National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- COVID-19 (1)
- (-) Critical Care (6)
- Digestive Disease and Health (1)
- Healthcare-Associated Infections (HAIs) (1)
- Implementation (1)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (4)
- Kidney Disease and Health (1)
- Medication (2)
- Medication: Safety (1)
- Newborns/Infants (1)
- Outcomes (1)
- Patient Safety (2)
- Prevention (2)
- Provider: Pharmacist (1)
- (-) Quality Improvement (6)
- Quality of Care (6)
- Surgery (1)
- Urinary Tract Infection (UTI) (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedSikora A, Martin GS
Critical care pharmacists: improving care by increasing access to medication expertise.
This article discusses the shortage and need for critical care pharmacists in ICUs to improve care and prevent medication errors. There is a gap in critical care pharmacists with both low supply and low demand. Identifying the optimal patient:pharmacist ratio in the ICU is a key question. The authors discuss ways to reduce the gap by increasing the number of critical care pharmacy residency programs and including critical care pharmacists more in multidisciplinary rounds. The authors developed a toolkit for increasing critical care pharmacy services in five actionable steps and provide an annotated bibliography of key references.
AHRQ-funded; HS028485.
Citation: Sikora A, Martin GS .
Critical care pharmacists: improving care by increasing access to medication expertise.
Ann Am Thorac Soc 2022 Nov;19(11):1796-98. doi: 10.1513/AnnalsATS.202206-502VP..
Keywords: Provider: Pharmacist, Medication, Quality Improvement, Quality of Care, Critical Care
Krauss DM, Molefe A, Hung L
AHRQ Author: Henderson S, Miller M
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
Groetzinger LM, Rivosecchi RM, McVerry BJ
A quality improvement evaluation of a primary as-needed light sedation protocol in mechanically ventilated adults.
This study assessed outcomes of using a light-sedation protocol as needed compared to the more usual continuous infusion sedation in mechanically ventilated adults in medical intensive care units (ICUs). This retrospective review compared patients who received the as needed sedation protocol to similar patients treated initially with continuous infusion sedation at a 32-bed medical ICU in a large academic center. Over a 2-year period, 254 total mechanically ventilated patients were evaluated. Of the evaluable patients, 114 received the prioritizing as-needed sedation protocol, and 140 received the continuous infusion approach. In the as-needed group, 42% of patients never received continuous infusion sedation. The group also received significantly less opioid, propofol, and benzodiazepine; and experienced less delirium, shorter duration of mechanical ventilation, and shorter ICU length of stay compared to the continuous infusion sedation group.
AHRQ-funded; HS025455.
Citation: Groetzinger LM, Rivosecchi RM, McVerry BJ .
A quality improvement evaluation of a primary as-needed light sedation protocol in mechanically ventilated adults.
Crit Care Explor 2020 Dec;2(12):e0264. doi: 10.1097/cce.0000000000000264..
Keywords: Quality Improvement, Quality of Care, Intensive Care Unit (ICU), Critical Care, Implementation
Leeds IL, Jones C, DiBrito SR
Delay in emergency hernia surgery is associated with worse outcomes.
The purpose of this study was to determine if the variation in timing of urgent surgery impacts surgical outcomes. The National Surgical Quality Improvement Program (NSQIP) database was searched for emergent surgeries in 2011-2016 for abdominal hernia resulting in obstruction or gangrene by primary post-op diagnosis. Findings showed that delayed surgery was associated with increased rates of major complications, longer operative times, longer postoperative lengths of stay, increased re-operations, increased readmissions, and increased 30-day mortality. Next-day surgery and surgery delayed more than one day were associated with increased odds of a major complication.
AHRQ-funded; HS024547.
Citation: Leeds IL, Jones C, DiBrito SR .
Delay in emergency hernia surgery is associated with worse outcomes.
Surg Endosc 2020 Oct;34(10):4562-73. doi: 10.1007/s00464-019-07245-4..
Keywords: Surgery, Quality Improvement, Quality of Care, Critical Care, Access to Care, Digestive Disease and Health, Outcomes
Napolitano N, Laverriere EK, Craig N
Apneic oxygenation as a quality improvement intervention in an academic PICU.
The objective of this prospective pre/post observational study was to evaluate if the use of apneic oxygenation during tracheal intubation in children is feasible and would decrease the occurrence of oxygen desaturation. The investigators concluded that implementation of apneic oxygenation in PICU was feasible, and was associated with significant reduction in moderate and severe oxygen desaturation. They suggest that use of apneic oxygenation should be considered when intubating critically ill children.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Napolitano N, Laverriere EK, Craig N .
Apneic oxygenation as a quality improvement intervention in an academic PICU.
Pediatr Crit Care Med 2019 Dec;20(12):e531-e37. doi: 10.1097/pcc.0000000000002123..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Quality Improvement, Quality of Care, Patient Safety, Adverse Events
Stoops C, Stone S, Evans E
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
The purpose of this study was to test if acute kidney injury (AKI) is preventable in patients in the neonatal intensive care unit and if infants at high-risk of nephrotoxic medication-induced AKI can be identified using a systematic surveillance program previously used in the pediatric non-intensive care unit setting. The authors concluded that a systematic surveillance program to identify high-risk infants can prevent nephrotoxic-induced AKI and has the potential to prevent short and long-term consequences of AKI in critically ill infants.
AHRQ-funded; HS023763.
Citation: Stoops C, Stone S, Evans E .
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
J Pediatr 2019 Dec;215:223-28.e6. doi: 10.1016/j.jpeds.2019.08.046..
Keywords: Newborns/Infants, Medication, Medication: Safety, Patient Safety, Kidney Disease and Health, Intensive Care Unit (ICU), Critical Care, Quality Improvement, Quality of Care, Prevention, Adverse Drug Events (ADE), Adverse Events