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
76 to 100 of 191 Research Studies DisplayedMoghavem N, Morrison D, Ratliff JK
Cranial neurosurgical 30-day readmissions by clinical indication.
The objects of this study were to determine population-level, 30-day, all-cause readmission rates for cranial neurosurgery and identify factors associated with readmission. It fund that the frequency of 30-day readmission rates for patients undergoing cranial neurosurgery varied by diagnosis between 14% and 24%. Important patient characteristics and comorbidities that were associated with an increased readmission risk were identified.
AHRQ-funded; HS018558.
Citation: Moghavem N, Morrison D, Ratliff JK .
Cranial neurosurgical 30-day readmissions by clinical indication.
J Neurosurg 2015 Jul;123(1):189-97. doi: 10.3171/2014.12.jns14447..
Keywords: Hospital Readmissions, Surgery, Patient Safety, Outcomes
Carrington JM, Gephart SM, Verran JA
Development of an instrument to measure the unintended consequences of EHRs.
The authors examined the creation and design of an instrument measuring unintended consequences of electronic health records. They suggested that other researchers will find their methods article informative for similar undertakings.
AHRQ-funded; HS022908.
Citation: Carrington JM, Gephart SM, Verran JA .
Development of an instrument to measure the unintended consequences of EHRs.
West J Nurs Res 2015 Jul;37(7):842-58. doi: 10.1177/0193945915576083.
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Keywords: Communication, Decision Making, Electronic Health Records (EHRs), Nursing, Patient Safety
Osterman MT, Haynes K, Delzell E
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
This study assessed the effectiveness and safety of immunomodulators with anti-tumor necrosis factor (anti-TNF) therapy in Crohn’s disease (CD). It found that continuation of immunomodulators after “stepping up” to anti-TNF therapy did not improve outcomes but was associated with an increased risk of opportunistic infection.
AHRQ-funded; HS018517.
Citation: Osterman MT, Haynes K, Delzell E .
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
Clin Gastroenterol Hepatol 2015 Jul;13(7):1293-301.e5; quiz e70, e72. doi: 10.1016/j.cgh.2015.02.017..
Keywords: Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Stewart GL, Manges KA, Ward MM
Empowering sustained patient safety: the benefits of combining top-down and bottom-up approaches.
Implementation of TeamSTEPPS for improving patient safety is examined via descriptive qualitative analysis of semistructured interviews with 21 informants at 12 hospitals. Implementation approaches fit 3 strategies: top-down, bottom-up, and combination. The top-down approach failed to develop enough commitment to spread implementation. The bottom-up approach was unable to marshal the resources necessary to spread implementation. Combining top-down and bottom-up, processes best facilitated the implementation and spread of the TeamSTEPPS safety initiative.
AHRQ-funded; HS018396.
Citation: Stewart GL, Manges KA, Ward MM .
Empowering sustained patient safety: the benefits of combining top-down and bottom-up approaches.
J Nurs Care Qual 2015 Jul-Sep;30(3):240-6. doi: 10.1097/ncq.000000000000103.
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Keywords: Patient Safety, TeamSTEPPS, Hospitals, Training
Mody L, Meddings J, Edson BS
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
The authors describe a new initiative based on lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent catheter-associated urinary tract infections in over 950 acute care hospitals. This initiative will now be implemented in nearly 500 nursing homes through a project funded by AHRQ. It will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship.
AHRQ-funded; 2902010000251; HS019979; HS019767.
Citation: Mody L, Meddings J, Edson BS .
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
Clin Infect Dis 2015 Jul 1;61(1):86-94. doi: 10.1093/cid/civ236..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Inpatient Care
Padula WV, Valuck RJ, Makic MB
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced, the overall reduction of pressure ulcers (PUs). It found that several internal factors influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns and data sharing among peer institutions.
AHRQ-funded; HS023710.
Citation: Padula WV, Valuck RJ, Makic MB .
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
J Wound Ostomy Continence Nurs 2015 Jul-Aug;42(4):327-30. doi: 10.1097/won.0000000000000145..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Prevention
Murray MT, Pavia M, Jackson O
Health care-associated infection outbreaks in pediatric long-term care facilities.
The researchers performed a retrospective study from January 2010- December 2013 at 3 pediatric long-term care facilities to describe HAI outbreaks and associated infection control interventions. They found that there were 62 outbreaks involving 700 cases in residents and 250 cases in staff. The most common interventions were isolation precautions and education and in-services.
AHRQ-funded; HS021470.
Citation: Murray MT, Pavia M, Jackson O .
Health care-associated infection outbreaks in pediatric long-term care facilities.
Am J Infect Control 2015 Jul;43(7):756-8. doi: 10.1016/j.ajic.2015.03.010..
Keywords: Healthcare-Associated Infections (HAIs), Long-Term Care, Children/Adolescents, Children/Adolescents, Patient Safety
Rock C, Harris AD, Johnson JK
Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients.
The researchers, by using a validated air sampling method, found Acinetobacter baumannii in the air surrounding only 1 of 12 patients known to be colonized or infected with A. baumannii. Patients’ closed-circuit ventilator status, frequent air exchanges in patient rooms, and short sampling time may have contributed to this low burden.
AHRQ-funded; HS022291.
Citation: Rock C, Harris AD, Johnson JK .
Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients.
Infect Control Hosp Epidemiol 2015 Jul;36(7):830-2. doi: 10.1017/ice.2015.68..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU)
Dalal AK, Pesterev BM, Eibensteiner K
Linking acknowledgement to action: closing the loop on non-urgent, clinically significant test results in the electronic health record.
This study measured use of an acknowledgment tool by 146 primary care physicians (PCPs) at 13 network-affiliated practices that use the same EHR. It then surveyed PCPs to assess use of, satisfaction with, and desired enhancements to the acknowledgment tool. Most (64 percent) were satisfied with the tool. Both satisfied and nonsatisfied PCPs reported that enhancements linking acknowledgment to routine actions would be useful.
AHRQ-funded; HS019603.
Citation: Dalal AK, Pesterev BM, Eibensteiner K .
Linking acknowledgement to action: closing the loop on non-urgent, clinically significant test results in the electronic health record.
J Am Med Inform Assoc 2015 Jul;22(4):905-8. doi: 10.1093/jamia/ocv007..
Keywords: Patient Safety, Electronic Health Records (EHRs), Primary Care, Health Information Technology (HIT)
Simonov M, Pittiruti M, Rickard CM
Navigating venous access: a guide for hospitalists.
The authors provided an in-depth summary of the relevant anatomical considerations, physical characteristics, advantages, and disadvantages of venous access devices commonly used in the hospital setting in order to improve the safety and share the science of vascular access with frontline clinicians.
AHRQ-funded; HS022835.
Citation: Simonov M, Pittiruti M, Rickard CM .
Navigating venous access: a guide for hospitalists.
J Hosp Med 2015 Jul;10(7):471-8. doi: 10.1002/jhm.2335.
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Keywords: Evidence-Based Practice, Guidelines, Patient Safety
Basco WT, Ebeling M, Garner SS
Opioid prescribing and potential overdose errors among children 0 to 36 months old.
This study estimated the frequency of potential overdoses among outpatient opioid-containing prescriptions. It found that, overall, 2.7 percent of the prescriptions contained potential overdose quantities, and the average excess amount dispensed was 48% above expected. Younger ages were associated with higher frequencies of potential overdose.
AHRQ-funded; HS015679.
Citation: Basco WT, Ebeling M, Garner SS .
Opioid prescribing and potential overdose errors among children 0 to 36 months old.
Clin Pediatr 2015 Jul;54(8):738-44. doi: 10.1177/0009922815586050..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Newborns/Infants, Medication, Medication: Safety, Newborns/Infants, Opioids, Patient Safety
Pakyz AL, Patterson JA, Motzkus-Feagans C
Performance of the present-on-admission indicator for Clostridium difficile infection.
The researchers compared performance of a hospital- and community-onset Clostridium difficile infection definition using administrative data to a present on- admission indicator with definitions using clinical surveillance. For hospital-onset C. difficile infection, there was moderate sensitivity (68 percent) and high specificity (93 percent); for community-onset, sensitivity and specificity were high (both 85 percent).
AHRQ-funded; HS018578.
Citation: Pakyz AL, Patterson JA, Motzkus-Feagans C .
Performance of the present-on-admission indicator for Clostridium difficile infection.
Infect Control Hosp Epidemiol 2015 Jul;36(7):838-40. doi: 10.1017/ice.2015.63..
Keywords: Clostridium difficile Infections, Patient Safety, Healthcare-Associated Infections (HAIs), Data
Fallouh N, McGuirk HM, Flanders SA
Peripherally inserted central catheter-associated deep vein thrombosis: a narrative review.
To better guide clinicians, the researchers performed a comprehensive literature review to summarize best practices for peripherally inserted central catheter-related deep vein thrombosis (PICC-DVT). They concluded that centrally positioned, otherwise functional and clinically necessary PICCs need not be removed despite concomitant DVT. Anticoagulation with low-molecular-weight heparin or warfarin for at least 3 months represents the mainstay of treatment.
AHRQ-funded; HS022835.
Citation: Fallouh N, McGuirk HM, Flanders SA .
Peripherally inserted central catheter-associated deep vein thrombosis: a narrative review.
Am J Med 2015 Jul;128(7):722-38. doi: 10.1016/j.amjmed.2015.01.027..
Keywords: Adverse Events, Blood Clots, Evidence-Based Practice, Patient Safety
Durkin MJ, Dicks KV, Baker AW
Postoperative infection in spine surgery: does the month matter?
The authors evaluated for seasonal variation of surgical site infection (SSI) following spine surgery in a network of nonteaching community hospitals. They found that the rate of SSI following fusion or spinal laminectomy/laminoplasty was higher during the summer in this network of community hospitals, most likely due to S. aureus rather than the July effect.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Postoperative infection in spine surgery: does the month matter?
J Neurosurg Spine 2015 Jul;23(1):128-34. doi: 10.3171/2014.10.spine14559.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Hospitals, Outcomes, Quality of Care
Mueller SK, Giannelli K, Boxer R
Readability of patient discharge instructions with and without the use of electronically available disease-specific templates.
The investigators examined the impact of the use of electronic, patient-friendly, templated discharge instructions on the readability of discharge instructions provided to patients at discharge. They concluded that the use of electronically available templated discharge instructions may be a viable option to improve the readability of written material provided to patients at discharge, although the library of available templates requires expansion.
AHRQ-funded; HS023331.
Citation: Mueller SK, Giannelli K, Boxer R .
Readability of patient discharge instructions with and without the use of electronically available disease-specific templates.
J Am Med Inform Assoc 2015 Jul;22(4):857-63. doi: 10.1093/jamia/ocv005.
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Keywords: Education: Patient and Caregiver, Health Literacy, Hospital Discharge, Patient Safety
Feemster KA
Remembering the benefits of vaccination.
This commentary discussed the issue of vaccination and tightening exemptions for school entry. The author pointed out that events show that the success of vaccines can be fragile, as the measles cases associated with Disneyland were preceded by 644 cases in 2014. And 2012 saw more than 40,000 cases of pertussis, the largest number since 1960. These events provided a dramatic reminder that vaccines remain an important and necessary public health tool.
AHRQ-funded; HS020939.
Citation: Feemster KA .
Remembering the benefits of vaccination.
JAMA Pediatr 2015 Jul;169(7):624-6. doi: 10.1001/jamapediatrics.2015.0647.
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Keywords: Children/Adolescents, Infectious Diseases, Patient Safety, Policy, Vaccination
Crane S, Sloane PD, Elder N
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
This study assessed the feasibility of a near-miss reporting system in primary care practices and to describe initial reports and practice responses to them. It found that all 7 practices successfully implemented the system, reporting 632 near-miss events in 9 months and initiating 32 quality improvement projects based on the reports.
AHRQ-funded; HS019558.
Citation: Crane S, Sloane PD, Elder N .
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
J Am Board Fam Med 2015 Jul-Aug;28(4):452-60. doi: 10.3122/jabfm.2015.04.140050..
Keywords: Adverse Events, Medical Errors, Patient Safety, Primary Care, Public Reporting, Quality Improvement, Quality of Care
Gonzalez AA, Abdelsattar ZM, Dimick JB
Time-to-readmission and mortality after high-risk surgery.
This study used 5 years of data on Medicare beneficiaries undergoing high-risk surgical procedures to investigate whether postdischarge mortality varies by time to readmission. It found that surgical readmissions within 10 days of discharge are disproportionately common and associated with increased mortality independent of index complications.
AHRQ-funded; HS017765; HS000053.
Citation: Gonzalez AA, Abdelsattar ZM, Dimick JB .
Time-to-readmission and mortality after high-risk surgery.
Ann Surg 2015 Jul;262(1):53-9. doi: 10.1097/sla.0000000000000912..
Keywords: Patient Safety, Mortality, Hospital Readmissions, Adverse Events, Surgery
Meddings J, Reichert H, Rogers MA
Under pressure: Financial effect of the hospital-acquired conditions initiative-a statewide analysis of pressure ulcer development and payment.
This study assessed the financial effect of the 2008 Hospital-Acquired Conditions Initiative (HACI) pressure ulcer payment changes on Medicare, other payers, and hospitals. It found that the total financial effect of the 2008 payment changes for pressure ulcers was negligible. Most payment decreases occurred by removal of comorbidity payments for present-on-admission pressure ulcers other than Stages III and IV.
AHRQ-funded; HS019767; HS018334.
Citation: Meddings J, Reichert H, Rogers MA .
Under pressure: Financial effect of the hospital-acquired conditions initiative-a statewide analysis of pressure ulcer development and payment.
J Am Geriatr Soc 2015 Jul;63(7):1407-12. doi: 10.1111/jgs.13475..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare-Associated Infections (HAIs), Pressure Ulcers, Patient Safety, Healthcare-Associated Infections (HAIs)
Sage WM, Jablonski JS, Thomas EJ
Use of nondisclosure agreements in medical malpractice settlements by a large academic health care system.
The researchers sought to determine the frequency of nondisclosure agreements in medical malpractice settlements and the extent to which the restrictions in these agreements seem incompatible with good patient care. They found that an academic health system with a declared commitment to patient safety and transparency used nondisclosure clauses in most malpractice settlement agreements but with little standardization or consistency.
AHRQ-funded; HS019561.
Citation: Sage WM, Jablonski JS, Thomas EJ .
Use of nondisclosure agreements in medical malpractice settlements by a large academic health care system.
JAMA Intern Med 2015 Jul;175(7):1130-5. doi: 10.1001/jamainternmed.2015.1035..
Keywords: Adverse Events, Medical Errors, Medical Liability, Patient Safety
Carter EJ, Cohen B, Murray MT
Using workflow diagrams to address hand hygiene in pediatric long-term care facilities.
The aim of the study was to engage staff in the development of workflow diagrams, which highlighted hand hygiene (HH) practices during commonly performed patient-care activities. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene.
AHRQ-funded; HS021470.
Citation: Carter EJ, Cohen B, Murray MT .
Using workflow diagrams to address hand hygiene in pediatric long-term care facilities.
J Pediatr Nurs 2015 Jul-Aug;30(4):e17-21. doi: 10.1016/j.pedn.2014.12.002..
Keywords: Patient Safety, Quality of Care, Children/Adolescents, Long-Term Care
Abdelsattar ZM, Hendren S, Wong SL
Variation in transfusion practices and the effect on outcomes after noncardiac surgery.
The researchers assessed the hospital-level variation in transfusion practices for packed red blood cells and the patient-level effects on outcomes after noncardiac general or vascular surgery, using population-based prospectively collected data. They found that postoperative transfusions after noncardiac surgery are associated with increased adverse postoperative outcomes, with the exception of postoperative myocardial infarction.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
Variation in transfusion practices and the effect on outcomes after noncardiac surgery.
Ann Surg 2015 Jul;262(1):1-6. doi: 10.1097/sla.0000000000001264..
Keywords: Patient Safety, Surgery, Outcomes, Adverse Events
Crotty BH, Mostaghimi A, O'Brien J
Prevalence and risk profile of unread messages to patients in a patient web portal.
The researchers sought to assess the prevalence and risk profile of unread messages in a mature patient portal. They found that overall, secure messaging appears a safe form of communication, but systems to notify senders when messages are unread may have value. While most clinical messages were read, many outreach messages were not.
AHRQ-funded; HS021495.
Citation: Crotty BH, Mostaghimi A, O'Brien J .
Prevalence and risk profile of unread messages to patients in a patient web portal.
Appl Clin Inform 2015 Jun 12;6(2):375-82. doi: 10.4338/aci-2015-01-cr-0006..
Keywords: Communication, Health Information Technology (HIT), Web-Based, Patient Safety
Manojlovich M, Adler-Milstein J, Harrod M
The effect of health information technology on health care provider communication: a mixed-method protocol.
The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians. It seeks to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, and (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings.
AHRQ-funded; HS022305.
Citation: Manojlovich M, Adler-Milstein J, Harrod M .
The effect of health information technology on health care provider communication: a mixed-method protocol.
JMIR Res Protoc 2015 Jun 11;4(2):e72. doi: 10.2196/resprot.4463..
Keywords: Adverse Events, Communication, Health Information Technology (HIT), Patient Safety, Medical Errors
Nuckols TK, Smith-Spangler C, Morton SC
The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis.
The primary objective of this systematic review and meta-analysis study was to quantitatively assess the effectiveness of computerized provider order entry (CPOE) at reducing preventable adverse drug events (pADE). It found that CPOE is associated with cutting in half the number of pADEs. Medication errors were also about half as common with CPOE.
AHRQ-funded; HS017954
Citation: Nuckols TK, Smith-Spangler C, Morton SC .
The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis.
Syst Rev. 2014 Jun 4;3:56. doi: 10.1186/2046-4053-3-56..
Keywords: Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Patient Safety