National Healthcare Quality and Disparities Report
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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
26 to 50 of 191 Research Studies DisplayedHan JH, Sullivan N, Leas BF
Cleaning hospital room surfaces to prevent health care-associated infections: a technical brief.
The authors review the evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness. Their review of the literature indicates an increased interest in environmental cleaning and disinfecting for the prevention of HAIs. However, there are many limitations in the current evidence base.
AHRQ-funded; 290201200011I.
Citation: Han JH, Sullivan N, Leas BF .
Cleaning hospital room surfaces to prevent health care-associated infections: a technical brief.
Ann Intern Med 2015 Oct 20;163(8):598-607. doi: 10.7326/m15-1192..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Healthcare-Associated Infections (HAIs), Patient Safety
Peterson LR, Wright MO, Beaumont JL
Nonimpact of decolonization as an adjunctive measure to contact precautions for the control of methicillin-resistant Staphylococcus aureus transmission in acute care.
This was an observational study comparing methicillin-resistant Staphylococcus aureus (MRSA) transmission with no decolonization of medical patients to required decolonization of all MRSA carriers during two consecutive periods: baseline with no decolonization of medical patients and universal MRSA carrier decolonization. The study concluded that decolonization of MRSA patients does not add benefit when contact precautions are used for patients colonized with MRSA in acute (hospital) care.
AHRQ-funded; HS019968.
Citation: Peterson LR, Wright MO, Beaumont JL .
Nonimpact of decolonization as an adjunctive measure to contact precautions for the control of methicillin-resistant Staphylococcus aureus transmission in acute care.
Antimicrob Agents Chemother 2015 Oct 12;60(1):99-104. doi: 10.1128/aac.02046-15.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Critical Care, Antimicrobial Stewardship, Elderly, Patient Safety
Kho JY, Johns BD, Thomas GW
A hybrid reality radiation-free simulator for teaching wire navigation skills.
The objective of this study was to assess the construct validity for a novel radiation-free simulator designed to teach wire navigation skills in hip fracture fixation. It found that the magnitude of improvement on successive simulator attempts was dependent on the level of expertise; tip-apex distance improved significantly in the novice group, whereas it was unchanged in the experienced group.
AHRQ-funded; HS022077.
Citation: Kho JY, Johns BD, Thomas GW .
A hybrid reality radiation-free simulator for teaching wire navigation skills.
J Orthop Trauma 2015 Oct;29(10):e385-90. doi: 10.1097/bot.0000000000000372..
Keywords: Surgery, Training, Health Information Technology (HIT), Injuries and Wounds, Patient Safety
Weinger MB, Slagle JM, Kuntz AH
A multimodal intervention improves postanesthesia care unit handovers.
The researchers introduced a multimodal intervention in an adult and a pediatric postanesthesia care unit (PACU) to improve postoperative handovers between anesthesia providers (APs) and PACU registered nurses (RNs). They concluded that a multimodal intervention substantially improved interprofessional PACU handovers, including those by clinicians who had not undergone formal simulation training.
AHRQ-funded; HS016651.
Citation: Weinger MB, Slagle JM, Kuntz AH .
A multimodal intervention improves postanesthesia care unit handovers.
Anesth Analg 2015 Oct;121(4):957-71. doi: 10.1213/ane.0000000000000670..
Keywords: Patient Safety, Care Coordination, Surgery
Hollenbeck BK, Dunn RL, Suskind AM
Ambulatory surgery centers and their intended effects on outpatient surgery.
Using a twenty percent national sample of Medicare beneficiaries, the researchers assessed the impact of ambulatory surgery centers (ASCs) on rates of hospital-based outpatient procedures and adverse events. They found that opening of an ambulatory surgery center in a Hospital Service Area resulted in a decline in hospital-based outpatient surgery without increasing mortality or admission.
AHRQ-funded; HS020927; HS018726.
Citation: Hollenbeck BK, Dunn RL, Suskind AM .
Ambulatory surgery centers and their intended effects on outpatient surgery.
Health Serv Res 2015 Oct;50(5):1491-507. doi: 10.1111/1475-6773.12278..
Keywords: Ambulatory Care and Surgery, Adverse Events, Patient Safety
McElroy LM, Macapagal KR, Collins KM
Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study.
The goal of this study is to use qualitative research methods to describe clinician perceptions of OR-to-ICU handoffs, and to elucidate attributes of the handoff process associated with high quality, as well as those with poor quality that can lead to patient harm. The findings suggest that ambiguous roles and conflicting expectations of team members during the OR-to-ICU handoff can increase risk of patient harm.
AHRQ-funded; HS000078.
Citation: McElroy LM, Macapagal KR, Collins KM .
Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study.
Am J Surg 2015 Oct;210(4):629-35. doi: 10.1016/j.amjsurg.2015.05.008..
Keywords: Patient Safety, Intensive Care Unit (ICU), Surgery, Adverse Events, Care Coordination
Feldman DS, Bollman DL, Fridman M
Do laborists improve delivery outcomes for laboring women in California community hospitals?
The researchers sought to determine the impact of the laborists staffing model on cesarean rates and maternal morbidity in California community hospitals. They were unable to demonstrate differences in cesarean and maternal childbirth complication rates in community hospitals with and without laborists.
AHRQ-funded; HS020915.
Citation: Feldman DS, Bollman DL, Fridman M .
Do laborists improve delivery outcomes for laboring women in California community hospitals?
Am J Obstet Gynecol 2015 Oct;213(4):587.e1-87.e13. doi: 10.1016/j.ajog.2015.05.051..
Keywords: Labor and Delivery, Outcomes, Patient Safety, Women
Patorno E, Wang SV, Schneeweiss S
Patterns of beta-blocker initiation in patients undergoing intermediate to high-risk noncardiac surgery.
The objective of this study is to examine patterns of β-Blocker initiation among patients undergoing noncardiac elective surgery in the US. It concluded that after a period of a rapidly increasing trend, perioperative β-Blocker initiation decreased sharply in the second half of 2008 and continued to decrease afterwards.
AHRQ-funded; HS022193.
Citation: Patorno E, Wang SV, Schneeweiss S .
Patterns of beta-blocker initiation in patients undergoing intermediate to high-risk noncardiac surgery.
Am Heart J 2015 Oct;170(4):812-20.e6. doi: 10.1016/j.ahj.2015.06.028..
Keywords: Surgery, Patient-Centered Outcomes Research, Patient Safety, Medication
Wiseman JT, Fernandes-Taylor S, Barnes ML
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
This study explored the factors that lead to postdischarge surgical site infections (SSI), investigated the differences between risk factors for in-hospital vs postdischarge SSI, and developed a scoring system to identify patients who might benefit from postdischarge monitoring of their wounds. In a comparative analysis, it found that comorbidities were the primary driver of postdischarge SSI, whereas in-hospital factors (operative time, emergency case status) and complications predicted in-hospital SSI.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
J Vasc Surg 2015 Oct;62(4):1023-31.e5. doi: 10.1016/j.jvs.2015.04.453..
Keywords: Surgery, Hospital Discharge, Healthcare-Associated Infections (HAIs), Patient Safety, Injuries and Wounds, Adverse Events
Downes KJ, Patil NR, Rao MB
Risk factors for acute kidney injury during aminoglycoside therapy in patients with cystic fibrosis.
The aim of this study was to identify factors associated with acute kidney injury (AKI) during intravenous aminoglycoside (AG) courses in this population. It identified receipt of an AG within 90 days prior to admission, longer duration of AG therapy, low serum albumin, and receipt of trimethoprim/ sulfamethoxazole as independent risk factors for developing AKI.
AHRQ-funded; HS021114.
Citation: Downes KJ, Patil NR, Rao MB .
Risk factors for acute kidney injury during aminoglycoside therapy in patients with cystic fibrosis.
Pediatr Nephrol 2015 Oct;30(10):1879-88. doi: 10.1007/s00467-015-3097-3..
Keywords: Adverse Events, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions
Alruwaily AF, Eisner BH, Bierlein MJ
Statin use and risk of sepsis after percutaneous nephrolithotomy.
The researchers examined the association between statin medication use and sepsis risk after percutaneous nephrolithotomy (PCNL). They found that statin use is not associated with reductions in postoperative sepsis, nonfebrile urinary tract infections, ICU utilization, or hospital length of stay after PCNL.
AHRQ-funded; HS020927.
Citation: Alruwaily AF, Eisner BH, Bierlein MJ .
Statin use and risk of sepsis after percutaneous nephrolithotomy.
J Endourol 2015 Oct;29(10):1126-30. doi: 10.1089/end.2015.0042..
Keywords: Medication, Risk, Surgery, Adverse Events, Patient Safety
Valley TS, Cooke CR
The epidemiology of sepsis: questioning our understanding of the role of race.
Black individuals have been demonstrated to be nearly twice as likely to develop sepsis. However, in a recent study involving a cohort of stroke patients, investigators determined that black participants were significantly less likely than white participants to present to the hospital with either infection or sepsis. Although these results are intriguing, they highlight the inadequate understanding of the relationship between race and sepsis.
AHRQ-funded; HS020672.
Citation: Valley TS, Cooke CR .
The epidemiology of sepsis: questioning our understanding of the role of race.
Crit Care 2015 Oct 1;19:347. doi: 10.1186/s13054-015-1074-7..
Keywords: Racial and Ethnic Minorities, Patient Safety, Risk
Caya T, Musuuza J, Yanke E
Using a systems engineering initiative for patient safety to evaluate a hospital-wide daily chlorhexidine bathing intervention.
The researchers undertook a systems engineering approach to evaluate housewide implementation of daily chlorhexidine bathing. They performed direct observations of the bathing process and conducted provider and patient surveys. The main outcome was compliance with bathing using a checklist. Fifty-seven percent of baths had full compliance with the chlorhexidine bathing protocol. Additional time was the main barrier.
AHRQ-funded; HS024039.
Citation: Caya T, Musuuza J, Yanke E .
Using a systems engineering initiative for patient safety to evaluate a hospital-wide daily chlorhexidine bathing intervention.
J Nurs Care Qual 2015 Oct-Dec;30(4):337-44. doi: 10.1097/ncq.0000000000000129..
Keywords: Patient Safety, Prevention, Healthcare-Associated Infections (HAIs)
Valley TS, Sjoding MW, Ryan AM
Association of intensive care unit admission with mortality among older patients with pneumonia.
The purpose of this study was to estimate the relationship between ICU admission and outcomes for elderly patients with pneumonia. It concluded that among Medicare beneficiaries hospitalized with pneumonia, ICU admission of patients for whom the decision appeared to be discretionary was associated with improved survival and no significant difference in costs.
AHRQ-funded; HS020672.
Citation: Valley TS, Sjoding MW, Ryan AM .
Association of intensive care unit admission with mortality among older patients with pneumonia.
JAMA 2015 Sep 22-29;314(12):1272-9. doi: 10.1001/jama.2015.11068..
Keywords: Patient Safety, Intensive Care Unit (ICU), Elderly, Mortality, Hospitalization
Chopra V, Flanders SA, Saint S
The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results from a multispecialty panel using the RAND/UCLA Appropriateness Method.
The authors organized and conducted a multidisciplinary meeting of national and international experts to develop appropriateness criteria for use, care, and management of peripherally inserted central catheters (PICCs) and related ventricular assist devices (VADs) in hospitalized patients. Among the objectives were developing a list of appropriate indications for use of PICCs in relation to other VADs, and defining the appropriateness of practices associated with the insertion and care of PICCs.
AHRQ-funded; HS022835.
Citation: Chopra V, Flanders SA, Saint S .
The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results from a multispecialty panel using the RAND/UCLA Appropriateness Method.
Ann Intern Med 2015 Sep 15;163(6 Suppl):S1-40. doi: 10.7326/m15-0744..
Keywords: Adverse Events, Guidelines, Inpatient Care, Patient Safety
Kao DP, Haigney MC, Mehler PS
Arrhythmia associated with buprenorphine and methadone reported to the Food and Drug Administration.
The researchers assessed the relative frequency of reporting of adverse events involving ventricular arrhythmia, cardiac arrest, corrected QT interval prolongation or torsade de pointes to the US Food and Drug Administration between buprenorphine and methadone. They found that in spontaneously reported adverse events between 1969 and June 2011 originating in 196 countries, methadone is associated with disproportionate reporting of cardiac arrhythmias, whereas buprenorphine is not.
AHRQ-funded; HS021138.
Citation: Kao DP, Haigney MC, Mehler PS .
Arrhythmia associated with buprenorphine and methadone reported to the Food and Drug Administration.
Addiction 2015 Sep;110(9):1468-75. doi: 10.1111/add.13013.
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Keywords: Adverse Drug Events (ADE), Medication: Safety, Medication, Patient Safety
Moehring RW, Hazen KC, Hawkins MR
Challenges in preparation of cumulative antibiogram reports for community hospitals.
This descriptive cohort study of antibiogram reporting practices included community hospitals enrolled in the Duke Infection Control Outreach Network. Survey respondents’ self-assessment of full or partial compliance with Clinical and Laboratory Standards Institute (CLSI) guidelines was 50 percent and 15 percent, respectively; 33 percent reported uncertainty with CLSI guidelines. Full adherence to CLSI guidelines for hospital antibiograms was uncommon.
AHRQ-funded; HS023866.
Citation: Moehring RW, Hazen KC, Hawkins MR .
Challenges in preparation of cumulative antibiogram reports for community hospitals.
J Clin Microbiol 2015 Sep;53(9):2977-82. doi: 10.1128/jcm.01077-15..
Keywords: Hospitals, Patient Safety, Guidelines
Wiseman JT, Fernandes-Taylor S, Barnes ML
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
The researchers surveyed a vulnerable patient population to evaluate smartphone capability and willingness to adopt this technology. Their survey demonstrated that an older patient cohort with significant comorbidity is able and willing to adopt a smartphone-based postoperative monitoring program.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
J Surg Res 2015 Sep;198(1):245-51. doi: 10.1016/j.jss.2015.05.011..
Keywords: Ambulatory Care and Surgery, Surgery, Telehealth, Health Information Technology (HIT), Injuries and Wounds, Adverse Events, Patient Safety, Caregiving
Whicher DM, Kass NE, Audera-Lopez C
Ethical issues in patient safety research: a systematic review of the literature.
The authors provided a review of the literature related to ethics, oversight, and patient safety research; identified issues highlighted in articles as being of ethical relevance; described areas of consensus regarding how to respond to these ethical issues; and highlighted areas where additional ethical analysis and discussion are needed to provide guidance to those in the field.
AHRQ-funded; HS000029.
Citation: Whicher DM, Kass NE, Audera-Lopez C .
Ethical issues in patient safety research: a systematic review of the literature.
J Patient Saf 2015 Sep;11(3):174-84. doi: 10.1097/pts.0000000000000064.
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Keywords: Health Services Research (HSR), Patient Safety, Patient-Centered Outcomes Research
O'Leary KJ, Creden AJ, Slade ME
Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.
The authors compared a pre- versus post-intervention on Structured Interdisciplinary Rounds (SIDRs). They found that paired analyses for 82 professionals completing surveys revealed improved teamwork, which was driven mainly by nurses, and that the adverse events rate was similar across study periods; however, SIDR did not reduce adverse events.
AHRQ-funded; HS019630.
Citation: O'Leary KJ, Creden AJ, Slade ME .
Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.
Am J Med Qual 2015 Sep-Oct;30(5):409-16. doi: 10.1177/1062860614538093.
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Keywords: Adverse Events, Provider: Health Personnel, Inpatient Care, Patient Safety, Teams
Thompson DA, Marsteller JA, Pronovost PJ
Locating errors through networked surveillance: A multimethod approach to peer assessment, hazard identification, and prioritization of patient safety efforts in cardiac surgery.
The objectives of the study were to develop a scientifically sound and feasible peer-to-peer assessment model that allows health-care organizations to evaluate patient safety in cardiovascular operating rooms and to establish safety priorities for improvement. It identified 6 top priority hazard themes: safety culture, teamwork and communication, infection prevention, transitions of care, failure to adhere to practices or policies, and operating room layout and equipment.
AHRQ-funded; HS013904.
Citation: Thompson DA, Marsteller JA, Pronovost PJ .
Locating errors through networked surveillance: A multimethod approach to peer assessment, hazard identification, and prioritization of patient safety efforts in cardiac surgery.
J Patient Saf 2015 Sep;11(3):143-51. doi: 10.1097/pts.0000000000000059..
Keywords: Patient Safety, Medical Errors, Adverse Events, Surgery, Cardiovascular Conditions, Prevention
Powers C, Gabriel MH, Encinosa W
AHRQ Author: Encinosa W
Meaningful use stage 2 e-prescribing threshold and adverse drug events in the Medicare Part D population with diabetes.
The authors investigated whether physicians who meet the meaningful use stage 2 threshold for e-prescribing (50 percent of prescriptions e-prescribed) have lower rates of ADEs among their diabetic patients. They found that physician e-prescribing to Medicare beneficiaries was associated with reduced risk of ADEs among their diabetes patients, as were several prescriber and panel characteristics.
AHRQ-authored
Citation: Powers C, Gabriel MH, Encinosa W .
Meaningful use stage 2 e-prescribing threshold and adverse drug events in the Medicare Part D population with diabetes.
J Am Med Inform Assoc 2015 Sep;22(5):1094-8. doi: 10.1093/jamia/ocv036..
Keywords: Electronic Prescribing (E-Prescribing), Diabetes, Medication, Patient Safety
Stifter J, Yao Y, Lodhi MK
Nurse continuity and hospital-acquired pressure ulcers: A comparative analysis using an electronic health record "big data" set.
The aim of this study was to examine the association of nurse continuity with the prevention of hospital-acquired pressure ulcers (HAPU). It found that patient characteristics including nutrition, mobility, and perfusion were associated with HAPUs, but nurse continuity was not.
AHRQ-funded; HS023072.
Citation: Stifter J, Yao Y, Lodhi MK .
Nurse continuity and hospital-acquired pressure ulcers: A comparative analysis using an electronic health record "big data" set.
Nurs Res 2015 Sep-Oct;64(5):361-71. doi: 10.1097/nnr.0000000000000112..
Keywords: Patient Safety, Pressure Ulcers, Nursing
McElroy LM, Collins KM, Koller FL
Operating room to intensive care unit handoffs and the risks of patient harm.
The goal of this study was to assess systems and processes involved in the operating room(OR) to intensive care unit (ICU) handoff in an attempt to understand the criticality of specific steps of the handoff. In total, 81 process failures were identified, Process failures with the greatest risk of harm were lack of preliminary OR to ICU communication, team member absence during handoff communication, and transport equipment malfunction.
AHRQ-funded; HS000078.
Citation: McElroy LM, Collins KM, Koller FL .
Operating room to intensive care unit handoffs and the risks of patient harm.
Surgery 2015 Sep;158(3):588-94. doi: 10.1016/j.surg.2015.03.061..
Keywords: Intensive Care Unit (ICU), Patient Safety, Surgery, Communication, Adverse Events
Crnich CJ, Jump R, Trautner B
Optimizing antibiotic stewardship in nursing homes: a narrative review and recommendations for improvement.
This review summarizes the findings of research on ways to improve antibiotic prescribing practices in nursing homes and presents ways in which antibiotic stewardship can be implemented and optimized in the nursing home setting. It concludes that implementing and sustaining antibiotic stewardship in nursing homes requires an organizational commitment and a strategy based on goal setting.
AHRQ-funded; 290201000018I; 2902010000251; HS022298; HS022465; HS019979; HS022846.
Citation: Crnich CJ, Jump R, Trautner B .
Optimizing antibiotic stewardship in nursing homes: a narrative review and recommendations for improvement.
Drugs Aging 2015 Sep;32(9):699-716. doi: 10.1007/s40266-015-0292-7..
Keywords: Patient Safety, Nursing Homes, Medication