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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Antibiotics (1)
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- Central Line-Associated Bloodstream Infections (CLABSI) (2)
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- Clostridium difficile Infections (2)
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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 15 of 15 Research Studies DisplayedKeller SC, Williams D, Rock C
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
As more home infusion agencies consider ways to perform surveillance for central line–associated bloodstream infection (CLABSI), an understanding of the assorted challenges is necessary. The authors discussed these challenges, which include a lack of a widely accepted standard definition of CLABSIs in home infusion therapy, the lack of a reporting platform, the absence of a reporting requirement, and barriers in obtaining the needed information to identify the presence of a potential CLABSI and adjudicate whether it meets a CLABSI definition. The 21st Century Cures Act will expand Medicare coverage for home infusion therapy services by 2021, likely leading to increased pressure for home infusion therapy CLABSI surveillance. Benchmarking of CLABSI data can usher in informed work to reduce CLABSIs and enhance patient safety in home infusion therapy.
AHRQ-funded; HS025782.
Citation: Keller SC, Williams D, Rock C .
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
Am J Infect Control 2018 Dec;46(12):1419-21. doi: 10.1016/j.ajic.2018.05.016..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Home Healthcare, Patient Safety, Sepsis, Infectious Diseases, Prevention
Blanco N, Johnson JK, Sorkin JD
Transmission of resistant Gram-negative bacteria to healthcare personnel gowns and gloves during care of residents in community-based nursing facilities.
The purpose of this study was to estimate the risk of transmission of antibiotic-resistant Gram-negative bacteria (RGNB) to gowns and gloves worn by healthcare personnel when providing care to residents of community-based nursing facilities to identify the types of care and resident characteristics associated with transmission. The investigators found that RGNB transmission to either gloves or gowns occurred during 11% of the 584 interactions. Showering the resident, hygiene or toilet assistance, and wound dressing changes were associated with a high risk of transmission.
AHRQ-funded; HS019979.
Citation: Blanco N, Johnson JK, Sorkin JD .
Transmission of resistant Gram-negative bacteria to healthcare personnel gowns and gloves during care of residents in community-based nursing facilities.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1425-30. doi: 10.1017/ice.2018.247.
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Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Nursing Homes, Prevention, Provider, Provider: Health Personnel
Kline SE, Sanstead EC, Johnson JR
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
In this study, the investigators developed a decision analytic model to evaluate the impact of a preoperative Staphylococcus aureus decolonization bundle on surgical site infections (SSIs), health-care-associated costs (HCACs), and deaths due to SSI. The investigators predict that the treat-all strategy would be the most effective and cost-saving strategy for preventing SSIs. However, they concluded that because this strategy might select more extensively for mupirocin-resistant S. aureus and cause more medication adverse effects than the test-and-treat approach or the SOC, additional studies are needed to define its comparative benefits and harms.
AHRQ-funded; HS022912.
Citation: Kline SE, Sanstead EC, Johnson JR .
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
Infect Control Hosp Epidemiol 2018 Nov;39(11):1340-46. doi: 10.1017/ice.2018.228..
Keywords: Surgery, Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention, Healthcare Costs
Russell D, Dowding DW, McDonald MV
Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control.
This study analyzed survey responses from nurses at 2 large, certified home healthcare agencies to explore levels of compliance with infection control practices and identify associated demographic, knowledge, and attitudinal correlates. The findings suggested that efforts to improve compliance with infection control practices in home healthcare should focus on strategies to alter perceptions about infection risk and other attitudinal factors.
AHRQ-funded; HS024723.
Citation: Russell D, Dowding DW, McDonald MV .
Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control.
Am J Infect Control 2018 Nov;46(11):1211-17. doi: 10.1016/j.ajic.2018.05.005..
Keywords: Healthcare-Associated Infections (HAIs), Home Healthcare, Prevention, Patient Safety
Wilmont S, Hessels AJ, Kelly AM
Family experiences and perspectives on infection prevention in pediatric long-term care.
The aims of this qualitative study were to (a) explore perspectives on infection prevention among families visiting children in pediatric long-term care facilities and (b) identify facilitators of and barriers to optimal hand hygiene using semistructured in-depth interviews with 10 family members visiting two New York City metropolitan area facilities.
AHRQ-funded; HS021470.
Citation: Wilmont S, Hessels AJ, Kelly AM .
Family experiences and perspectives on infection prevention in pediatric long-term care.
Children/Adolescents, Healthcare-Associated Infections, Long-term Care, Pediatrics, Prevention Practices.
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Prevention, Patient Safety
Anderson DJ, Moehring RW, Weber DJ
Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover
In this study, the investigators aimed to assess the effectiveness of four disinfection strategies on hospital-wide incidence of multidrug-resistant organisms and Clostridium difficile in the Benefits of Enhanced Terminal Room (BETR) Disinfection study. The investigators found that enhanced terminal room disinfection with ultraviolet (UV) in a targeted subset of high-risk rooms led to a decrease in hospital-wide incidence of C difficile and vancomycin-resistant enterococci.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Moehring RW, Weber DJ .
Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover
Lancet Infect Dis 2018 Aug;18(8):845-53. doi: 10.1016/s1473-3099(18)30278-0..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Infectious Diseases, Inpatient Care, Patient Safety, Prevention
Baker AW, Haridy S, Salem J
Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.
The authors performed a pilot study within a large network of community hospitals to evaluate performance of statistical process control (SPC) methods for detecting surgical site infections (SSI) outbreaks. Their findings illustrated the potential usefulness and feasibility of real-time SPC surveillance of SSI to rapidly identify outbreaks and improve patient safety. Further study is needed to optimize SPC chart selection and calculation, statistical outbreak detection rules and the process for reacting to signals of potential outbreaks.
AHRQ-funded; HS023821.
Citation: Baker AW, Haridy S, Salem J .
Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.
BMJ Qual Saf 2018 Aug;27(8):600-10. doi: 10.1136/bmjqs-2017-006474..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Surgery, Hospitals, Public Health, Prevention, Adverse Events
Robinson GL, Otieno L, Johnson JK
Comparison of two glove-sampling methods to discriminate between study arms of a hand hygiene and glove-use study.
The authors of this article compared direct-imprint versus sponge-stick glove-sampling methods in order to identify an effective sampling method. Their study is imbedded in a randomized trial in which 42 healthcare personnel entered contact precaution rooms, randomized to perform either intervention or usual care. In both study arms, at the last hand hygiene opportunity before exiting the room or after the completion of seven hygiene opportunities, gloved hands were sampled to assess bacterial contamination; one hand (right/left randomized) was sampled using the sponge-stick method and the other was sampled by a direct imprint of the glove onto a tryptic soy agar plate. The authors detected a significant difference in both presence of pathogenic bacteria and colony-forming units between the intervention and usual care groups with the direct-imprint method. A significant difference was not detected with the sponge-stick method. Although they acknowledge that their study is limited by its small sample size, the authors conclude that the data supports the use of the direct imprint method for the culturing of gloved hands, which also has the advantages of a shorter sampling time, a shorter laboratory processing time, and is the less expensive of the two methods.
AHRQ-funded; HS024108.
Citation: Robinson GL, Otieno L, Johnson JK .
Comparison of two glove-sampling methods to discriminate between study arms of a hand hygiene and glove-use study.
Infect Control Hosp Epidemiol 2018 Jul;39(7):884-85. doi: 10.1017/ice.2018.91..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Allegranzi B, Aiken AM, Zeynep Kubilay N
A multimodal infection control and patient safety intervention to reduce surgical site infections in Africa: a multicentre, before-after, cohort study.
The researchers aimed to establish the effect of a multimodal intervention on surgical site infections (SSIs) in Africa. SSI cumulative incidence significantly decreased post intervention, from 8.0 percent to 3.8 percent and this decrease persisted in the sustainability period. A substantial improvement in compliance with prevention measures was consistently observed in the follow-up and sustainability periods.
AHRQ-funded; 290201000027.
Citation: Allegranzi B, Aiken AM, Zeynep Kubilay N .
A multimodal infection control and patient safety intervention to reduce surgical site infections in Africa: a multicentre, before-after, cohort study.
Lancet Infect Dis 2018 May;18(5):507-15. doi: 10.1016/s1473-3099(18)30107-5.
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Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Surgery, Injuries and Wounds, Prevention
Larson EL, Murray MT, Cohen B
Behavioral interventions to reduce infections in pediatric long-term care facilities: the keep it clean for kids trial.
Researchers examined the success of behavioral interventions to reduce infections in pediatric long-term care facilities. The intervention, called Keep it Clean for Kids, included leadership commitment, frequent hand-washing, and electronic monitoring of hand hygiene. Improvements were show in infection reduction in two sites, fewer hospitalizations in all sites, and varied outcomes in the number of outbreaks/cases.
AHRQ-funded; HS021470.
Citation: Larson EL, Murray MT, Cohen B .
Behavioral interventions to reduce infections in pediatric long-term care facilities: the keep it clean for kids trial.
Behav Med 2018 Apr-Jun;44(2):141-50. doi: 10.1080/08964289.2017.1288607..
Keywords: Children/Adolescents, Long-Term Care, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Lee YSH, Stone PW, Pogorzelska-Maziarz M
Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.
The objective of this study was to determine what aspects of the work environment lead to better adherence to best safety practice for central line-associated bloodstream infections (CLABSIs) prevention. Data was obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey with data on ICU and hospital characteristics obtained from the National Healthcare Safety Network. Workload and a quality-conscious environment were the most important factors associated with CLABSI bundle compliance.
AHRQ-funded; HS018987.
Citation: Lee YSH, Stone PW, Pogorzelska-Maziarz M .
Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.
Health Care Manage Rev 2018 Apr/Jun;43(2):138-47. doi: 10.1097/hmr.0000000000000134..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Patient Safety, Prevention
Taaffe K, Lee B, Ferrand Y
The influence of traffic, area location, and other factors on operating room microbial load.
The researchers sought to determine how the movement of patients, equipment, materials, staff, and door openings within the operating room (OR) affect microbial loads at various locations within the OR. They found that the microbial load was affected by the time of year that the samples were taken. Both microbial load measured by the air samplers and by settle plates in 1 area of the OR was correlated with the physical movement of people in the same area.
AHRQ-funded; HS024380.
Citation: Taaffe K, Lee B, Ferrand Y .
The influence of traffic, area location, and other factors on operating room microbial load.
Infect Control Hosp Epidemiol 2018 Apr;39(4):391-97. doi: 10.1017/ice.2017.323.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Prevention, Patient Safety
Khamash DF, Voskertchian A, Milstone AM
Manipulating the microbiome: evolution of a strategy to prevent S. aureus disease in children.
Hospitalized infants have the highest rates of invasive Staphylococcus aureus disease of any population and infection control strategies such as decolonization have been insufficient. In this article, the authors review what is known about bacterial communities in the nasal cavity of infants and discuss how future microbiome studies may help identify novel interventions to protect high-risk infants from S. aureus disease.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Milstone AM .
Manipulating the microbiome: evolution of a strategy to prevent S. aureus disease in children.
J Perinatol 2018 Feb;38(2):105-09. doi: 10.1038/jp.2017.155..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Children/Adolescents, Prevention, Newborns/Infants, Patient Safety
Anderson DJ, Knelson LP, Moehring RW
Implementation lessons learned from the Benefits of Enhanced Terminal Room (BETR) Disinfection study: process and perceptions of enhanced disinfection with ultraviolet disinfection devices.
The purpose of this article was to summarize and discuss logistic and administrative challenges encountered during the Benefits of Enhanced Terminal Room (BETR) Disinfection Study and lessons learned that are pertinent to future utilization of ultraviolet (UV) disinfection devices in other hospitals.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Knelson LP, Moehring RW .
Implementation lessons learned from the Benefits of Enhanced Terminal Room (BETR) Disinfection study: process and perceptions of enhanced disinfection with ultraviolet disinfection devices.
Infect Control Hosp Epidemiol 2018 Feb;39(2):157-63. doi: 10.1017/ice.2017.268..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Patient Safety
Seibert G, Ewers T, Barker AK
What do visitors know and how do they feel about contact precautions?
This study surveyed visitors of Clostridium difficile infection (CDI) patients to understand their compliance, knowledge, and perceptions of contact precautions. Nursing staff were the fundamental source for information on personal protective equipment (PPE) for visitors, but the researchers discovered variation in staff communication regarding the need for PPE use. Although most visitors knew where to find required personal protective equipment, less than half were fully compliant with gown and gloves.
AHRQ-funded; HS024039.
Citation: Seibert G, Ewers T, Barker AK .
What do visitors know and how do they feel about contact precautions?
Am J Infect Control 2018 Jan;46(1):115-17. doi: 10.1016/j.ajic.2017.05.011..
Keywords: Clostridium difficile Infections, Guidelines, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention