National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (3)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Blood Clots (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Community-Acquired Infections (1)
- Elderly (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (9)
- Health Information Technology (HIT) (1)
- Home Healthcare (1)
- Hospitals (3)
- (-) Infectious Diseases (13)
- Inpatient Care (1)
- Long-Term Care (1)
- Medication (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (3)
- Nursing Homes (1)
- Outcomes (2)
- (-) Patient Safety (13)
- Payment (1)
- Practice Patterns (1)
- Prevention (4)
- Provider (1)
- Provider Performance (1)
- Public Health (1)
- Quality Improvement (1)
- Quality of Care (1)
- Risk (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 13 of 13 Research Studies DisplayedPatel SA, Araujo T, Rodriguez LP
Long peripheral catheters: a retrospective review of major complications.
The risk of infectious and noninfectious complications associated with long peripheral catheters (LPCs) is unknown. In this retrospective study of 539 catheters, the investigators did a retrospective review of major complications. Among other discoveries, they found LPCs were often placed for the indications of difficult access and long-term antibiotics.
AHRQ-funded; HS025891.
Citation: Patel SA, Araujo T, Rodriguez LP .
Long peripheral catheters: a retrospective review of major complications.
J Hosp Med 2019 Dec;14(12):758-60. doi: 10.12788/jhm.3313..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Blood Clots, Infectious Diseases, Risk
Parrish KL, Wylie KM, Reich PJ
Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates.
J Pediatric Infect Dis Soc 2019 Nov 6;8(5):470-73. doi: 10.1093/jpids/piy098.
In this study, the investigators report the prevalence of the tst-1 gene among 252 methicillin-susceptible Staphylococcus aureus (MSSA) isolates and 458 methicillin-resistant S aureus (MRSA) isolates collected from 531 subjects between 2008 and 2017.
In this study, the investigators report the prevalence of the tst-1 gene among 252 methicillin-susceptible Staphylococcus aureus (MSSA) isolates and 458 methicillin-resistant S aureus (MRSA) isolates collected from 531 subjects between 2008 and 2017.
AHRQ-funded; HS024269.
Citation: Parrish KL, Wylie KM, Reich PJ .
Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates.
Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Infectious Diseases, Community-Acquired Infections, Sepsis, Patient Safety
Sheetz KH, Dimick JB, Englesbe MJ
Hospital-acquired condition reduction program is not associated with additional patient safety improvement.
In 2013 the Centers for Medicare and Medicaid Services announced that it would begin levying penalties against hospitals with the highest rates of hospital-acquired conditions through the Hospital-Acquired Condition Reduction Program. This study evaluates whether the program has been successful in improving patient safety or not. The investigators concluded that the program did not improve patient safety in Michigan beyond existing trends.
AHRQ-funded; HS000053; HS026244.
Citation: Sheetz KH, Dimick JB, Englesbe MJ .
Hospital-acquired condition reduction program is not associated with additional patient safety improvement.
Health Aff 2019 Nov;38(11):1858-65. doi: 10.1377/hlthaff.2018.05504..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Provider Performance, Quality Improvement, Quality of Care, Infectious Diseases, Payment
Chopra V, Kaatz S, Swaminathan L
Variation in use and outcomes related to midline catheters: results from a multicentre pilot study.
This study examined complication rates from placement of midline vascular catheters. They have become more common in use recently. Complications were analyzed using medical records from hospitalized patients in 12 hospitals from January 2017 to February 2018. Most midline catheters were placed in general ward settings for difficult intravenous access. About half were removed within 5 days of insertion. Major or minor complications occurred in 10.3% of midlines with minor complications accounting for 71% of all adverse events. These minor complications included dislodgement, leaking, and infiltration. Major complications included occlusion, upper-extremity DVT and BSI. Use of midlines and outcomes varied widely across hospitals.
AHRQ-funded; HS025891.
Citation: Chopra V, Kaatz S, Swaminathan L .
Variation in use and outcomes related to midline catheters: results from a multicentre pilot study.
BMJ Qual Saf 2019 Sep;28(9):714-20. doi: 10.1136/bmjqs-2018-008554..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases, Adverse Events, Practice Patterns, Outcomes, Hospitals
Anderson DJ, Watson S, Moehring RW
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Watson S, Moehring RW .
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Hospitals, Infectious Diseases, Medication, Patient Safety
Krein SL, Saint S, Trautner BW
Patient-reported complications related to peripherally inserted central catheters: a multicentre prospective cohort study.
The objective of this study was to systematically elicit and characterize peripherally inserted central catheter-related complications as experienced by patients during and after hospitalization. Results showed that over 60% of patients reported signs or symptoms of a possible complication or adverse effect after peripherally inserted central catheter placement. Bothersome complications from the patient perspective were more common than those that typically rise to the level of healthcare provider attention or concern. Recommendations included an understanding of the patient experience in order to provide safe and effective care.
AHRQ-funded; HS025891.
Citation: Krein SL, Saint S, Trautner BW .
Patient-reported complications related to peripherally inserted central catheters: a multicentre prospective cohort study.
BMJ Qual Saf 2019 Jul;28(7):574-81. doi: 10.1136/bmjqs-2018-008726..
Keywords: Adverse Events, Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases
Burnham JP, Fritz SA, Yaeger LH
Telemedicine infectious diseases consultations and clinical outcomes: a systematic review and meta-analysis protocol.
This article describes a proposed systematic review that will evaluate the current evidence on the effect of telemedicine infectious diseases consultation within a range of clinical outcomes, including mortality, hospital readmission, antimicrobial use, and cost. Standard systematic review methodology will be used. Data will be grouped by outcome. Primary outcome will be 30-day all-cause mortality. Secondary outcomes will include: readmission within 30 days after discharge from an initial hospitalization with an infection; patient compliance/adherence; patient satisfaction; cost effectiveness; hospital length of stay, use of antimicrobials and antimicrobial stewardship. The findings of this review will add to the established literature regarding feasibility of telemedicine consultation.
AHRQ-funded; HS024269.
Citation: Burnham JP, Fritz SA, Yaeger LH .
Telemedicine infectious diseases consultations and clinical outcomes: a systematic review and meta-analysis protocol.
Syst Rev 2019 Jun 7;8(1):135. doi: 10.1186/s13643-019-1056-y..
Keywords: Evidence-Based Practice, Health Information Technology (HIT), Infectious Diseases, Outcomes, Patient Safety
Musuuza JS, Guru PK, O'Horo JC
The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis.
This review and meta-analysis examined the effect of chlorhexidine gluconate (CHG) bathing on reducing hospital-acquired bloodstream infections (HABSIs) and also assessed fidelity to the implementation of this intervention. The literature research included randomized controlled trials, cluster randomized trials, and quasi-experimental studies that evaluated the effect of CHG bathing versus a non-CHG comparator; studies involving pediatric patients, pre-surgical CHG use, and those without a non-CHG comparison arm were excluded. Outcomes were HABSIs, patient-centered outcomes, and implementation fidelity assessed through five elements: adherence, exposure or dose, quality of delivery, participant responsiveness, and program differentiation. The findings indicate that patient bathing with CHG significantly reduced the incidence of HABSIs in both ICU and non-ICU settings. Many studies, however, did not report fidelity to intervention or patient-centered outcomes.
AHRQ-funded; HS024039.
Citation: Musuuza JS, Guru PK, O'Horo JC .
The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis.
BMC Infect Dis 2019 May 14;19(1):416. doi: 10.1186/s12879-019-4002-7..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention
Woodard JA, Leekha S, Jackson SS
Beyond entry and exit: Hand hygiene at the bedside.
This study assessed compliance with, knowledge of, and attitudes toward the World Health Organization (WHO) 5 moments for hand hygiene (HH) using a modified WHO HH observation form and a survey that assessed health care personnel (HCP) knowledge, opinions, and barriers to HH. Of the 218 HCPs who completed the survey, less than one-third were familiar with the WHO 5 moments and only 21& of that group could recall the 5 moments. 302 HH opportunities in 104 unique HCP-patient interactions were observed, but with infrequent compliance. The researchers conclude that lack of recognition of opportunities at the bedside and for glove use may contribute to low compliance.
AHRQ-funded; HS024108.
Citation: Woodard JA, Leekha S, Jackson SS .
Beyond entry and exit: Hand hygiene at the bedside.
Am J Infect Control 2019 May;47(5):487-91. doi: 10.1016/j.ajic.2018.10.026..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention, Provider, Public Health
Jarvenpaa M, Sater MRA, Lagoudas GK
A Bayesian model of acquisition and clearance of bacterial colonization incorporating within-host variation.
The authors present a Bayesian model that provides probabilities of whether two bacterial strains could be considered the same. This will help in predicting the spread of infections such as methicillin resistant Staphylococcus aureus (MRSA).
AHRQ-funded; HS019388.
Citation: Jarvenpaa M, Sater MRA, Lagoudas GK .
A Bayesian model of acquisition and clearance of bacterial colonization incorporating within-host variation.
PLoS Comput Biol 2019 Apr 22;15(4):e1006534. doi: 10.1371/journal.pcbi.1006534..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Patient Safety
Keller SC, Cosgrove SE, Kohut M
Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy.
This study looked at hazards that patients undergoing outpatient parenteral antimicrobial therapy (OPAT) have to avoid while undergoing the treatment at home with a venous catheter. A qualitative study was conducted with patients discharged from 2 academic medical centers in Baltimore, Maryland. Hazards identified included bathing, pets, temperature extremes, household clutter, food and soil exposures and travel. Patients that were interviewed developed strategies to avoid these hazards.
AHRQ-funded; HS025782.
Citation: Keller SC, Cosgrove SE, Kohut M .
Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy.
Am J Infect Control 2019 Apr;47(4):425-30. doi: 10.1016/j.ajic.2018.09.020..
Keywords: Home Healthcare, Infectious Diseases, Patient Safety, Prevention
Jackson SS, Lydecker AD, Magder LS
Development and validation of a clinical prediction rule to predict transmission of methicillin-resistant Staphylococcus aureus in nursing homes.
This study’s goal was to develop and validate a clinical prediction rule that can predict transmission of methicillin-resistant Staphylococcus aureus (MRSA) in nursing homes. The researchers wanted to identify residents who were most likely to transmit MRSA to health-care workers (HCWs) on their hands or clothing during clinical care. Demographic and clinical characteristic data was used from residents of community nursing homes in Maryland and Michigan from 2012 to 2014. The clinical prediction rule that was developed was then externally validated in a cohort of Department of Veterans Affairs nursing home residents from 7 states between 2012 and 2016. Variables in the prediction model included sex, race, resident dependency on care, the presence of any medical device, diabetes mellitus, and chronic skin breakdown. The prediction model showed good performance although it showed less utility in the validation cohort.
AHRQ-funded; HS019979.
Citation: Jackson SS, Lydecker AD, Magder LS .
Development and validation of a clinical prediction rule to predict transmission of methicillin-resistant Staphylococcus aureus in nursing homes.
Am J Epidemiol 2019 Jan;188(1):214-21. doi: 10.1093/aje/kwy220..
Keywords: Elderly, Healthcare-Associated Infections (HAIs), Infectious Diseases, Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Nursing Homes, Patient Safety
Rosenman MB, Szucs KA, Finnell SM
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
The authors sought to build and to begin evaluating a regional automated system to notify infection preventionists (IPs) when a patient with a history of gram-negative rod multidrug-resistant organism (GNRMDRO) is admitted to an emergency department (ED) or inpatient setting. They found it feasible to create a regional microbiology-based alert system and observed substantial crossover between institutions. They concluded that this system, if it contributes to timely isolation, may help reduce the spread of GNRMDROs.
AHRQ-funded; HS020014.
Citation: Rosenman MB, Szucs KA, Finnell SM .
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S40-7. doi: 10.1086/677833.
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Keywords: Emergency Department, Infectious Diseases, Inpatient Care, Patient Safety, Prevention