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
- Ambulatory Care and Surgery (2)
- Breast Feeding (1)
- Burnout (1)
- Cancer (1)
- Care Coordination (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (2)
- Community-Acquired Infections (1)
- Community-Based Practice (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (2)
- Critical Care (2)
- Decision Making (2)
- Education: Academic (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Preparedness (1)
- Falls (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
- Health Services Research (HSR) (1)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospital Readmissions (1)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- Inpatient Care (3)
- Intensive Care Unit (ICU) (3)
- Labor and Delivery (1)
- Maternal Care (1)
- Neonatal Intensive Care Unit (NICU) (2)
- Newborns/Infants (2)
- (-) Nursing (15)
- Outcomes (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Patient Safety (1)
- Practice Patterns (1)
- Pregnancy (1)
- Pressure Ulcers (1)
- Prevention (2)
- Provider (3)
- Provider: Nurse (5)
- Public Health (1)
- Quality Indicators (QIs) (3)
- Quality Measures (2)
- Quality of Care (5)
- Research Methodologies (1)
- Skin Conditions (1)
- Social Determinants of Health (1)
- Teams (2)
- Treatments (1)
- Women (1)
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 15 of 15 Research Studies DisplayedThate JA, Couture B, Schnock KO
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
It is clear that interdisciplinary communication and collaboration have the potential to mitigate healthcare-associated harm, yet there is limited research on how communication through documentation in the patient record can support collaborative decision making. Understanding what information is needed to support collaborative decision making is necessary to design electronic health information systems that facilitate effective communication and, ultimately, safe care. To explore this issue, the investigators focused on information needs related to central venous catheter management and the prevention of central line-associated blood stream infections.
AHRQ-funded; HS0235335.
Citation: Thate JA, Couture B, Schnock KO .
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
Comput Inform Nurs 2020 Nov 2;39(4):208-14. doi: 10.1097/cin.0000000000000683..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Decision Making, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Smith JG, Rogowski JA, Lake ET
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
Being unable to provide required nursing care to infants could contribute to poorer neonatal nurse job outcomes, which may exacerbate staffing challenges. Little evidence exists about how missed nursing care relates to neonatal nurse job outcomes. The purpose of this study was to determine relationships among missed nursing care, job enjoyment and intention to leave for neonatal nurses.
AHRQ-funded; HS024918.
Citation: Smith JG, Rogowski JA, Lake ET .
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
J Nurs Manag 2020 Nov;28(8):1940-47. doi: 10.1111/jonm.12943..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Provider: Nurse, Provider, Burnout, Nursing
Gance-Cleveland B, McDonald CC, Walker RK
Use of theory to guide development and application of sensor technologies in nursing.
In this paper, three nurse scientists summarize their presentations at the Council for the Advancement of Nursing Science 2019 Advanced Methods Conference on Expanding Science of Sensor Technology in Research discussing the theoretical underpinnings of sensor technologies development and use in nursing research and practice.
AHRQ-funded; HS024738; HS018646.
Citation: Gance-Cleveland B, McDonald CC, Walker RK .
Use of theory to guide development and application of sensor technologies in nursing.
Nurs Outlook 2020 Nov-Dec;68(6):698-710. doi: 10.1016/j.outlook.2020.04.007..
Keywords: Health Information Technology (HIT), Nursing, Health Services Research (HSR), Research Methodologies
Lake ET, Staiger DO, Cramer E
Association of patient acuity and missed nursing care in U.S. neonatal intensive care units.
The health outcomes of infants in neonatal intensive care units (NICUs) may be jeopardized when required nursing care is missed. The authors conducted a correlational study of using 2016 NICU registered nurse survey responses from the National Database of Nursing Quality Indicators. They found that 36% of nurses missed one or more care activities on their past shift. The most common activities missed involved patient comfort and counseling and parent education. They recommended that nurses' assignments account for patient acuity. NICU nurse staffing and work environments warrant attention to reduce missed care and promote optimal infant and family outcomes.
AHRQ-funded; HS024918.
Citation: Lake ET, Staiger DO, Cramer E .
Association of patient acuity and missed nursing care in U.S. neonatal intensive care units.
Med Care Res Rev 2020 Oct;77(5):451-60. doi: 10.1177/1077558718806743..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Nursing, Quality Indicators (QIs), Quality of Care
Burns Z, Khasnabish S, Hurley AC
Classification of injurious fall severity in hospitalized adults.
The purpose of this project was to refine the National Database of Nursing Quality Indicators Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries. Three subcategories were created: A - injuries that caused temporary functional impairment, major facial injury without internal injury, or disruption of a surgical wound; B - injuries that caused long-term functional impairment or had the potential risk of increased mortality; and C - injuries that had a well-established risk of mortality. These subcategories enhanced the National Database of Nursing Quality Indicators categorization. Using this project’s administration manual, trained personnel can classify injurious fall severity with excellent reliability.
AHRQ-funded; HS025128.
Citation: Burns Z, Khasnabish S, Hurley AC .
Classification of injurious fall severity in hospitalized adults.
J Gerontol A Biol Sci Med Sci 2020 Sep 25;75(10):e138-e44. doi: 10.1093/gerona/glaa004..
Keywords: Elderly, Falls, Injuries and Wounds, Nursing, Quality Measures, Quality Indicators (QIs), Quality of Care, Inpatient Care
Bettencourt AP, Vance AJ, Jun J
Maximizing the academic nursing model in the era of COVID-19 and beyond.
This opinion paper revisits the 2016 American Association of Colleges of Nursing (AACN) position statement on academic nursing. In the age of COVID-19, the statement is reimagined as a means to maximize nursing’s contributions to this global health crises. The 2016 position statement discussed the potentials for nursing schools to work within healthcare systems beyond clinic training. Most academic nurses do not also provide clinical care which is limited by structural barriers that inhibit academic nursing transformation. Many academic nurses who also have a clinical practice have had to do so on their own time. This new vision would capitalize on nursing’s strength in population health. The authors urge nursing schools to transform their model of academic nursing.
AHRQ-funded; HS024552.
Citation: Bettencourt AP, Vance AJ, Jun J .
Maximizing the academic nursing model in the era of COVID-19 and beyond.
Nurs Outlook 2020 Sep-Oct;68(5):542-44. doi: 10.1016/j.outlook.2020.04.013..
Keywords: COVID-19, Nursing, Provider: Nurse, Public Health, Education: Academic
Simpson KR, Lyndon A, Spetz J
Missed nursing care during labor and birth and exclusive breast milk feeding during hospitalization for childbirth.
The purpose of this study was to determine associations between missed nursing care and nurse staffing during labor and birth, and exclusive breast milk feeding at hospital discharge. Exclusive breast milk feeding is a national quality indicator of inpatient maternity care. Nurses have substantial responsibility for direct support of infant feeding during the childbirth hospitalization. The investigators indicate that the results support exclusive breast milk feeding as a nurse-sensitive quality indicator.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Missed nursing care during labor and birth and exclusive breast milk feeding during hospitalization for childbirth.
MCN Am J Matern Child Nurs 2020 Sep/Oct;45(5):280-88. doi: 10.1097/nmc.0000000000000644..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Breast Feeding, Inpatient Care, Nursing, Women
Shuman CJ, Costa DK
Stepping in, stepping up, and stepping out: competencies for intensive care unit nursing leaders during disasters, emergencies, and outbreaks.
In this paper, the authors discuss competencies for intensive care unit nursing leaders during disasters, emergencies, and outbreaks. They draw on the recent example of COVID-19s substantially burdened intensive care units and nursing staff. Informed by extant literature, American Organization of Nurse Leaders--identified competencies, and expert opinion, the authors suggest 3 areas of focused skill development to ensure leaders, especially leaders in ICU settings, are prepared for future crises.
AHRQ-funded; HS024552.
Citation: Shuman CJ, Costa DK .
Stepping in, stepping up, and stepping out: competencies for intensive care unit nursing leaders during disasters, emergencies, and outbreaks.
Am J Crit Care 2020 Sep 1;29(5):403-06. doi: 10.4037/ajcc2020421..
Keywords: Critical Care, Provider: Nurse, Nursing, COVID-19, Emergency Preparedness
Lafferty M, Fauer A, Wright N
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
The purpose of this study was to examine the causes and consequences of chemotherapy treatment delays and possible solutions to improve quality of care. The authors identified four primary themes from the analysis that affect delays. They suggest future investigations to examine nurses' communication practices in the context of timely chemotherapy administration since communication and documentation technologies within healthcare settings continuously evolve.
AHRQ-funded; HS024914.
Citation: Lafferty M, Fauer A, Wright N .
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
Oncol Nurs Forum 2020 Jul 1;47(4):417-27. doi: 10.1188/20.Onf.417-427..
Keywords: Treatments, Cancer, Ambulatory Care and Surgery, Quality of Care, Clinician-Patient Communication, Communication, Provider: Nurse, Provider, Nursing, Chronic Conditions
Dowding D, Russell D, Trifilio M
Home care nurses' identification of patients at risk of infection and their risk mitigation strategies: a qualitative interview study.
Investigators sought to understand if and how home care nurses identify patients at high risk of infection and which strategies they use to mitigate that risk. Interviews with fifty nurses were audio recorded and transcribed. Factors identified by the nurses as putting a patient at higher risk of infection included being older, having diabetes, and inadequate nutrition as well as inadequate clinical information available at start of care. The main strategy for infection prevention was patient and caregiver education. Nurses also discussed the importance of their own infection prevention behaviors and the ability to adjust a patient's plan of care according to their infection risk.
AHRQ-funded; HS024723.
Citation: Dowding D, Russell D, Trifilio M .
Home care nurses' identification of patients at risk of infection and their risk mitigation strategies: a qualitative interview study.
Int J Nurs Stud 2020 Jul;107:103617. doi: 10.1016/j.ijnurstu.2020.103617..
Keywords: Home Healthcare, Community-Acquired Infections, Infectious Diseases, Patient Safety, Prevention, Nursing, Decision Making
Baernholdt M, Yan G, Hinton ID
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
This study looked at the effects of nursing care interventions aimed at preventing pressure ulcers in rural and urban hospitals over a 4-year period. This longitudinal study used unit-level data from the National Database of Nursing Quality Indicators 2010-2013. The authors analyzed 5761 units (332 rural and 5429 urban) in 772 hospitals (89 rural and 683 urban) that reported ulcer rates in two or more quarters. Outcomes from use of a three-care intervention combination was measured with decreases in pressure ulcers shown from any of those interventions (patients receiving skin assessment on admission, receiving risk assessment on admission, and receiving any risk assessment before the pressure ulcer). An increase in RN skill mix and two nurse outcomes (increase in job satisfaction and intent-to-stay) also led to decreases in ulcer rates.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Yan G, Hinton ID .
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
Int J Nurs Stud 2020 May;105:103455. doi: 10.1016/j.ijnurstu.2019.103455..
Keywords: Pressure Ulcers, Prevention, Skin Conditions, Nursing, Practice Patterns, Provider: Nurse, Provider, Quality Indicators (QIs), Quality Measures, Quality of Care
Nembhard IM, Buta E, Lee YSH
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
The authors assessed effects of adding care coordination formally to nurses’ roles on care experiences of high-risk patients and clinician teamwork during the first 6 months of use. They conducted a quasi-experimental study in which changes in staff and patient experiences at six community health center practice locations that introduced the added-role approach for high-risk patients were compared to changes in six locations without the program in the same health system. They found that there were some positive effects of adding care coordination to nurses' role within 6 months of implementation, suggesting value in this improvement strategy. They concluded that addressing compatibility between coordination and other job demands is important when implementing this approach to coordination.
AHRQ-funded; HS016978.
Citation: Nembhard IM, Buta E, Lee YSH .
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
BMC Health Serv Res 2020 Feb 24;20(1):137. doi: 10.1186/s12913-020-4986-0..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Care Coordination, Nursing, Patient Experience, Community-Based Practice, Patient-Centered Healthcare, Ambulatory Care and Surgery, Teams
Kelly Costa D, Liu H, Boltey EM
The structure of critical care nursing teams and patient outcomes: a network analysis.
This examined the connectiveness of critical nursing teams and patient outcomes. The study measured “coreness” (the degree to which a network is represented by a densely integrated core) and “betweenness” (whether a nurse lies on the path of others not directly connected). The researchers used ICU data from a medical center during 2011 and looked at nurses who worked in surgical ICU (SICU) or neurosurgical ICU (NICU) during that same time period. The sample included 598 adult patients and 281 nurses. The researchers found that the greater the coreness of the team, and the more betweenness there was with ICU nurses the less likely patients were to die.
AHRQ-funded; HS024552.
Citation: Kelly Costa D, Liu H, Boltey EM .
The structure of critical care nursing teams and patient outcomes: a network analysis.
Am J Respir Crit Care Med 2020 Feb 15;201(4):483-85. doi: 10.1164/rccm.201903-0543LE..
Keywords: Intensive Care Unit (ICU), Critical Care, Nursing, Teams, Outcomes, Healthcare Delivery, Patient-Centered Outcomes Research, Patient-Centered Healthcare
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.
.
.
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