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
1 to 25 of 81 Research Studies DisplayedWeiss AB, Newnam KW, Wyles C
Exploring internal facilitators' experience with NeoECHO to foster NEC prevention and timely recognition through the iPARIHS lens.
AHRQ-funded; HS022908.
Citation: Weiss AB, Newnam KW, Wyles C .
Exploring internal facilitators' experience with NeoECHO to foster NEC prevention and timely recognition through the iPARIHS lens.
Adv Neonatal Care 2021 Dec 1;21(6):462-72. doi: 10.1097/anc.0000000000000966..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Prevention
Gephart SM, Newnam K, Weiss A
Feasibility and acceptability of a Neonatal Project ECHO (NeoECHO) as a dissemination and implementation strategy to prevent necrotizing enterocolitis.
Investigators examined the feasibility and acceptability of the care tools bundle NeoECHO to disseminate NEC-Zero education and describe the intentions of internal facilitators and clinicians to initiate quality improvement changes. They found that NeoECHO was an acceptable and feasible way to engage under-resourced NICUs and share NEC-Zero evidence and tools. They recommended more research to examine the impact of NeoECHO on care processes and patient outcomes.
AHRQ-funded; HS022908.
Citation: Gephart SM, Newnam K, Weiss A .
Feasibility and acceptability of a Neonatal Project ECHO (NeoECHO) as a dissemination and implementation strategy to prevent necrotizing enterocolitis.
Worldviews Evid Based Nurs 2021 Dec;18(6):361-70. doi: 10.1111/wvn.12529..
Keywords: Newborns/Infants, Quality Improvement, Quality of Care, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Implementation
Michelson KA, Rees CA, Sarathy J
Interregional transfers for pandemic surges.
Hospital inpatient and intensive care unit (ICU) bed shortfalls may arise due to regional surges in volume. In this study, the investigators sought to determine how interregional transfers could alleviate bed shortfalls during a pandemic, using estimates of past and projected inpatient and ICU cases of coronavirus disease 2019 (COVID-19) from 4 February 2020 to 1 October 2020.
AHRQ-funded; HS026503.
Citation: Michelson KA, Rees CA, Sarathy J .
Interregional transfers for pandemic surges.
Clin Infect Dis 2021 Dec 6;73(11):e4103-e10. doi: 10.1093/cid/ciaa1549..
Keywords: COVID-19, Hospitals, Public Health, Intensive Care Unit (ICU), Critical Care
Savarimuthu SM, Cairns C, Allorto NL SM, Cairns C, Allorto NL
qSOFA as a predictor of ICU outcomes in a resource-limited setting in KwaZulu-Natal Province, South Africa.
This study’s goal was to determine whether the quick sequential organ failure assessment (qSOFA) score based on bedside assessment alone was a promising tool for risk prediction in low-resource settings. This retrospective cohort study included adult patients admitted to the intensive care unit (ICU) at Edendale Hospital in Pietermaritzburg, South Africa (SA), recruited into the study between 2014 and 2018. Using multivariable logistic regression, the association of qSOFA with in-ICU mortality was measured, and discrimination was assessed using the area under the receiver operating characteristic curve and the additive contribution to a baseline model using likelihood ratio testing. The qSOFA scores of 0, 1 and 2 were not associated with increased odds of in-ICU mortality in patients with infection, while the qSOFA of 3 was associated with in-ICU mortality in infected patients. Discrimination for mortality was fair to poor and adding qSOFA to a baseline model yielded a statistical improvement in both cases.
AHRQ-funded; HS026372.
Citation: Savarimuthu SM, Cairns C, Allorto NL SM, Cairns C, Allorto NL .
qSOFA as a predictor of ICU outcomes in a resource-limited setting in KwaZulu-Natal Province, South Africa.
South Afr J Crit Care 2020; 36(2). doi: 10.7196/SAJCC.2020.v36i2.433..
Keywords: Intensive Care Unit (ICU), Sepsis, Critical Care, Outcomes
Vranas KC, Golden SE, Mathews KS
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
The COVID-19 pandemic resulted in unprecedented adjustments to intensive care unit (ICU) organization and care processes globally. The investigators examined if hospital emergency responses to the COVID-19 pandemic differed depending on hospital setting and explored which strategies worked well to mitigate strain as perceived by intensivists. The investigators concluded that their study demonstrated the importance of trust and transparency between frontline staff and hospital leadership as key components of effective emergency responses during public health crises.
AHRQ-funded; HS028038.
Citation: Vranas KC, Golden SE, Mathews KS .
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
Chest 2021 Nov;160(5):1714-28. doi: 10.1016/j.chest.2021.05.041..
Keywords: COVID-19, Intensive Care Unit (ICU), Critical Care, Healthcare Delivery, Workforce, Public Health
Applebury DE, Robinson EJ, Gold JA
Pilot testing of simulation in the evaluation of a novel, rapidly deployable electronic health record for use in disaster intensive care.
This purpose of this study was to present the application of simulation to assess a quickly scalable hub-and-spoke model for Electronic Health Record (EHR) system deployment and monitoring, utilizing asynchronous training. The researchers modified existing commercial EHR products to function as the entry point from a simulated hospital and a separate system for tele-ICU support and data monitoring. A modular video-based curriculum was developed for asynchronous training of users. The curriculum's effectiveness was evaluated through the completion of standard ICU documentation tasks in a high-fidelity simulation. Additional endpoints included EHR navigation assessment, user satisfaction (Net Promoter), system usability (System Usability Scale-SUS), and cognitive load (NASA-TLX). The study found that 5 participants achieved a 100% task completion rate in all domains, except for ventilator data (91%). The systems demonstrated high satisfaction, satisfactory usability, and acceptable cognitive load, with higher cognitive loads correlating to the number of screens used.
AHRQ-funded; HS023793.
Citation: Applebury DE, Robinson EJ, Gold JA .
Pilot testing of simulation in the evaluation of a novel, rapidly deployable electronic health record for use in disaster intensive care.
Disaster Med Public Health Prep 2021 Oct 22; 17:e51. doi: 10.1017/dmp.2021.302..
Keywords: COVID-19, Emergency Preparedness, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health, Intensive Care Unit (ICU), Critical Care
Holding EZ, Turner EM, Hall TA
The association between functional status and health-related quality of life following discharge from the pediatric intensive care unit.
This study investigated the association between new functional impairments, measured by the Functional Status Scale (FSS), and health-related quality of life (HRQOL) in pediatric patients with acquired brain injury (ABI) after critical care. This secondary analysis was conducted using children aged 2 months to 18 years with ABI. Complete data were analyzed for 195 children, including 127 with traumatic brain injury. New functional impairment was common with 32 patients experiencing FSS ≥ 3, 50 (26%) patients with FSS increases of 1-2 points, and 113 (58%) patients with no change from prehospital baseline. The majority of children (63%) demonstrated HRQOL ratings ≥ 1 standard deviation below healthy age-based standards.
AHRQ-funded; HS022981.
Citation: Holding EZ, Turner EM, Hall TA .
The association between functional status and health-related quality of life following discharge from the pediatric intensive care unit.
Neurocrit Care 2021 Oct;35(2):347-57. doi: 10.1007/s12028-021-01271-8..
Keywords: Children/Adolescents, Quality of Life, Brain Injury, Intensive Care Unit (ICU)
Anesi GL, Kerlin MP
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Researchers discuss the impact of resource limitations on care delivery and outcomes. They conclude that the interaction between resource limitation and care delivery and outcomes is complex and incompletely understood. Further, the COVID-19 pandemic provides a learning opportunity for strain response during both pandemic and non-pandemic times.
AHRQ-funded; HS026372.
Citation: Anesi GL, Kerlin MP .
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Curr Opin Crit Care 2021 Oct 1;27(5):513-19. doi: 10.1097/mcc.0000000000000859..
Keywords: COVID-19, Public Health, Healthcare Delivery, Intensive Care Unit (ICU), Outcomes
Jeffery AD, Werthman JA, Danesh V
Assess, prevent, and manage pain; both spontaneous awakening and breathing trials; choice of analgesia/sedation; delirium: assess, prevent, and manage; early mobility; family engagement and empowerment bundle implementation: quantifying the association of
This paper discusses a multicenter, exploratory, cross-sectional study to describe the physical environment factors of bundle-enhancing items and the association of physical environment with bundle adherence. The study included 10 medical and surgical ICUs in 6 academic medical centers. The cohort included adults with qualifying respiratory failure and/or septic shock. The interventions used were the Awakening, and Breathing trial Coordination, Delirium assessment/management, and Early mobility bundle as the recommended standard of care for randomized controlled trial patients. Primary outcome was adherence to the full bundle and the early mobility bundle component as identified from daily adherence documentation of 751 patient observations. Both unit- and patient-level factors such as unit size, a standard walker, and age were associated with increased or decreased adherence. Mechanical ventilation was always associated with decreased bundle adherence.
AHRQ-funded; HS026395.
Citation: Jeffery AD, Werthman JA, Danesh V .
Assess, prevent, and manage pain; both spontaneous awakening and breathing trials; choice of analgesia/sedation; delirium: assess, prevent, and manage; early mobility; family engagement and empowerment bundle implementation: quantifying the association of
Crit Care Explor 2021 Sep 14;3(9):e0525. doi: 10.1097/cce.0000000000000525..
Keywords: Critical Care, Intensive Care Unit (ICU), Care Management, Evidence-Based Practice
Parker MG, Garg A, Brochier A
Approaches to addressing social determinants of health in the NICU: a mixed methods study.
The objective of this study was to examine current approaches to addressing social determinants of health (SDOH) in the NICU and perceived appropriateness of a standardized screening and referral process. The investigators performed a mixed methods study in two Massachusetts safety-net NICUs. They concluded that current NICU assessment of SDOH was limited and use of a standardized screening and referral process could be useful.
AHRQ-funded; HS026370.
Citation: Parker MG, Garg A, Brochier A .
Approaches to addressing social determinants of health in the NICU: a mixed methods study.
J Perinatol 2021 Aug;41(8):1983-91. doi: 10.1038/s41372-020-00867-w..
Keywords: Social Determinants of Health, Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU)
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
Brei BK, Sawyer T, Umoren R
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
This study looked at whether the presence of family members had an impact on neonatal tracheal intubation (TI) outcomes. This retrospective analysis looked at TIs performed in NICUs participating in the National Emergency Airway Registry for Neonates (NEAR4NEOS) at 13 academic NICUS from October 2014 to December 2017. Family members were present in less than 10% of TIs, but this varied by site. Success rates were not significantly different, with the first attempt success rate at 55% with family present versus 49% and success within 2 attempts was 74% versus 66%. Adverse TI-associated events (TIAEs) were 17% versus 20% and severe oxygen desaturation was 49% versus 52%. No independent association between any of these outcomes was found with family presence.
AHRQ-funded; HS027259; HS024511.
Citation: Brei BK, Sawyer T, Umoren R .
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
Arch Dis Child Fetal Neonatal Ed 2021 Jul;106(4):392-97. doi: 10.1136/archdischild-2020-319709..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Registries, Patient Safety
Murray DJ, Boulet JR, Boyle WA
Competence in decision making: setting performance standards for critical care.
Health care professionals must be able to make frequent and timely decisions that can alter the illness trajectory of intensive care patients. A competence standard for this ability is difficult to establish yet assuring practitioners can make appropriate judgments is an important step in advancing patient safety. In this study, the investigators hypothesized that simulation could be used effectively to assess decision-making competence.
AHRQ-funded; HS022265.
Citation: Murray DJ, Boulet JR, Boyle WA .
Competence in decision making: setting performance standards for critical care.
Anesth Analg 2021 Jul 1;133(1):142-50. doi: 10.1213/ane.0000000000005053..
Keywords: Critical Care, Shared Decision Making, Intensive Care Unit (ICU), Simulation, Provider Performance, Patient Safety, Quality of Care
Carayon P, Thuemling T, Parmasad V
Implementation of an antibiotic stewardship intervention to reduce prescription of fluoroquinolones: a human factors analysis in two intensive care units.
In this study, researchers conducted an in-depth analysis of an intervention aimed at limiting ICU prescriber access to fluoroquinolones (FQ) in the ICUs of two hospitals. Their results showed some differences in the implementation of the FQ intervention between the two studied ICUs, such as level and method of FQ restriction, and training and communication with physicians and pharmacists. In both ICUs, several organizational learning mechanisms helped quickly to identify problems with the intervention and to ensure that changes were made in a just-in-time manner. Despite their organizational differences, both sites developed strategies to implement the FQ intervention successfully.
AHRQ-funded; HS026226.
Citation: Carayon P, Thuemling T, Parmasad V .
Implementation of an antibiotic stewardship intervention to reduce prescription of fluoroquinolones: a human factors analysis in two intensive care units.
J Patient Saf Risk Manag 2021 Jul;26(4):161-71..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Intensive Care Unit (ICU)
Safdar N, Parmasad V, Brown R
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interventions are effective in CDI control, but there is little evidence regarding the most effective AS interventions. In this paper the investigators describe their multisite, stepped-wedge, cluster, effectiveness-implementation clinical trial.
AHRQ-funded; R01 HS026226.
Citation: Safdar N, Parmasad V, Brown R .
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
BMJ Open 2021 Jun 29;11(6):e046480. doi: 10.1136/bmjopen-2020-046480..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Antimicrobial Stewardship, Antibiotics, Medication, Prevention
Ma AL, Loughland MED, Lapcharoensap W
California and Oregon NICU wildfire disaster preparedness tools.
In a follow-up to their previous study, the authors asked, "what tools/strategies do medical professionals deem as important and most helpful as they are preparing for wildfire disaster response?" They conducted surveys in 11 Oregon and Southwest Washington NICUs about their wildfire evacuation preparedness and interviewed two neonatologists about their wildfire disaster evacuation and preparation experiences. Their findings suggested that there is more work needed to fully prepare NICUs for wildfire disasters, and they hope that their work helps to educate and support future NICU disaster preparedness responses.
AHRQ-funded; HS023506.
Citation: Ma AL, Loughland MED, Lapcharoensap W .
California and Oregon NICU wildfire disaster preparedness tools.
Children 2021 Jun;8(6). doi: 10.3390/children8060465..
Keywords: Emergency Preparedness, Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU)
Riley AR, Williams CN, Moyer D
Parental posttraumatic stress symptoms in the context of pediatric post intensive care syndrome: impact on the family and opportunities for intervention.
Pediatric intensive care unit (PICU) survivors and their families experience ongoing impacts on physical, cognitive, and psychosocial functioning, described as Post-Intensive Care Syndrome (PICS). The objective of this study was to determine whether the posttraumatic stress symptoms (PTSS) of parents predict the impact of critical illness on families following PICU admission beyond other factors (e.g., sex, race/ethnicity, age, insurance status, illness severity, family involvement or death).
AHRQ-funded; HS022981.
Citation: Riley AR, Williams CN, Moyer D .
Parental posttraumatic stress symptoms in the context of pediatric post intensive care syndrome: impact on the family and opportunities for intervention.
Clin Pract Pediatr Psychol 2021 Jun;9(2):156-66. doi: 10.1037/cpp0000399..
Keywords: Children/Adolescents, Caregiving, Intensive Care Unit (ICU), Family Health and History, Stress
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
Anesi GL, Jablonski J, Harhay MO
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
This study’s objective is to describe the epidemiology of COVID-19-related critical illness, including trends in outcomes and care delivery, using five hospitals within the University of Pennsylvania Health System as a setting. Findings showed that, among patients with COVID-19-related critical illness admitted to ICUs of a learning health system in the United States, mortality seemed to decrease over time despite stable patient characteristics. Recommendations included further studies to confirm this result and to investigate causal mechanisms.
AHRQ-funded; HS026372.
Citation: Anesi GL, Jablonski J, Harhay MO .
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
Ann Intern Med 2021 May;174(5):613-21. doi: 10.7326/m20-5327..
Keywords: COVID-19, Critical Care, Intensive Care Unit (ICU), Mortality, Hospitals, Outcomes, Infectious Diseases
Sick-Samuels AC, Linz M, Bergmann J
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
This study describes the development and impact of a clinical decision support algorithm to standardize the use of endotracheal aspirate cultures (EACs) from ventilated PICU patients in the evaluation of suspected ventilator-associated infections. Bacterial growth in EACs does not distinguish bacterial colonization from infection and may lead to overtreatment with antibiotics. The rate of EACs was compared pre- and postintervention. In the preintervention year there were 557 EACs over 5092 ventilator days. After introduction of the algorithm the rate went down to 234 EACs over 3654 ventilator days. There was a 41% decrease in the monthly rate of EACs. This intervention did not affect mortality, readmissions, or length of stay in ventilated PICU patients.
AHRQ-funded; HS025642.
Citation: Sick-Samuels AC, Linz M, Bergmann J .
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-1634..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Clinical Decision Support (CDS), Shared Decision Making, Healthcare-Associated Infections (HAIs), 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
Krupp A, Di Martino M, Chung W
Communication and role clarity inform TeleICU use: a qualitative analysis of opportunities and barriers in an established program using AACN framework.
This study is a qualitative analysis of opportunities and barriers to tele-intensive care unit (teleICU) use. The authors sought to explore if novel ways to utilize teleICU services can emerge within an established, consulting-style teleICU model considering the program’s flexible, provider-driven operation. This study used semi-structured interviews from a convenience sample of ICU (n = 19) and teleICU (n = 13) nurses. Interviews were analyzed to identify themes that describe their experiences with teleICU using a deductive codebook developed from the American Association of Critical Care Nurses (AACN) statement on teleICU nursing. Three themes identified by the nurses were: 1) unique teleICU knowledge, including systems thinking and technological skills, 2) the teleICU partnership supported quality improvement initiatives, and 3) elements of the work environment influenced perceptions of teleICU and its use. When effective communication and role clarity were not present, teleICU was variable.
AHRQ-funded; HS026372.
Citation: Krupp A, Di Martino M, Chung W .
Communication and role clarity inform TeleICU use: a qualitative analysis of opportunities and barriers in an established program using AACN framework.
BMC Health Serv Res 2021 Mar 25;21(1):277. doi: 10.1186/s12913-021-06287-6..
Keywords: Communication, Intensive Care Unit (ICU), Telehealth, Health Information Technology (HIT)
Woods-Hill CZ, Papili K, Nelson E
Harnessing implementation science to optimize harm prevention in critically ill children: a pilot study of bedside nurse CLABSI bundle performance in the pediatric intensive care unit.
Central-line associated bloodstream infection (CLABSI) is associated with increased mortality, morbidity, and cost in hospitalized children. An evidence-based bundle of care can decrease CLABSI, but bundle compliance is imperfect. In this study, the investigators explored factors impacting bundle performance in the pediatric intensive care unit (PICU) by bedside nurses. The investigators concluded that PICU nurses were knowledgeable and motivated to prevent CLABSI, but faced challenges from competing clinical tasks, limited resources, and complex family interactions. Physician engagement was specifically noted to impact nurse motivation to complete the bundle.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Papili K, Nelson E .
Harnessing implementation science to optimize harm prevention in critically ill children: a pilot study of bedside nurse CLABSI bundle performance in the pediatric intensive care unit.
Am J Infect Control 2021 Mar;49(3):345-51. doi: 10.1016/j.ajic.2020.08.019..
Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Intensive Care Unit (ICU), Nursing, Patient Safety
Haidari ES, Lee HC, Illuzzi JL
Hospital variation in admissions to neonatal intensive care units by diagnosis severity and category.
The objective of this study was to examine interhospital variation in admissions to neonatal intensive care units (NICU) and reasons for the variation. 2010-2012 linked birth certificate and hospital discharge data from 35 hospitals in California on live births at 35-42 weeks gestation and ≥1500 g birth weight were used. The authors concluded that interhospital variation in NICU admissions is mostly driven by admissions for mild diagnoses.
AHRQ-funded; HS023801.
Citation: Haidari ES, Lee HC, Illuzzi JL .
Hospital variation in admissions to neonatal intensive care units by diagnosis severity and category.
J Perinatol 2021 Mar;41(3):468-77. doi: 10.1038/s41372-020-00775-z..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Hospitalization, Hospitals
Flannery DD, Akinboyo IC, Mukhopadhyay S
Antibiotic susceptibility of Escherichia coli among infants admitted to neonatal intensive care units across the US From 2009 to 2017.
Investigators assessed the epidemiologic characteristics and antibiotic susceptibility patterns of E coli in infants admitted to neonatal intensive care units in the US over time. Using the Premier Health Database, they found nonsusceptibility to commonly administered antibiotics in substantial proportions of neonatal E coli isolates, with no significant change from 2009 to 2017. They suggested that their findings may inform empirical antibiotic choices for newborn infants.
AHRQ-funded; HS027468.
Citation: Flannery DD, Akinboyo IC, Mukhopadhyay S .
Antibiotic susceptibility of Escherichia coli among infants admitted to neonatal intensive care units across the US From 2009 to 2017.
JAMA Pediatr 2021 Feb;175(2):168-75. doi: 10.1001/jamapediatrics.2020.4719..
Keywords: Newborns/Infants, Antibiotics, Medication, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Infectious Diseases