National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Antibiotics (2)
- Antimicrobial Stewardship (2)
- Brain Injury (1)
- Care Management (1)
- (-) Critical Care (7)
- Electronic Health Records (EHRs) (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Intensive Care Unit (ICU) (4)
- Kidney Disease and Health (1)
- (-) Medication (7)
- Medication: Safety (2)
- Mortality (1)
- Neurological Disorders (2)
- Newborns/Infants (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (2)
- Prevention (1)
- Quality Improvement (1)
- Quality of Care (1)
- Sepsis (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 7 of 7 Research Studies DisplayedStoops C, Stone S, Evans E
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
The purpose of this study was to test if acute kidney injury (AKI) is preventable in patients in the neonatal intensive care unit and if infants at high-risk of nephrotoxic medication-induced AKI can be identified using a systematic surveillance program previously used in the pediatric non-intensive care unit setting. The authors concluded that a systematic surveillance program to identify high-risk infants can prevent nephrotoxic-induced AKI and has the potential to prevent short and long-term consequences of AKI in critically ill infants.
AHRQ-funded; HS023763.
Citation: Stoops C, Stone S, Evans E .
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
J Pediatr 2019 Dec;215:223-28.e6. doi: 10.1016/j.jpeds.2019.08.046..
Keywords: Newborns/Infants, Medication, Medication: Safety, Patient Safety, Kidney Disease and Health, Intensive Care Unit (ICU), Critical Care, Quality Improvement, Quality of Care, Prevention, Adverse Drug Events (ADE), Adverse Events
Carayon P, Wetterneck TB, Cartmill R
Medication safety in two intensive care units of a community teaching hospital after electronic health record implementation: sociotechnical and human factors engineering considerations.
This study examined the impact of electronic health record (EHR) implementation in two intensive care units (ICUs). The authors assessed 1254 consecutive admissions before and after an EHR implementation. They identified 4063 medication-related events either pre-implementation (2074 events) or post-implementation (1989 events). The overall potential for harm due to medication errors decreased post-implementation, but only 2 of the 3 error rates were significantly lower post-implementation. They observed reductions in rates of medication errors per admission at the stages of transcription, dispensing, and administration. In the ordering stage, 4 error types decreased post-implementation (orders with omitted information, error-prone abbreviations, illegible orders, failure to renew orders) and 4 error types increased post-implementation (orders of wrong drug, orders containing a wrong start or stop time, duplicate orders, orders with inappropriate or wrong information).
AHRQ-funded; HS015274; HS000083.
Citation: Carayon P, Wetterneck TB, Cartmill R .
Medication safety in two intensive care units of a community teaching hospital after electronic health record implementation: sociotechnical and human factors engineering considerations.
J Patient Saf 2021 Aug 1;17(5):e429-e39. doi: 10.1097/pts.0000000000000358.
AHRQ-funded; HS015274; HS000083..
AHRQ-funded; HS015274; HS000083..
Keywords: Medication: Safety, Medication, Intensive Care Unit (ICU), Critical Care, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
Pepper DJ, Sun J, Rhee C
Procalcitonin-guided antibiotic discontinuation and mortality in critically ill adults: a systematic review and meta-analysis.
This study is a systematic review and meta-analysis on survival outcomes of using procalcitonin (PCT)-guided antibiotic discontinuation on critically ill adults. The study quality was assessing with the Cochrane risk of bias tool, and GRADEpro was used to grade evidence. PCT-guided discontinuation was associated with decreased mortality, but there was a high risk of bias in many of the studies reviewed with a low certainty of evidence. The authors suggest properly designed studies with mortality as the primary outcome is needed to further answer this question.
AHRQ-funded; HS025008.
Citation: Pepper DJ, Sun J, Rhee C .
Procalcitonin-guided antibiotic discontinuation and mortality in critically ill adults: a systematic review and meta-analysis.
Chest 2019 Jun;155(6):1109-18. doi: 10.1016/j.chest.2018.12.029..
Keywords: Antibiotics, Critical Care, Evidence-Based Practice, Medication, Mortality, Outcomes, Sepsis
Barbash IJ
Cognitive impairment, anesthesia, and critical illness: learning from the past to gain perspective on the future.
This study examined the link between cognitive impairment, ICU admission and anesthesia. The author’s hypothesis was that patients with cognitive impairment would be more likely to undergo surgical procedures. However, analysis using data from the Mayo Clinical Study on Aging on 1,977 cognitive normal patients, 387 patients with mild cognitive impairment (MCI), and 72 patients with established dementia found that patients with MCI were more likely to undergo anesthesia and those with dementia were less likely to undergo procedural anesthesia. The author hypothesizes this may be linked to impaired decision-making of the patient and the risk-benefit analysis of performing surgery on patients with established dementia. However, ICU admissions were increased in patients with MCI and dementia.
AHRQ-funded; HS025455.
Citation: Barbash IJ .
Cognitive impairment, anesthesia, and critical illness: learning from the past to gain perspective on the future.
Mayo Clin Proc 2018 Nov;93(11):1537-39. doi: 10.1016/j.mayocp.2018.09.007..
Keywords: Adverse Events, Critical Care, Medication, Intensive Care Unit (ICU), Neurological Disorders
Doernberg SB, Aboo LM, Burdette SD
Essential resources and strategies for antibiotic stewardship programs in the acute care setting.
This study measured the success of antibiotic stewardship programs to rates of antibiotic resistant disease. A survey was conducted of US stewardship programs using a cross-section of members of 3 infectious diseases subspecialty societies. Two-hundred forty-four respondents from a variety of acute care settings filled out the survey. Eighty-five percent of surveyed programs demonstrated at least 1 improved outcome in the prior 2 years. Every 0.50 increase in pharmacist and physician full-time equivalent (FTE) support predicted a 1.48-fold increase in demonstration effectiveness.
AHRQ-funded; HS023866.
Citation: Doernberg SB, Aboo LM, Burdette SD .
Essential resources and strategies for antibiotic stewardship programs in the acute care setting.
Clin Infect Dis 2018 Sep 28;67(8):1168-74. doi: 10.1093/cid/ciy255..
Keywords: Antimicrobial Stewardship, Antibiotics, Critical Care, Medication
Mahmoud L, Zullo AR, Thompson BB
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Researchers conducted a retrospective cohort study of 1197 mechanically ventilated patients admitted to a 12-bed neurocritical care unit (NCCU) over four years in order to evaluate the effect of an analgesia-based sedation protocol on medication use and costs in the NCCU. The protocol resulted in increased in fentanyl use and decreased in propofol use, but their findings indicate no effect on healthcare utilization, healthcare costs, or in-hospital mortality. Based on these results, the researchers suggest that similar NCCUs should consider using population-specific protocols to manage analgesia and sedation.
AHRQ-funded; HS022998.
Citation: Mahmoud L, Zullo AR, Thompson BB .
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Brain Inj 2018;32(7):941-47. doi: 10.1080/02699052.2018.1469167..
Keywords: Care Management, Brain Injury, Critical Care, Healthcare Costs, Intensive Care Unit (ICU), Medication, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research
Donnelly JP, Baddley JW, Wang HE
Antibiotic utilization for acute respiratory tract infections in U.S. emergency departments.
Using national surveillance data for acute respiratory tract infections (ARTIs), this study characterized patterns of antibiotic usage in U.S. emergency departments between 2001 and 2010. It found significant progress toward reductions on inappropriate antibiotic use among children; however, adults with ARTI continued to receive inappropriately high amounts of antibiotics.
AHRQ-funded; HS013852
Citation: Donnelly JP, Baddley JW, Wang HE .
Antibiotic utilization for acute respiratory tract infections in U.S. emergency departments.
Antimicrob Agents Chemother. 2014 Mar;58(3):1451-7. doi: 10.1128/AAC.02039-13..
Keywords: Antimicrobial Stewardship, Emergency Medical Services (EMS), Medication, Critical Care