National Healthcare Quality and Disparities Report
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Topics
- Blood Clots (1)
- Case Study (1)
- Children/Adolescents (3)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Communication (3)
- Critical Care (2)
- Cultural Competence (1)
- Diagnostic Safety and Quality (1)
- Education: Continuing Medical Education (1)
- Elderly (2)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Emergency Preparedness (1)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (3)
- Health Services Research (HSR) (1)
- Hospital Discharge (1)
- Hospital Readmissions (1)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Long-Term Care (1)
- Medicare (1)
- Medication (2)
- Mortality (1)
- (-) Nursing (20)
- Obesity (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Safety (2)
- Pneumonia (1)
- Practice Patterns (1)
- Pressure Ulcers (1)
- Prevention (2)
- Provider (1)
- Provider: Health Personnel (1)
- Provider: Nurse (2)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (3)
- Risk (1)
- Rural Health (3)
- Sepsis (2)
- Social Determinants of Health (1)
- Training (1)
- Transitions of Care (2)
- Urban Health (1)
- Web-Based (1)
- Workforce (3)
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 20 of 20 Research Studies DisplayedWilliams PH, Gilmartin HM, Leonard C
The influence of the Rural Transitions Nurse Program for veterans on healthcare utilization costs.
This study’s objective was to examine changes from pre- to post-hospitalization in total, inpatient, and outpatient 30-day healthcare utilization costs for Veterans Affairs Healthcare System Rural Transitions Nurse Program (TNP) enrollees compared to controls. Although findings showed no difference in change in total costs between veterans enrolled in TNP and controls, TNP was associated with a smaller increase in direct inpatient medical costs and a larger increase in direct outpatient medical costs, suggesting a shifting of costs from the inpatient to outpatient setting.
AHRQ-funded; HS024569.
Citation: Williams PH, Gilmartin HM, Leonard C .
The influence of the Rural Transitions Nurse Program for veterans on healthcare utilization costs.
J Gen Intern Med 2022 Nov;37(14):3529-34. doi: 10.1007/s11606-022-07401-y..
Keywords: Rural Health, Nursing, Transitions of Care, Healthcare Utilization, Healthcare Costs
Cimiotti JP, Becker ER, Li Y
Association of registered nurse staffing with mortality risk of Medicare beneficiaries hospitalized with sepsis.
The purpose of this cross-sectional study was to determine if registered nurse workload was related with mortality in Medicare beneficiaries admitted to an acute care hospital with sepsis. The researchers evaluated the records of Medicare beneficiaries ages 65 to 99 years with a primary diagnosis of sepsis that was present on admission to 1 of 1958 nonfederal, general acute care hospitals that had data on CMS SEP-1 scores and registered nurse workload. Researchers utilized 2018 data from the American Hospital Association Annual Survey, CMS Hospital Compare, and Medicare claims. The patient outcome of interest was mortality within 60 days of admission. The study found that 702,140 Medicare beneficiaries with a mean age of 78.2 years, 51% of whom were women, had a diagnosis of sepsis. In a multivariable regression model, each additional registered nurse hour per patient day (HPPD) was associated with a 3% decrease in the odds of 60-day mortality. The researchers concluded that hospitals which provide more registered nurse hours of care could possibly decrease the likelihood of mortality in Medicare beneficiaries with sepsis.
AHRQ-funded; HS026232.
Citation: Cimiotti JP, Becker ER, Li Y .
Association of registered nurse staffing with mortality risk of Medicare beneficiaries hospitalized with sepsis.
JAMA Health Forum 2022 May;3(5):e221173. doi: 10.1001/jamahealthforum.2022.1173..
Keywords: Sepsis, Mortality, Provider: Nurse, Nursing, Workforce
Gilmartin HM, Warsavage T, Hines A
Effectiveness of the rural transitions nurse program for veterans: a multicenter implementation study.
This study evaluated the effectiveness of the rural Transitions Nurse Program (TNP), a program to help veterans transferred from rural areas to urban VA Medical Centers for care. A case-control study was conducted from April 2017 to September 2019 with 3001 veterans enrolled in TNP and 6002 matched controls. Interventions were led by a transition nurse who assessed discharge readiness, provided postdischarge communication with primary care providers (PCPs), and called the Veteran within 72 h of discharge home to assess needs, and encouraged follow-up appointment attendance. Controls had no change to their care. Primary outcomes evaluated were PCP visits within 14 days of discharge and all-cause 30-day readmissions, with secondary outcomes 30-day emergency department (ED) visits and 30-day mortality. Patients were matched by their length of stay, prior hospitalizations and PCP visits, urban/rural status, and 32 Elixhauser comorbidities. The veterans enrolled in TNP were more likely to see their PCP within 14 days of discharge than their matched controls. TNP enrollment was not associated with reduced 30-day ED visits or readmissions but was associated with reduced 30-day mortality.
AHRQ-funded; HS024569.
Citation: Gilmartin HM, Warsavage T, Hines A .
Effectiveness of the rural transitions nurse program for veterans: a multicenter implementation study.
J Hosp Med 2022 Mar;17(3):149-57. doi: 10.1002/jhm.12802..
Keywords: Rural Health, Transitions of Care, Nursing, Healthcare Delivery
Douthit BJ, Walden RL, Cato K
Data science trends relevant to nursing practice: a rapid review of the 2020 literature.
This study’s objective was to summarize the latest research and applications of nursing-relevant patient outcomes and clinical processes in the data science literature. Numerous contemporary data science methods were represented in the literature including the use of machine learning, neural networks, and natural language processing. This review provides an overview of the data science trends that were relevant to nursing practice in 2020.
AHRQ-funded; HS026395.
Citation: Douthit BJ, Walden RL, Cato K .
Data science trends relevant to nursing practice: a rapid review of the 2020 literature.
Appl Clin Inform 2022 Jan;13(1):161-79. doi: 10.1055/s-0041-1742218..
Keywords: Nursing, Health Information Technology (HIT), Patient-Centered Outcomes Research
Niznik J, Zhao X, Jiang T
Anticholinergic prescribing in Medicare Part D beneficiaries residing in nursing homes: results from a retrospective cross-sectional analysis of Medicare data.
The primary objective of this study was to identify factors associated with low- and high-level anticholinergic burden in nursing home residents. Overall, 29.6 percent of subjects had a high anticholinergic burden and 35.2 percent had a low burden. High burden was most often (72 percent) due to one highly anticholinergic medication rather than a cumulative effect.
AHRQ-funded; HS023779.
Citation: Niznik J, Zhao X, Jiang T .
Anticholinergic prescribing in Medicare Part D beneficiaries residing in nursing homes: results from a retrospective cross-sectional analysis of Medicare data.
Drugs Aging 2017 Dec;34(12):925-39. doi: 10.1007/s40266-017-0502-6.
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Keywords: Elderly, Medicare, Medication, Nursing
Larson EL, Cohen B, Liu J
Assessing intensity of nursing care needs using electronically available data.
The aim of this project was to develop and test a Nursing Intensity of Care Index using electronically available data from 152,072 patient discharges from three hospitals. In preliminary testing, data for the Nursing Intensity of Care Index, which accurately reflect nursing care intensity, can be obtained electronically in real time. The next steps will be a discrete-event simulation model and large-scale field trials.
AHRQ-funded; HS024915.
Citation: Larson EL, Cohen B, Liu J .
Assessing intensity of nursing care needs using electronically available data.
Comput Inform Nurs 2017 Dec;35(12):617-23. doi: 10.1097/cin.0000000000000375.
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Keywords: Electronic Health Records (EHRs), Nursing, Workforce
Benda N, Hettinger A, Bisantz A
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
This study described the patterns and content of nurse to physician verbal conversations in three emergency departments (EDs) with electronic health records. It found that physician participants experienced significantly more communication events than nurse participants, while nurses initiated significantly more communication events than physicians. Most of the communication events occurred at the physician workstation followed by patient treatment areas.
AHRQ-funded; HS022542.
Citation: Benda N, Hettinger A, Bisantz A .
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
Journal of Healthcare Informatics Research 2017 Dec;1(2):218-30.
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Keywords: Communication, Electronic Health Records (EHRs), Provider: Health Personnel, Emergency Department, Nursing
Hessels AJ, Darby SW, Simpser E
National testing of the nursing-kids intensity of care survey for pediatric long-term care.
The purpose of this study is to test the Nursing-Kids Intensity of Care, a measure of the intensity of nursing care needs, defined as the quantity and type of direct and indirect care activities performed by caregivers in a national sample. The authors concluded that additional testing to further establish psychometric sufficiency and expanded use to quantify the intensity of nursing care needs of children with complex medical conditions in pediatric long-term care settings is recommended.
AHRQ-funded; HS021470.
AHRQ-funded; HS021470.
AHRQ-funded; HS021470.
Citation: Hessels AJ, Darby SW, Simpser E .
National testing of the nursing-kids intensity of care survey for pediatric long-term care.
J Pediatr Nurs 2017 Nov/Dec;37:86-90. doi: 10.1016/j.pedn.2017.08.026..
Keywords: Children/Adolescents, Health Services Research (HSR), Long-Term Care, Nursing, Children/Adolescents
Squires A
Evidence-based approaches to breaking down language barriers.
This article provides background information about language barriers between nurses and patients and some strategies for addressing these gaps. After detailing how these barriers affect patient outcomes, practice-based strategies are offered to improve outcomes and reduce readmissions. Although the article doesn’t address barriers to communicating with patients with hearing loss, many of the same principles apply to these patients.
AHRQ-funded; HS023593.
Citation: Squires A .
Evidence-based approaches to breaking down language barriers.
Nursing 2017 Sep;47(9):34-40. doi: 10.1097/01.NURSE.0000522002.60278.ca.
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Keywords: Communication, Cultural Competence, Evidence-Based Practice, Nursing, Clinician-Patient Communication
Lau BD, Shaffer DL, Hobson DB
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
AHRQ-funded; HS024547.
Citation: Lau BD, Shaffer DL, Hobson DB .
Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: a randomized clinical trial.
PLoS One 2017 Aug 16;12(8):e0181664. doi: 10.1371/journal.pone.0181664.
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Keywords: Blood Clots, Education: Continuing Medical Education, Medication, Nursing, Prevention, Provider: Nurse, Web-Based, Practice Patterns
Farra SL, Miller ET, Gneuhs M
Disaster management: communication up, across, and down.
This case study uses the National Preparedness Leadership Initiative’s (NPLI) meta-leadership model as the guiding framework for developing and implementing an evacuation exercise focused on the safe evacuation of neonates. Key components of this framework include strategies for communicating up, across, and down among various stakeholders.
AHRQ-funded; HS023149.
Citation: Farra SL, Miller ET, Gneuhs M .
Disaster management: communication up, across, and down.
Nurs Manage 2017 Jul;48(7):51-54. doi: 10.1097/01.NUMA.0000520720.78549.e4..
Keywords: Emergency Preparedness, Communication, Nursing, Case Study
Boltey E, Yakusheva O, Costa DK
5 nursing strategies to prevent ventilator-associated pneumonia.
This article reviews the top five evidence-based nursing practices for reducing ventilator-associated pneumonia (VAP) risk in critically ill adults.
AHRQ-funded; HS024552.
Citation: Boltey E, Yakusheva O, Costa DK .
5 nursing strategies to prevent ventilator-associated pneumonia.
Am Nurse Today 2017 Jun;12(6):42-43..
Keywords: Critical Care, Healthcare-Associated Infections (HAIs), Nursing, Prevention, Pneumonia
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID, Guofen Y .
A national comparison of rural/urban pressure ulcer and fall rates.
Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health
Bhattacharjee P, Churpek MM, Snyder A
Detecting sepsis: are two opinions better than one?
Researchers conducted a study to characterize the agreement between different providers' suspicion of infection and the correlation with patient outcomes using prospective data from a general medicine ward. They concluded that provider disagreement regarding suspected infection is common, with RNs suspecting infection more often, suggesting that a collaborative model for sepsis detection may improve timing and accuracy.
AHRQ-funded; HS000078.
Citation: Bhattacharjee P, Churpek MM, Snyder A .
Detecting sepsis: are two opinions better than one?
J Hosp Med 2017 Apr;12(4):256-58. doi: 10.12788/jhm.2721.
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Keywords: Diagnostic Safety and Quality, Nursing, Risk, Sepsis
Dunn Lopez K, Gephart SM, Raszewski R
Integrative review of clinical decision support for registered nurses in acute care settings.
To report on the state of the science of clinical decision support (CDS) for hospital bedside nurses, the researchers performed an integrative review of qualitative and quantitative peer-reviewed original research studies. They concluded that clinical support systems targeting bedside nurses have positive effects on outcomes and hold promise for improving care quality.
AHRQ-funded; HS022908.
Citation: Dunn Lopez K, Gephart SM, Raszewski R .
Integrative review of clinical decision support for registered nurses in acute care settings.
J Am Med Inform Assoc 2017 Mar 1;24(2):441-50. doi: 10.1093/jamia/ocw084.
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Keywords: Critical Care, Clinical Decision Support (CDS), Health Information Technology (HIT), Nursing, Patient Safety
Asan O, Flynn KE, Azam L
Nurses’ perceptions of a novel health information technology: a qualitative study in the pediatric intensive care unit.
The purpose of this study was to evaluate the use of a novel health information technology (HIT), a large customizable interactive monitor (LCIM), implemented in a pediatric intensive care unit (PICU). The study collected and analyzed data from 55 PICU nurses in seven focus groups. Six major themes emerged including familiarity and use routines, positive perceptions with the LCIM, negative perceptions with the LCIM, privacy, training, and suggestions for improvement.
AHRQ-funded; HS023626.
Citation: Asan O, Flynn KE, Azam L .
Nurses’ perceptions of a novel health information technology: a qualitative study in the pediatric intensive care unit.
Int J Hum Comput Interact 2017;33(4):258-64. doi: 10.1080/10447318.2017.1279828.
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Keywords: Health Information Technology (HIT), Intensive Care Unit (ICU), Patient and Family Engagement, Children/Adolescents, Nursing
Kolko RP, Kass AE, Hayes JF
Provider training to screen and initiate evidence-based pediatric obesity treatment in routine practice settings: a randomized pilot trial.
This randomized pilot trial evaluated two training modalities for first-line, evidence-based pediatric obesity services (screening and goal setting) among nursing students. Both live interactive training and Web-facilitated self-study training were acceptable, with higher ratings for live training and participants with previous experience. Knowledge and skill improved from pretraining to post-training and follow-up in both conditions.
AHRQ-funded; HS000078.
Citation: Kolko RP, Kass AE, Hayes JF .
Provider training to screen and initiate evidence-based pediatric obesity treatment in routine practice settings: a randomized pilot trial.
J Pediatr Health Care 2017 Jan - Feb;31(1):16-28. doi: 10.1016/j.pedhc.2016.01.001.
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Keywords: Children/Adolescents, Evidence-Based Practice, Nursing, Obesity, Training
de Cordova PB
Staffing and nurse-perceived quality of care.
This article comments on a study by Cho and colleagues, the purpose of which was to explore the associations between nurse staffing and overtime with nurse-perceived patient safety and care left undone. Cho and colleagues found that as patients per nurse and nurse work hours increase, so does the perception of reduced patient safety. The author argues that the study reinforces the view that educating nurses, administrators and policymakers about the importance of nurse staffing on quality care should continue.
AHRQ-funded; HS024339.
Citation: de Cordova PB .
Staffing and nurse-perceived quality of care.
Evid Based Nurs 2017 Jan;20(1):19. doi: 10.1136/eb-2016-102478.
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Keywords: Quality of Care, Provider, Nursing, Workforce
Martsolf GR, Auerbach D, Benevent R
AHRQ Author: Stocks C, Jiang HJ
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
The authors assessed the effect of nurse staffing on quality of care and inpatient care costs. They found that increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, while changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Martsolf GR, Auerbach D, Benevent R .
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
Med Care 2014 Nov;52(11):982-8. doi: 10.1097/mlr.0000000000000248.
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Keywords: Healthcare Costs, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Nursing
Goldman LE, Sarkar U, Kessell E
Support from hospital to home for elders: a randomized trial.
The researchers studied a peridischarge, nurse-led intervention combined with telephone follow-up designed to reduce readmissions among patients who were 55 or older. They found that the nurse-led, in-hospital discharge support intervention did not show a reduction in readmissions or ED visits among 700 diverse, low-income older adults at a safety-net hospital.
AHRQ-funded; HS018090.
Citation: Goldman LE, Sarkar U, Kessell E .
Support from hospital to home for elders: a randomized trial.
Ann Intern Med 2014 Oct 7;161(7):472-81. doi: 10.7326/m14-0094..
Keywords: Hospital Discharge, Hospital Readmissions, Emergency Department, Elderly, Social Determinants of Health, Nursing