National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (3)
- Antibiotics (2)
- Cancer (1)
- (-) Catheter-Associated Urinary Tract Infection (CAUTI) (19)
- Central Line-Associated Bloodstream Infections (CLABSI) (3)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- COVID-19 (1)
- Critical Care (2)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (16)
- Health Information Technology (HIT) (1)
- Hospitals (2)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (2)
- Long-Term Care (4)
- Medicare (1)
- Nursing Homes (4)
- Patient-Centered Outcomes Research (2)
- Patient Safety (11)
- Practice Patterns (2)
- Prevention (10)
- Quality Improvement (4)
- Quality of Care (3)
- Research Methodologies (1)
- Risk (1)
- Urinary Tract Infection (UTI) (10)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedGovindan S, O'Malley ME, Flanders SA
The MI-PICC Score: a risk-Prediction Model for PICC-associated Complications in the ICU.
The authors examined predictive factors for adverse events in critically ill patients with peripherally inserted central catheters (PICCs). They found that PICC-related complications in the ICU were significantly associated with history of deep vein thrombosis, active diagnosis of cancer, presence of a second central venous catheter, blood transfusion through the PICC, and PICC dwell time.
AHRQ-funded; HS025891.
Citation: Govindan S, O'Malley ME, Flanders SA .
The MI-PICC Score: a risk-Prediction Model for PICC-associated Complications in the ICU.
Am J Respir Crit Care Med 2022 Nov 15;206(10):1286-89. doi: 10.1164/rccm.202204-0760LE..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Critical Care, Intensive Care Unit (ICU), Risk, Adverse Events
Krauss DM, Molefe A, Hung L
AHRQ Author: Henderson S, Miller M
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
MacEwan SR, Beal EW, Gaughan AA
Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections.
The purpose of this study was to contribute to evidence of standardized approaches to educate patients about how they can prevent infections. The researchers explored the perspectives of hospital leaders and staff across 18 hospitals about patient education for device-related healthcare-associated infections (HAIs) including catheter-associated urinary tract infections (CAUTIs) and central-line-associated bloodstream infections (CLABSIs). A total of 471 interviews were conducted with key informants and analyzed to identify themes within the topic of preventing infection through patient education. The study found that the key informants identified CAUTI and CLABSI infection-prevention-specific patient education topics including: the necessity of hand hygiene, the importance of maintenance care, the risks of indwelling urinary catheters and central lines, and having the support to voice concerns. The study concluded that hospital leaders and staff identified patient education topics and ways to deliver the information that were important in the prevention of CAUTIs and CLABSIs, and can provide guidance on how patient education can be improved.
AHRQ-funded; HS024958.
Citation: MacEwan SR, Beal EW, Gaughan AA .
Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections.
Infect Control Hosp Epidemiol 2022 Sep;43(9):1129-34. doi: 10.1017/ice.2021.271..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Education: Patient and Caregiver, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI)
McAlearney AS, MacEwan SR, Gregory ME
Identifying management practices for promoting infection prevention: perspectives on strategic communication.
The purpose of this study was to better understand the topics and communication strategies used by hospital administrative and clinical leaders to facilitate healthcare-associated infection prevention. Between 2017 and 2019 the researchers interviewed 188 administrative and clinical leaders in 18 U.S. Hospitals and interviewed them about management practices used to promote the prevention of HAI, with a focus on strategic communications. The study found that information sharing regarding infection prevention focused on two main topics: facilitators of success and barriers to success. The researchers also reported that storytelling using examples of real events was useful. The study concluded that the findings provide useful information about how the strategic communication of HAI information can contribute to improvement and advance hospitals’ infection prevention plans and efforts.
AHRQ-funded; HS024958.
Citation: McAlearney AS, MacEwan SR, Gregory ME .
Identifying management practices for promoting infection prevention: perspectives on strategic communication.
Am J Infect Control 2022 Jun;50(6):593-97. doi: 10.1016/j.ajic.2021.11.025..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Prevention, Communication
Makic MBF, Stevens KR, Gritz RM
AHRQ Author: Rodrick D
Dashboard design to identify and balance competing risk of multiple hospital-acquired conditions.
A national patient safety priority is hospital-acquired conditions (HACs) such as falls, hospital-acquired pressure injuries (HAPI), and catheter-associated urinary tract infections (CAUTIs). Most HAC prevention interventions focus on each risk individually, and do not take into consideration how addressing one HAC independently can compete with other HACs and cause unintended consequences. The purpose of this proof-of-concept study was to design a framework to identify, evaluate, and quantify competing individual HAC interventions and the related risks of multiple HACs (MHACs), and design a dashboard to help guide provider decisions. The researchers focused on the how the removal of urinary catheters for reduction of CAUTI could unintentionally impact falls and HAPI. A database to quantify the competing risks of HACs was developed using data from five hospital systems; three of those hospitals tested the resulting predictive model dashboard developed by the researchers and provided feedback. Twenty-five clinicians participated in the qualitative interviews. The clinicians confirmed that a visual dashboard is useful for guiding their decision-making for MHAC risks, and preferred a red, green, yellow stoplight visual for understanding. The researchers also found that clinicians did not want mandatory alerts for tool integration into the electronic health record. The study concluded that additional research is needed to better understand multiple hospital acquired risks and methods for guiding provider decision-making.
AHRQ-authored; AHRQ-funded; 2332015000251.
Citation: Makic MBF, Stevens KR, Gritz RM .
Dashboard design to identify and balance competing risk of multiple hospital-acquired conditions.
Appl Clin Inform 2022 May;13(3):621-31. doi: 10.1055/s-0042-1749598..
Keywords: Healthcare-Associated Infections (HAIs), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI)
Krein SL, Harrod M, Collier S
A national collaborative approach to reduce catheter-associated urinary tract infections in nursing homes: a qualitative assessment.
AHRQ’s Safety Program for Long-term Care: Health Care-Associated Infections/Catheter-Associated Urinary Tract Infection, a national performance improvement program, was designed to promote implementation of a catheter-associated urinary tract infections (CAUTI) prevention program through state-based or regional collaboratives in more than 500 nursing homes across the United States. The observed program success and positive views of those participating suggest that collaboratives are an important strategy for providing nursing homes with enhanced expertise and support.
AHRQ-funded; 290201000025I; 29032008T.
Citation: Krein SL, Harrod M, Collier S .
A national collaborative approach to reduce catheter-associated urinary tract infections in nursing homes: a qualitative assessment.
Am J Infect Control 2017 Dec;45(12):1342-48. doi: 10.1016/j.ajic.2017.07.006.
.
.
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Long-Term Care, Nursing Homes, Quality Improvement, Patient Safety
Mody L, Greene MT, Meddings J
AHRQ Author: Burwen DR, Battles J
A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents.
The researchers developed, implemented, and evaluated an intervention to reduce catheter-associated urinary tract infection (UTI). They found that in a large-scale, national implementation project involving community-based nursing homes, combined technical and socioadaptive catheter-associated UTI prevention interventions successfully reduced the incidence of catheter-associated UTIs.
AHRQ-authored; AHRQ-funded; 290201000025I; HS019767; HS024385; HS018334.
Citation: Mody L, Greene MT, Meddings J .
A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents.
JAMA Intern Med 2017 Aug;177(8):1154-62. doi: 10.1001/jamainternmed.2017.1689.
.
.
Keywords: Antibiotics, Catheter-Associated Urinary Tract Infection (CAUTI), Elderly, Long-Term Care, Nursing Homes, Prevention, Urinary Tract Infection (UTI)
Metersky ML, Eldridge N, Wang Y
AHRQ Author: Eldridge N
National trends in the frequency of bladder catheterization and physician-diagnosed catheter-associated urinary tract infections: results from the Medicare Patient Safety Monitoring System.
The researchers assessed bladder catheterization frequency (percentage of patients catheterized) and risk-adjusted catheter-associated urinary tract infection (CAUTI frequency (percentage of catheterized patients developing CAUTI) from 2009-2014. They found statistically significant declines in observed bladder catheterization frequency and adjusted CAUTI frequency in some patient populations between 2009 and 2014.
AHRQ-authored; AHRQ-funded; 290201200003C; HS019767; HS024385; HS018334.
Citation: Metersky ML, Eldridge N, Wang Y .
National trends in the frequency of bladder catheterization and physician-diagnosed catheter-associated urinary tract infections: results from the Medicare Patient Safety Monitoring System.
Am J Infect Control 2017 Aug;45(8):901-04. doi: 10.1016/j.ajic.2017.03.008.
.
.
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Adverse Events, Medicare
McAlearney AS, Hefner JL, Sieck CJ
Searching for Management Approaches To Reduce HAI Transmission (SMART): a study protocol.
Using a mixed-methods approach to evaluate the contribution of management factors to successful HAI-reduction efforts, this study aims to develop valid and reliable measures of structural management practices associated with the recommended central line-associated bloodstream infections Management Strategies for use as a survey (HAI Management Practice Guideline Survey) to support HAI-reduction efforts in both medical/surgical units and ICUs.
AHRQ-funded; HS024958.
Citation: McAlearney AS, Hefner JL, Sieck CJ .
Searching for Management Approaches To Reduce HAI Transmission (SMART): a study protocol.
Implement Sci 2017 Jun 28;12(1):82. doi: 10.1186/s13012-017-0610-z.
.
.
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Research Methodologies
Rickard CM, Marsh NM, Webster J
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
The researchers designed this trial to assess the clinical and cost-effectiveness of dressing and securements to prevent peripherally inserted central catheters (PICCs) failure. For the dressing hypothesis, they hypothesize (chlorhexidine gluconate (CHG) discs will reduce catheter-associated bloodstream infection (CABSI) compared with no CHG disc. For the securement hypothesis, they hypothesize that integrated securement dressing will reduce composite PICC failure (infection (CABSI/local infection), occlusion, dislodgement or thrombosis), compared with securement device.
AHRQ-funded; HS022835.
Citation: Rickard CM, Marsh NM, Webster J .
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
BMJ Open 2017 Jun 15;7(6):e015291. doi: 10.1136/bmjopen-2016-015291.
.
.
Keywords: Cancer, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety
Meddings J, Saint S, Krein SL
Systematic review of interventions to reduce urinary tract infection in nursing home residents.
This paper is a systematic literature review of strategies to reduce urinary tract infections (UTIs) in nursing home residents. It concludes that several practices, often implemented in bundles, such as improving hand hygiene, reducing and improving catheter use, managing incontinence without catheters, and enhanced barrier precautions, appear to reduce UTI or catheter-associated UTI in nursing home residents.
AHRQ-funded; HS019767; HS018334; 290201000025I.
Citation: Meddings J, Saint S, Krein SL .
Systematic review of interventions to reduce urinary tract infection in nursing home residents.
J Hosp Med 2017 May;12(5):356-68. doi: 10.12788/jhm.2724.
.
.
Keywords: Antibiotics, Catheter-Associated Urinary Tract Infection (CAUTI), Elderly, Evidence-Based Practice, Long-Term Care, Nursing Homes, Patient Safety, Prevention, Urinary Tract Infection (UTI)
Mody L, Greene MT, Saint S
Comparing catheter-associated urinary tract infection prevention programs between Veterans Affairs nursing homes and non-Veterans Affairs nursing homes.
Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to catheter-associated urinary tract infection (CAUTI) prevention via a needs assessment questionnaire. Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems.
AHRQ-funded; 290201000025I; HS019767; HS024385; HS018334.
Citation: Mody L, Greene MT, Saint S .
Comparing catheter-associated urinary tract infection prevention programs between Veterans Affairs nursing homes and non-Veterans Affairs nursing homes.
Infect Control Hosp Epidemiol 2017 Mar;38(3):287-93. doi: 10.1017/ice.2016.279.
.
.
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Long-Term Care, Nursing Homes, Prevention
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.
.
.
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
Fakih MG, Krein SL, Edson B
AHRQ Author: Battles JB
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
The "On the CUSP: Stop CAUTI" initiative represents the single largest national effort to mitigate urinary catheter risk. The program brings together key organizations to assist hospitals by providing education and coaching support. Continuity is secured by integrating the process into the health care worker's daily routine activities.
AHRQ-authored; AHRQ-funded; 290201000025I; 29032001T.
Citation: Fakih MG, Krein SL, Edson B .
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
Am J Infect Control 2014 Oct;42(10 Suppl):S223-9. doi: 10.1016/j.ajic.2014.03.355.
.
.
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention, Practice Patterns
Fakih MG, Krein SL, Edson B
AHRQ Author: Battles JB
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
This article discusses catheter-associated urinary tract infection (CAUTI) prevention efforts, describes the national collaboration between different organizations, briefly reviews the technical and socio-adaptive components of the program, and specifically describes an approach to engaging health care workers as an essential part of CAUTI prevention and averting patient harm.
AHRQ-authored; AHRQ-funded; 290201000025I; 29032001T
Citation: Fakih MG, Krein SL, Edson B .
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
Am J Infect Control. 2014 Oct;42(10 Suppl):S223-9. doi: 10.1016/j.ajic.2014.03.355..
Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention, Practice Patterns, Quality Improvement
Greene MT, Fakih MG, Fowler KE
Regional variation in urinary catheter use and catheter-associated urinary tract infection: results from a national collaborative.
The researchers explored nationwide variation in the use of urinary catheters and catheter-associated urinary tract infections (CAUTI) across a diverse set of units within acute care U.S. hospitals. Using data from 1,101 units in 726 hospitals across 34 States, they found regional differences in catheter use, appropriateness, and CAUTI rates, with possibly 30-40 percent of urinary catheters placed in non-ICU settings lacking an appropriate indication.
AHRQ-funded; HS018334; HS019767; 290201000025I; 29032001T
Citation: Greene MT, Fakih MG, Fowler KE .
Regional variation in urinary catheter use and catheter-associated urinary tract infection: results from a national collaborative.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S99-S106. doi: 10.1086/677825..
Keywords: Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care, Catheter-Associated Urinary Tract Infection (CAUTI)
Greene MT, Kiyoshi-Teo H, Reichert H
Urinary catheter indications in the United States: results from a national survey of acute care hospitals.
The researchers sought to determine how often various indications for catheter use were reported among a nationally representative sample of acute care hospitals. They found that many hospitals were using several indications deemed in appropriated by CAUTI prevention guidelines such as urinary incontinence without outlet obstruction and patient/family request.
AHRQ-funded; 290201000025I; 29032001T
Citation: Greene MT, Kiyoshi-Teo H, Reichert H .
Urinary catheter indications in the United States: results from a national survey of acute care hospitals.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S96-8. doi: 10.1086/677823..
Keywords: Urinary Tract Infection (UTI), Patient Safety, Healthcare-Associated Infections (HAIs), Quality of Care, Catheter-Associated Urinary Tract Infection (CAUTI)
Baillie CA, Epps M, Hanish A
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
The researchers evaluated the usability and effectiveness of a computerized clinical decision support (CDS) intervention aimed at reducing the duration of urinary tract catheterizations. They found that usability improved to 15% with the revised reminder. The catheter utilization ratio declined over the 3 time periods, as did CAUTIs per 1,000 patient-days. They concluded that the usability of the reminder was highly dependent on its user interface, with a homegrown version of the reminder resulting in higher impact than a stock reminder.
AHRQ-funded; HS016946.
Citation: Baillie CA, Epps M, Hanish A .
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2014 Sep;35(9):1147-55. doi: 10.1086/677630.
.
.
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Urinary Tract Infection (UTI)
Meddings J, Rogers MA, Krein SL
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
The authors updated a prior systematic review and a meta-analysis regarding interventions prompting urinary catheter (UC) removal by reminders or stop orders. They found that UC reminders and stop orders appear to reduce catheter-associated urinary tract infection rates and should be used to improve patient safety.
AHRQ-funded; 290200710062I; HS019767; HS018344.
Citation: Meddings J, Rogers MA, Krein SL .
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
BMJ Qual Saf 2014 Apr;23(4):277-89. doi: 10.1136/bmjqs-2012-001774.
.
.
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Patient-Centered Outcomes Research, Prevention, Quality Improvement, Urinary Tract Infection (UTI)