National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- (-) Central Line-Associated Bloodstream Infections (CLABSI) (18)
- Children/Adolescents (2)
- Communication (1)
- Comprehensive Unit-based Safety Program (CUSP) (2)
- Critical Care (1)
- Data (1)
- Decision Making (1)
- Disparities (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (15)
- Healthcare Costs (1)
- Hospitals (4)
- Intensive Care Unit (ICU) (3)
- Medical Errors (1)
- Medicare (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Nursing (1)
- Outcomes (1)
- Patient Safety (11)
- Payment (1)
- Prevention (4)
- Provider Performance (2)
- Quality Improvement (2)
- Quality Measures (1)
- Quality of Care (6)
- Risk (2)
- Sepsis (1)
- Social Media (1)
- Surgery (1)
- Urinary Tract Infection (UTI) (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 18 of 18 Research Studies DisplayedHerc E, Patel P, Washer LL
A model to predict central-line-associated bloodstream infection among patients with peripherally inserted central catheters: the MPC Score.
Peripherally inserted central catheters (PICCs) are associated with central-line-associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed. The purpose of this study is to operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate an individual's risk of PICC-CLABSI prior to device placement.
AHRQ-funded; HS022835.
Citation: Herc E, Patel P, Washer LL .
A model to predict central-line-associated bloodstream infection among patients with peripherally inserted central catheters: the MPC Score.
Infect Control Hosp Epidemiol 2017 Oct;38(10):1155-66. doi: 10.1017/ice.2017.167..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Decision Making, Healthcare-Associated Infections (HAIs), Patient Safety
Jackson SS, Leekha S, Magder LS
The effect of adding comorbidities to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology.
The authors of this study hypothesized that risk adjustment would be improved by including patient demographics and comorbidities from electronically available hospital discharge codes to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology. They concluded that their risk-adjustment model for CLABSI using electronically available comorbidities demonstrated better discrimination than did the CDC model.
AHRQ-funded; HS022291.
Citation: Jackson SS, Leekha S, Magder LS .
The effect of adding comorbidities to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1019-24. doi: 10.1017/ice.2017.129..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Risk
Smith SN, Reichert HA, Ameling JM
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Voluntary Leapfrog Safe Practices Score (SPS) measures were among the first public reports of hospital performance. Recently, Medicare's Hospital Compare website has reported compulsory measures. Leapfrog's Hospital Safety Score (HSS) grades incorporate SPS and Medicare measures. The researchers evaluated associations between Leapfrog SPS and Medicare measures. They found that voluntary Leapfrog SPS measures skew toward positive self-report and bear little association with compulsory Medicare outcomes and penalties.
AHRQ-funded; HS019767; HS024385; HS018334.
Citation: Smith SN, Reichert HA, Ameling JM .
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Med Care 2017 Jun;55(6):606-14. doi: 10.1097/mlr.0000000000000716.
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Keywords: Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Provider Performance
Harris AD, Pineles L, Anderson D
Which comorbid conditions should we be analyzing as risk factors for healthcare-associated infections?
This study sought to determine which comorbid conditions are considered causally related to central-line associated bloodstream infection (CLABSI) and surgical-site infection (SSI) based on expert consensus. Its results have produced a list of comorbid conditions that should be analyzed as risk factors for and further explored for risk adjustment of CLABSI and SSI.
AHRQ-funded; HS022291.
Citation: Harris AD, Pineles L, Anderson D .
Which comorbid conditions should we be analyzing as risk factors for healthcare-associated infections?
Infect Control Hosp Epidemiol 2017 Apr;38(4):449-54. doi: 10.1017/ice.2016.314.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Risk, Surgery
Meddings J, Reichert H, Greene MT
Evaluation of the association between Hospital Survey on Patient Safety Culture (HSOPS) measures and catheter-associated infections: results of two national collaboratives.
This study examined the association between hospital units' results for the Hospital Survey on Patient Safety Culture (HSOPS) and catheter-associated infection rates. It found no association between results of the HSOPS and catheter-associated infection rates when measured at baseline and postintervention in two successful large national collaboratives focused on prevention of central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI).
AHRQ-funded; 290201000025I; 29032001T; HS019767.
Citation: Meddings J, Reichert H, Greene MT .
Evaluation of the association between Hospital Survey on Patient Safety Culture (HSOPS) measures and catheter-associated infections: results of two national collaboratives.
BMJ Qual Saf 2017 Mar;26(3):226-35. doi: 10.1136/bmjqs-2015-005012.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Prevention
Govindan S, Chopra V, Iwashyna TJ
Do clinicians understand quality metric data? An evaluation in a Twitter-derived sample.
The researchers assessed clinician comprehension of central line-associated blood stream infection (CLABSI) quality metric data. It found that the mean percentage of correct answers was 61 percent. Overall, doctor performance was better than performance by nurses and other respondents. In basic numeracy, mean percent correct was 82 percent. For risk-adjustment numeracy, the mean percent correct was 70 percent.
AHRQ-funded; HS022835.
Citation: Govindan S, Chopra V, Iwashyna TJ .
Do clinicians understand quality metric data? An evaluation in a Twitter-derived sample.
J Hosp Med 2017 Jan;12(1):18-22.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Data, Quality of Care, Provider Performance, Social Media
Nuckols TK, Keeler E, Morton SC
Economic evaluation of quality improvement interventions for bloodstream infections related to central catheters: a systematic review.
The authors systematically reviewed economic evaluations of QI interventions designed to prevent central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI) in acute care hospitals. They concluded that interventions related to central venous catheters were, on average, associated with 57% fewer bloodstream infections and substantial savings to hospitals. Larger initial investments may be associated with greater savings.
AHRQ-funded.
Citation: Nuckols TK, Keeler E, Morton SC .
Economic evaluation of quality improvement interventions for bloodstream infections related to central catheters: a systematic review.
JAMA Intern Med 2016 Dec;176(12):1843-54. doi: 10.1001/jamainternmed.2016.6610.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Healthcare Costs, Quality Improvement
Mimoz O, Chopra V, Widmer A
What's new in skin antisepsis for short-term intravascular catheters: new data to address old problems?
Catheter-related infections remain a leading cause of healthcare-associated infections (HAI) in ICUs and the most preventable HAI. The authors discussed skin antiseptic solutions and included a table of practical recommendations for skin antisepsis before insertion of a short-term vascular catheter.
AHRQ-funded; HS022835.
Citation: Mimoz O, Chopra V, Widmer A .
What's new in skin antisepsis for short-term intravascular catheters: new data to address old problems?
Intensive Care Med 2016 Dec;42(12):2043-45. doi: 10.1007/s00134-016-4490-5.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
McAlearney AS, Hefner JL
Getting to zero: goal commitment to reduce blood stream infections.
The researchers examined goal-setting as a factor contributing to program outcomes in eight hospitals focused on preventing central line-associated bloodstream infections (CLABSIs). They conducted qualitative case studies to compare higher- and lower-performing hospitals, and explored differences in contextual factors that might contribute to performance variation. Finally, they present a goal commitment framework that characterizes factors associated with successful CLABSI program outcomes.
AHRQ-funded; 290200600022.
Citation: McAlearney AS, Hefner JL .
Getting to zero: goal commitment to reduce blood stream infections.
Med Care Res Rev 2016 Aug;73(4):458-77. doi: 10.1177/1077558715616028.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Outcomes, Patient Safety, Prevention
Dicks KV, Lofgren E, Lewis SS
A multicenter pragmatic interrupted time series analysis of chlorhexidine gluconate bathing in community hospital intensive care units.
This study sought to determine whether daily chlorhexidine gluconate (CHG) bathing of intensive care unit (ICU) patients leads to a decrease in hospital-acquired infections (HAIs), particularly infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). It concluded that hospitals that implemented CHG bathing attained a decrease in ICU central-line-associated bloodstream infections (CLABSIs), ICU primary BSIs, and VRE central-line-associated bloodstream infections.
AHRQ-funded; HS023866.
Citation: Dicks KV, Lofgren E, Lewis SS .
A multicenter pragmatic interrupted time series analysis of chlorhexidine gluconate bathing in community hospital intensive care units.
Infect Control Hosp Epidemiol 2016 Jul;37(7):791-7. doi: 10.1017/ice.2016.23.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety, Healthcare-Associated Infections (HAIs)
Pronovost PJ, Cleeman JI, Wright D
AHRQ Author: Cleeman JI
Fifteen years after to Err is Human: a success story to learn from.
This paper provides a historical profile of the central line-associated bloodstream infection (CLABSI) success story, comparing infection rates before and 15 years after the IOM report. It discusses the five elements essential to the national success in reducing CLABSI rates: a reliable and valid measurement system, evidence-based care practices, investment in implementation sciences, local ownership and peer learning communities, and coordination and alignment of CLABSI reduction efforts.
AHRQ-authored.
Citation: Pronovost PJ, Cleeman JI, Wright D .
Fifteen years after to Err is Human: a success story to learn from.
BMJ Qual Saf 2016 Jun;25(6):396-9. doi: 10.1136/bmjqs-2015-004720.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Medical Errors, Evidence-Based Practice, Quality of Care
Rock C, Thom KA, Harris AD
A multicenter longitudinal study of hospital-onset bacteremia: time for a new quality outcome measure?
This study evaluates hospital-onset bacteremia (HOB) as a healthcare-associated infection-related outcome measure by assessing the association between HOB and central-line-associated bloodstream infection (CLABSI) rates and comparing the power of each to discriminate quality among intensive care units (ICUs). The researchers found that change in HOB rate is strongly associated with change in CLABSI rate and has greater power to discriminate between ICU performances.
AHRQ-funded; HS022291.
Citation: Rock C, Thom KA, Harris AD .
A multicenter longitudinal study of hospital-onset bacteremia: time for a new quality outcome measure?
Infect Control Hosp Epidemiol 2016 Feb;37(2):143-8. doi: 10.1017/ice.2015.261.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Quality Measures, Quality Measures
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)
Calderwood MS, Vaz LE, Tse Kawai A
Impact of hospital operating margin on central line-associated bloodstream infections following Medicare's hospital-acquired conditions payment policy.
In October 2008, Medicare ceased additional payment for hospital-acquired conditions not present on admission. The researchers evaluated the policy's differential impact in hospitals with high vs low operating margins. They concluded that Medicare's payment policy may have had an impact on reducing central line-associated bloodstream infections in hospitals with low operating margins.
AHRQ-funded; HS018414.
Citation: Calderwood MS, Vaz LE, Tse Kawai A .
Impact of hospital operating margin on central line-associated bloodstream infections following Medicare's hospital-acquired conditions payment policy.
Infect Control Hosp Epidemiol 2016 Jan;37(1):100-3. doi: 10.1017/ice.2015.250.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Medicare, Quality of Care, Payment, Sepsis
Bundy DG, Gaur AH, Billett AL
Preventing CLABSIs among pediatric hematology/oncology inpatients: national collaborative results.
This study assessed the feasibility of a multicenter effort to standardize central line (CL) care and central line-associated bloodstream infection (CLABSI) tracking and to quantify the impact of standardizing these processes on CLABSI rates. It found a reduction of 28 percent in the mean CLABSI rate from 2.85 to 2.04 per 1,000 CL days over almost 3 years.
AHRQ-funded; HS019590
Citation: Bundy DG, Gaur AH, Billett AL .
Preventing CLABSIs among pediatric hematology/oncology inpatients: national collaborative results.
Pediatrics. 2014 Dec;134(6):e1678-85. doi: 10.1542/peds.2014-0582..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Quality of Care, Children/Adolescents
Patrick SW, Kawai AT, Kleinman K
Health care-associated infections among critically ill children in the US, 2007-2012.
The researchers examined trends in central line-associated blood stream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and ventilator-associated pneumonia (VAP) incidence rates between 2007 and 2012 based on standardized surveillance data from pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs) in the United States. They found that incidence rates of CLABSIs and VAPs decreased among critically ill neonates and children during this period.
AHRQ-funded; HS018414.
Citation: Patrick SW, Kawai AT, Kleinman K .
Health care-associated infections among critically ill children in the US, 2007-2012.
Pediatrics 2014 Oct;134(4):705-12. doi: 10.1542/peds.2014-0613..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Urinary Tract Infection (UTI), Critical Care, Children/Adolescents, Healthcare-Associated Infections (HAIs)
Berenholtz SM, Lubomski LH, Weeks K
Eliminating central line-associated bloodstream infections: a national patient safety imperative.
The researchers conducted a collaborative cohort study to evaluate the impact of the national "On the CUSP: Stop BSI" program on CLABSI rates among participating adult intensive care units (ICUs). It found that one thousand and seventy-one adult ICUs from 44 states, the District of Columbia, and Puerto Rico implemented the national program and achieved a 43% reduction in the overall rate of CLABSI.
AHRQ-funded; 2902006000222.
Citation: Berenholtz SM, Lubomski LH, Weeks K .
Eliminating central line-associated bloodstream infections: a national patient safety imperative.
Infect Control Hosp Epidemiol 2014 Jan;35(1):56-62. doi: 10.1086/674384..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Central Line-Associated Bloodstream Infections (CLABSI), Intensive Care Unit (ICU), Healthcare-Associated Infections (HAIs)
Rangachari P, Madaio M, Rethemeyer RK
Role of communication content and frequency in enabling evidence-based practices.
The study sought to promote central line bundle (CLB) implementation in a medical ICU and a pediatric ICU through periodic quality improvement (QI) interventions over a 52-week period. It found that proactive communications increased by 68 percent in the MICU and 61 percent in the PICU. During the same timeframe, both units increased CLB adherence to 100 percent. Both units also demonstrated statistically significant declines in catheter days.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Role of communication content and frequency in enabling evidence-based practices.
Qual Manag Health Care 2014 Jan-Mar;23(1):43-58. doi: 10.1097/qmh.0000000000000017..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Communication, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Quality of Care, Quality Improvement