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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 11 of 11 Research Studies DisplayedProfit J, Lee HC, Sharek PJ
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
The objectives of this study were to assess variation in safety and teamwork climate and in the neonatal intensive care unit (NICU) setting, and compare measurement of safety culture scales using two different instruments (Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSOPSC)). It concluded that large variation and opportunities for improvement in patient safety culture exist across NICUs. Important systematic differences exist between SAQ and HSOPSC.
AHRQ-funded; HS014246.
Citation: Profit J, Lee HC, Sharek PJ .
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
BMJ Qual Saf 2016 Dec;25(12):954-61. doi: 10.1136/bmjqs-2014-003924.
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Keywords: Hospitals, Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Safety, Teams
Quinn M, Gephart S
Evidence for implementation strategies to provide palliative care in the neonatal intensive care unit.
The authors sought to answer the clinical question: In neonatal intensive care, what evidence can be used to guide implementation of palliative care protocols? They found that successful team approaches included standardized order sets to initiate neonatal palliative care (NPC), NPC education for staff, and references to NPC guidelines or protocols.They recommended that barriers such as lack of interdisciplinary cooperation, lack of appropriate physical space, and lack of education be addressed during program development.
AHRQ-funded; HS022908.
Citation: Quinn M, Gephart S .
Evidence for implementation strategies to provide palliative care in the neonatal intensive care unit.
Adv Neonatal Care 2016 Dec;16(6):430-38. doi: 10.1097/anc.0000000000000354.
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Keywords: Evidence-Based Practice, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Palliative Care
Reich PJ, Boyle MG, Hogan PG
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Methicillin-resistant Staphylococcus aureus (MRSA) infections cause significant morbidity and mortality in neonatal intensive care units (NICUs). The researchers characterized the clinical and molecular epidemiology of MRSA strains colonizing NICU patients. They found that community-acquired MRSA strains are prominent in the NICU and associated with distinct risk factors.
AHRQ-funded; HS021736; HS024269.
Citation: Reich PJ, Boyle MG, Hogan PG .
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Clin Microbiol Infect 2016 Jul;22(7):645.e1-8. doi: 10.1016/j.cmi.2016.04.013.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Neonatal Intensive Care Unit (NICU), Patient Safety, Prevention, Antimicrobial Stewardship, Newborns/Infants, Healthcare-Associated Infections (HAIs)
Freedman S
Capacity and utilization in health care: the effect of empty beds on neonatal intensive care admission.
In this paper, the author exploited short-term variation in Neonatal Intensive Care Unit (NICU) capacity that is unlikely to be correlated with unobserved demand determinants. He found that available NICU beds have little to no effect on NICU utilization for the sickest infants, but do increase utilization for those in the range of birth weights where admission decisions are likely to be more discretionary.
AHRQ-funded; HS018266.
Citation: Freedman S .
Capacity and utilization in health care: the effect of empty beds on neonatal intensive care admission.
Am Econ J Econ Policy 2016 May 1;8(2):154-85. doi: 10.1257/pol.20120393.
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Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Healthcare Utilization, Critical Care, Decision Making
Garfield CF, Lee YS, Kim HN
Supporting parents of premature infants transitioning from the NICU to home: a pilot randomized control trial of a smartphone application.
This study determined whether parents of Very Low Birth Weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU) transitioning home with the NICU-2-Home smartphone application have greater parenting self-efficacy, are better prepared for discharge and have shorter length of stay (LOS) than control parents. It found that a smartphone application can improve parenting self-efficacy, discharge preparedness, and LOS with improved benefits based on usage.
AHRQ-funded; HS020316.
Citation: Garfield CF, Lee YS, Kim HN .
Supporting parents of premature infants transitioning from the NICU to home: a pilot randomized control trial of a smartphone application.
Internet Interv 2016 May;4(Pt 2):131-37. doi: 10.1016/j.invent.2016.05.004.
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Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Health Information Technology (HIT), Home Healthcare, Hospital Discharge
Farra S, Miller ET, Gneuhs M
Evacuation performance evaluation tool.
The authors described the development and implications of a disaster evacuation performance tool that measures one portion of the very complex process of evacuation. The tool was pilot tested with an administrative, medical, and nursing leadership group and then implemented with a group of healthcare workers during a disaster exercise. The authors found that the Delphi process based on the conceptual framework of DeVellis yielded a psychometrically sound evacuation performance evaluation tool for a neonatal intensive care unit.
AHRQ-funded; HS023149.
Citation: Farra S, Miller ET, Gneuhs M .
Evacuation performance evaluation tool.
Am J Disaster Med 2016 Spring;11(2):131-36. doi: 10.5055/ajdm.2016.0232.
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Keywords: Emergency Preparedness, Hospitals, Neonatal Intensive Care Unit (NICU), Children/Adolescents, Training
Moyer VA, Papile LA, Eichenwald E
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
The authors tested whether a multifaceted intervention that included a health coach to assist families and an enhanced personal health record to improve the quality of information available to parents and community professionals would decrease adverse events and improve family assessment of the transition of infants born prematurely or with complex medical problems to home. They found that a multicomponent discharge intervention designed to address specific problems identified using Healthcare Failure Modes and Effects Analysis did not reduce certain adverse outcomes in the post-discharge period.
AHRQ-funded; HS017889.
Citation: Moyer VA, Papile LA, Eichenwald E .
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
BMJ Qual Saf 2014 Dec;23(12):e3. doi: 10.1136/bmjqs-2012-001726.
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Keywords: Neonatal Intensive Care Unit (NICU), Ambulatory Care and Surgery, Patient Safety, Quality Improvement, Transitions of Care
Profit J, Sharek PJ, Amspoker AB
Burnout in the NICU setting and its relation to safety culture.
The objectives of this study are three-fold: to test the psychometric properties of a brief four-item burnout scale; to provide neonatal intensive care unit (NICU) burnout and resilience benchmarking data across different units and caregiver types; and to examine the relationships between caregiver burnout and patient safety culture. The authors found that NICU caregiver burnout appears to have 'climate-like' features, is prevalent, and is associated with lower perceptions of patient safety culture.
AHRQ-funded; HS014246.
Citation: Profit J, Sharek PJ, Amspoker AB .
Burnout in the NICU setting and its relation to safety culture.
BMJ Qual Saf 2014 Oct;23(10):806-13. doi: 10.1136/bmjqs-2014-002831.
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Keywords: Provider: Health Personnel, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Safety
Sexton JB, Sharek PJ, Thomas EJ
Exposure to Leadership WalkRounds in neonatal intensive care units is associated with a better patient safety culture and less caregiver burnout.
The aims of this study were to evaluate the association between WalkRound (WR) feedback, patient safety culture, and caregiver burnout. It found that more WR feedback was associated with better safety culture results and lower burnout rates in the neonatal intensive care units (NICUs).
AHRQ-funded; HS014246.
Citation: Sexton JB, Sharek PJ, Thomas EJ .
Exposure to Leadership WalkRounds in neonatal intensive care units is associated with a better patient safety culture and less caregiver burnout.
BMJ Qual Saf. 2014 Oct;23(10):814-22. doi: 10.1136/bmjqs-2013-002042..
Keywords: Neonatal Intensive Care Unit (NICU), Patient Safety, Caregiving, Children/Adolescents
Garfield CF, Lee Y, Kim HN
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
The authors examined the concerns and coping mechanisms of fathers and mothers of very low-birth-weight neonatal intensive care unit (NICU) infants as they transition to home from the NICU. They found that overriding concerns included pervasive uncertainty, lingering medical concerns, and partner-related adjustment concerns that differed by gender. They concluded that many parental concerns can be addressed with improved discharge information exchanges and anticipatory guidance.
AHRQ-funded; HS020316.
Citation: Garfield CF, Lee Y, Kim HN .
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
J Perinat Neonatal Nurs 2014 Oct-Dec;28(4):305-12. doi: 10.1097/jpn.0000000000000021.
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Keywords: Care Coordination, Hospital Discharge, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Transitions of Care
Lorch SA, Passarella M, Zeigler A
Challenges to measuring variation in readmission rates of neonatal intensive care patients.
The authors examined the viability of a hospital readmission quality metric for infants requiring neonatal intensive care. They found that the California cohort showed significant variation in hospital-level readmission rates, supporting the premise that readmission rates of prematurely born infants may reflect care quality. However, state data did not include term and early term infants requiring neonatal intensive care, and there were extensive missing data in the few states with sufficient information on managed care patients to calculate state-level measures. They concluded that constructing a valid readmission measure for NICU care across diverse states and regions requires improved data collection.
AHRQ-funded; HS018661; HS020508.
Citation: Lorch SA, Passarella M, Zeigler A .
Challenges to measuring variation in readmission rates of neonatal intensive care patients.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S47-53. doi: 10.1016/j.acap.2014.06.010.
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Keywords: Neonatal Intensive Care Unit (NICU), Newborns/Infants, Quality Indicators (QIs), Quality Measures, Hospital Readmissions
