bmjqs-2019-010586..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Hospitals, Public Health, Infectious Diseases
Alfred M, Catchpole K, Huffer E
Work systems analysis of sterile processing: decontamination.
This study examined the work of sterile processing departments (SPDs) from a systems perspective. This paper reports the results of a work systems analysis that sought to identify the complex multilevel interdependencies that create performance variation and identify potential improvement interactions. The analysis was conducted at a 700-bed academic hospital with two reprocessing facilities decontaminating approximately 23,000 units each month. Mixed methods, including 56 hours of observations of work was done, as well as formal and informal interviews with relevant stakeholders and analysis of data collected about the system. The authors identified 21 different performance shaping factors, 30 potential failures, 16 types of process variance, and 10 outcome variances in decontamination. Approximately 2% of trays were returned to decontamination from assembly with 1% of surgical cases having decontamination problems.
AHRQ-funded; HS025538.
Citation: Alfred M, Catchpole K, Huffer E .
Work systems analysis of sterile processing: decontamination.
BMJ Qual Saf 2020 Apr;29(4):320-28. doi: 10.1136/bmjqs-2019-009422..
Keywords: Patient Safety, Quality Improvement, Quality of Care, Prevention, Surgery, Healthcare-Associated Infections (HAIs)
Lander DP, Durakovic N, Kallogjeri D
Incidence of infectious complications following cochlear implantation in children and adults.
The goal of this study was to determine the incidence and timing of infectious complications following cochlear implantation. Results showed low rates of infectious complications in cochlear implant recipients, and meningitis was exceedingly rare. Children aged 1 and 2 years experienced infectious complications more frequently than older children, with benefits of early implantation on language development outweighing the risk. Recommendations included increased vigilance by physicians when caring for young children early after implantation and children with prior implant infections.
AHRQ-funded; HS019455.
Citation: Lander DP, Durakovic N, Kallogjeri D .
Incidence of infectious complications following cochlear implantation in children and adults.
JAMA 2020 Jan 14;323(2):182-83. doi: 10.1001/jama.2019.18611..
Keywords: Children/Adolescents, Adverse Events, Surgery, Healthcare-Associated Infections (HAIs)
Chandanabhumma PP, Fetters MD, Pagani FD
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
This paper discusses an ongoing AHRQ-funded study to understand and address variation in health care-associated infections (HAIs) after durable ventricular assist device (VAD) implantation surgery. This procedure is used only on patients with advanced heart failure who have a poor 1-year estimated survival rate. This is a sequential mixed methods study which is conducting a systematic review of HAI prevention studies, and an in-depth quantitative analyses using administration claims, in-depth clinical data, and organizational surveys of VAD centers. The last aim is to develop and disseminate a best practices toolkit for HAI prevention. Data analysis is currently underway.
AHRQ-funded; HS026003.
Citation: Chandanabhumma PP, Fetters MD, Pagani FD .
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
JMIR Res Protoc 2020 Jan 7;9(1):e14701. doi: 10.2196/14701..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Medical Devices, Prevention, Heart Disease and Health, Cardiovascular Conditions, Adverse Events
Song J, Tark A, Larson EL
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Pocket hematoma is a common adverse event following the insertion of cardiovascular implantable electronic devices (CIEDs), but the risk of wound infections associated with a pocket hematoma is unclear. The objective of this integrative review was to examine the relationship between pocket hematoma and risk of wound infection in a CIED population.
AHRQ-funded; HS024915.
Citation: Song J, Tark A, Larson EL .
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Heart Lung 2020 Jan-Feb;49(1):92-98. doi: 10.1016/j.hrtlng.2019.09.009..
Keywords: Medical Devices, Cardiovascular Conditions, Surgery, Adverse Events, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk
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
Likosky DS, Wallace AS, Prager RL
Sources of variation in hospital-level infection rates after coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons Adult Heart Surgery Database.
This descriptive study characterized the hospital-level variability in healthcare-acquired infection (HAI) rates across hospitals participating in The Society of Thoracic Surgeons Adult Cardiac Surgery Database. It found substantial hospital-level variation exists in postoperative HAIs among patients undergoing coronary artery bypass graft surgery, driven predominantly by pneumonia.
AHRQ-funded; HS022535; HS022909.
Citation: Likosky DS, Wallace AS, Prager RL .
Sources of variation in hospital-level infection rates after coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons Adult Heart Surgery Database.
Ann Thorac Surg 2015 Nov;100(5):1570-5; discussion 75-6. doi: 10.1016/j.athoracsur.2015.05.015.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Injuries and Wounds, Registries
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
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
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
Lewis SS, Dicks KV, Chen LF
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
The researchers compared time to diagnosis of invasive surgical site infection (SSI) following hip vs knee arthroplasty. They found that time to diagnosis of invasive SSI remained significantly shorter for hip than for knee arthroplasties after adjusting for age, pathogen virulence, and hospital surgical volume. They hypothesized that differences in symptom manifestation and disparities in access to care may contribute to the observed differential timing of diagnosis.
AHRQ-funded; HS023866.
Citation: Lewis SS, Dicks KV, Chen LF .
Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
Clin Infect Dis 2015 Apr 1;60(7):990-6. doi: 10.1093/cid/ciu975.
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Keywords: Diagnostic Safety and Quality, Healthcare-Associated Infections (HAIs), Orthopedics, Surgery, Injuries and Wounds, Adverse Events
Harris AD, Fleming B, Bromberg JS
Surgical site infection after renal transplantation.
The researchers sought to identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantation. They found that BMI was a risk factor for the development of SSI following renal transplantation. Somewhat surprisingly, they did not find other biologically plausible or transplant-specific risk factors such as presence of comorbid conditions or receipt of appropriate (type and dose) antibiotic prophylaxis.
AHRQ-funded; HS022291.
Citation: Harris AD, Fleming B, Bromberg JS .
Surgical site infection after renal transplantation.
Infect Control Hosp Epidemiol 2015 Apr;36(4):417-23. doi: 10.1017/ice.2014.77..
Keywords: Transplantation, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk, Adverse Events
Olsen MA, Nickel KB, Wallace AE
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
The researchers investigated whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. After analyzing a total of 119,973 hernia repair procedures, they found that the incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction necrosis.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Wallace AE .
Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.
Infect Control Hosp Epidemiol 2015 Mar;36(3):329-35. doi: 10.1017/ice.2014.44..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Risk, Patient Safety
Olsen MA, Nickel KB, Margenthaler JA
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
The aim of this study was to determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. It found that the risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Margenthaler JA .
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
Ann Surg Oncol 2015;22(6):2003-9. doi: 10.1245/s10434-014-4200-x..
Keywords: Surgery, Risk, Cancer: Breast Cancer, Cancer, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Women
Abdelsattar ZM, Krapohl G, Alrahmani L
Postoperative burden of hospital-acquired Clostridium difficile infection.
The researchers studied clostridium dificile infection (CDI) across diverse surgical settings. They found that incidence of postoperative CDI varied by surgical procedure and was associated with higher rates of extended length of stay, emergency room presentations, and readmissions, placing a potentially preventable burden on hospital resources.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Krapohl G, Alrahmani L .
Postoperative burden of hospital-acquired Clostridium difficile infection.
Infect Control Hosp Epidemiol 2015 Jan;36(1):40-6. doi: 10.1017/ice.2014.8.
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Keywords: Surgery, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Adverse Events, Hospitals
Letourneau AR, Calderwood MS, Huang SS
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
The researchers conducted retrospective cohort studies at 2 academic medical centers, extending analyses of patients undergoing hysterectomy or colorectal surgery. They concluded that claims-enhanced surveillance can help to identify surgical site infections (SSIs) missed by routine surveillance, identifying nearly twice as many SSIs following hysterectomy and 4 times more SSIs following colorectal surgery.
AHRQ-funded; HS021424.
Citation: Letourneau AR, Calderwood MS, Huang SS .
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
Infect Control Hosp Epidemiol 2013 Dec;34(12):1321-3. doi: 10.1086/673975..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Patient Safety, Adverse Events, Women, Digestive Disease and Health