National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Behavioral Health (1)
- Case Study (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- (-) Children/Adolescents (10)
- Communication (1)
- COVID-19 (2)
- (-) Critical Care (10)
- Diagnostic Safety and Quality (2)
- Healthcare-Associated Infections (HAIs) (1)
- Hospitals (1)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (5)
- Medical Errors (1)
- Patient Safety (3)
- Public Health (1)
- Quality Improvement (2)
- Quality of Care (2)
- Registries (1)
- Respiratory Conditions (1)
- Simulation (2)
- Training (1)
- Urinary Tract Infection (UTI) (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 10 of 10 Research Studies DisplayedGeneslaw AS, Lu Y, Miles CH
Long-term increases in mental disorder diagnoses after invasive mechanical ventilation for severe childhood respiratory disease: a propensity matched observational cohort study.
They found that children without major comorbidity requiring invasive mechanical ventilation for severe respiratory illness had a 43% higher incidence of subsequent mental disorder diagnoses and a 67% higher incidence of psychotropic medication use. Both increases were substantially higher than in PICU patients with respiratory illness not necessitating invasive mechanical ventilation. They recommended further research to determine which factors related to invasive mechanical ventilation and severe respiratory illness are associated with abnormal neurodevelopment.
AHRQ-funded; HS022941.
Citation: Geneslaw AS, Lu Y, Miles CH .
Long-term increases in mental disorder diagnoses after invasive mechanical ventilation for severe childhood respiratory disease: a propensity matched observational cohort study.
Pediatr Crit Care Med 2021 Dec;22(12):1013-25. doi: 10.1097/pcc.0000000000002790..
Keywords: Children/Adolescents, Respiratory Conditions, Behavioral Health, Critical Care
Woods-Hill CZ, Koontz DW, Voskertchian A
Consensus recommendations for blood culture use in critically ill children using a modified Delphi approach.
Blood cultures are fundamental in evaluating for sepsis, but excessive cultures can lead to false-positive results and unnecessary antibiotics. The study objective was to create consensus recommendations focusing on when to safely avoid blood cultures in PICU patients. Using a modified Delphi process, the investigators created consensus recommendations on when to avoid blood cultures and prevent overuse in the PICU.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, Voskertchian A .
Consensus recommendations for blood culture use in critically ill children using a modified Delphi approach.
Pediatr Crit Care Med 2021 Sep;22(9):774-84. doi: 10.1097/pcc.0000000000002749..
Keywords: Children/Adolescents, Critical Care
Cifra CL, Custer JW, Singh H
Diagnostic errors in pediatric critical care: a systematic review.
This study is a systematic review on the prevalence, impact, and contributing factors related to diagnostic errors in the PICU. A database search was done for literature up through December 2019. Using specific criteria, 396 abstracts were screened, and 17 studies were included. Fifteen of 17 studies had an observational research design. Autopsy studies showed a 10-23% rate of missed major diagnosis with 5-16% of the errors having a potential adverse impact on survival and would have changed care management. Retrospective record review studies reported varying rates of diagnostic error from 8% in a general PICU population to 12% among unexpected critical admissions. About a quarter of those patients were discussed at PICU morbidity and mortality conferences. Most misdiagnosed conditions were cardiovascular, infectious, congenital, or neurologic. System, cognitive, and both system and cognitive factors were associated with diagnostic error but there is limited information on the impact of misdiagnosis.
AHRQ-funded; HS026965.
Citation: Cifra CL, Custer JW, Singh H .
Diagnostic errors in pediatric critical care: a systematic review.
Pediatr Crit Care Med 2021 Aug;22(8):701-12. doi: 10.1097/pcc.0000000000002735..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Intensive Care Unit (ICU), Critical Care
Becker AE, Chiotos K, McGuire JL
Intracranial hypertension in multisystem inflammatory syndrome in children.
The authors presented 4 patients with multisystem inflammatory syndrome in children who had intracranial hypertension and discussed the unique management considerations when this occurs concurrently with significant myocardial dysfunction.
AHRQ-funded; HS026393.
Citation: Becker AE, Chiotos K, McGuire JL .
Intracranial hypertension in multisystem inflammatory syndrome in children.
J Pediatr 2021 Jun;233:263-67. doi: 10.1016/j.jpeds.2021.02.062..
Keywords: Children/Adolescents, COVID-19, Critical Care, Case Study
Cifra Cifra, CL Dukes, KC Ayres, et al.
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
This pilot study’s goal was to determine the feasibility of using focused ethnography to understand the relationship between referral communication and the diagnostic process for critically ill children. Findings showed that focused ethnography in the pediatric intensive care unit is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children.
AHRQ-funded; HS026965.
Citation: Cifra Cifra, CL Dukes, KC Ayres, et al..
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
J Crit Care 2021 Jun;63:246-49. doi: 10.1016/j.jcrc.2020.09.011..
Keywords: Children/Adolescents, Communication, Critical Care, Intensive Care Unit (ICU), Diagnostic Safety and Quality
Colman N, Newman JW, Nishisaki A
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
This single-center retrospective review discusses a translational simulation conducted to improve compliance with the National Emergency Airway Registry for Children (NEAR4KIDS) Airway Safety Quality Improvement (QI) bundle to improve the safety of tracheal intubations. The simulation was implemented between March and December 2018. Bundle adherence was assessed 12 months before simulation and 9 months after. Primary outcomes measures were compliance with the bundle and utilization of apneic oxygenation and secondary outcomes was the occurrence of adverse tracheal intubation-associated events. Preintervention bundle compliance was 66%, which increased to 93.7% after the simulation intervention. Adherence to apneic oxygenation was 27.9% before the intervention and increased to 77.9% after. There was no difference in the occurrence of tracheal intubation events.
AHRQ-funded; HS024511.
Citation: Colman N, Newman JW, Nishisaki A .
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
Pediatr Qual Saf 2021 May-Jun;6(3):e409. doi: 10.1097/pq9.0000000000000409..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Registries, Simulation, Patient Safety, Quality Improvement, Quality of Care
Nishisaki A, Lee A, Li S
Sustained improvement in tracheal intubation safety across a 15-center quality-improvement collaborative: an interventional study from the national emergency airway registry for children investigators.
The authors sought to evaluate the effect of a tracheal intubation safety bundle on adverse tracheal intubation-associated events across 15 PICUs. The safety bundle included a quarterly site benchmark performance reports and an airway safety checklist consisting of preprocedure risk factor, approach, and role planning, preprocedure bedside "time-out," and immediate postprocedure debriefing. The authors found that effective implementation of a quality-improvement bundle was associated with a decrease in the adverse tracheal intubation-associated event that was sustained for 24 months.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Nishisaki A, Lee A, Li S .
Sustained improvement in tracheal intubation safety across a 15-center quality-improvement collaborative: an interventional study from the national emergency airway registry for children investigators.
Crit Care Med 2021 Feb;49(2):250-60. doi: 10.1097/ccm.0000000000004725..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Patient Safety, Quality Improvement, Quality of Care
Balikai SC, Badheka A, Casey A
Simulation to train pediatric ICU teams in endotracheal intubation of patients with COVID-19.
This paper describes the outcomes of pediatric intensive care unit (PICU) simulation training to safely perform endotracheal intubations in children with suspected or confirmed COVID-19. Confidence levels before and after training was measured using the Simulation Effectiveness Tool-Modified (SET-M, Likert scale 0-2). Fifty unique PICU staff members participated in 9 simulation sessions and mean confidences scores increased from 0.9 to 2.
AHRQ-funded; HS026965.
Citation: Balikai SC, Badheka A, Casey A .
Simulation to train pediatric ICU teams in endotracheal intubation of patients with COVID-19.
Pediatr Qual Saf 2021 Jan-Feb;6(1):e373. doi: 10.1097/pq9.0000000000000373..
Keywords: Children/Adolescents, COVID-19, Intensive Care Unit (ICU), Critical Care, Simulation, Training, Public Health, Infectious Diseases
Balamuth F, Weiss SL, Neuman MI
Pediatric severe sepsis in U.S. children's hospitals.
The objective of this study was to compare epidemiological trends in the prevalence, resource utilization, and mortality of pediatric patients with severe sepsis and septic shock. The researchers found that the prevalence of severe sepsis/septic shock has increased in the studied U.S. children’s hospitals between 2004 and 2012, whereas resource utilization and mortality have decreased over that time period.
AHRQ-funded; HS021114
Citation: Balamuth F, Weiss SL, Neuman MI .
Pediatric severe sepsis in U.S. children's hospitals.
Pediatr Crit Care Med. 2014 Nov;15(9):798-805. doi: 10.1097/pcc.0000000000000225..
Keywords: Hospitals, Children/Adolescents, Critical Care
Patrick SW, Kawai AT, Kleinman K
Health care-associated infections among critically ill children in the US, 2007-2012.
The researchers examined trends in central line-associated blood stream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and ventilator-associated pneumonia (VAP) incidence rates between 2007 and 2012 based on standardized surveillance data from pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs) in the United States. They found that incidence rates of CLABSIs and VAPs decreased among critically ill neonates and children during this period.
AHRQ-funded; HS018414.
Citation: Patrick SW, Kawai AT, Kleinman K .
Health care-associated infections among critically ill children in the US, 2007-2012.
Pediatrics 2014 Oct;134(4):705-12. doi: 10.1542/peds.2014-0613..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Urinary Tract Infection (UTI), Critical Care, Children/Adolescents, Healthcare-Associated Infections (HAIs)