National Healthcare Quality and Disparities Report
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Topics
- Burnout (4)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Clostridium difficile Infections (1)
- Communication (1)
- Decision Making (1)
- Diagnostic Safety and Quality (1)
- Education: Academic (1)
- Education: Continuing Medical Education (3)
- Elderly (1)
- Electronic Health Records (EHRs) (4)
- Emergency Department (1)
- Falls (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (3)
- Health Information Technology (HIT) (5)
- Home Healthcare (2)
- Hospitals (3)
- Infectious Diseases (1)
- Inpatient Care (1)
- Labor and Delivery (2)
- Long-Term Care (1)
- Maternal Care (1)
- Newborns/Infants (1)
- Nursing (5)
- Nursing Homes (1)
- Patient Safety (5)
- Policy (3)
- Pregnancy (2)
- Prevention (2)
- Primary Care (4)
- Provider (14)
- Provider: Clinician (5)
- (-) Provider: Nurse (20)
- Provider: Physician (4)
- Public Health (1)
- Quality of Care (1)
- Rural Health (1)
- Stress (1)
- Teams (1)
- Urinary Tract Infection (UTI) (1)
- Women (1)
- Workflow (1)
- Workforce (3)
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 20 of 20 Research Studies DisplayedTan M, Lipman S, Lee H
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
The impact of the electronic medical record (EMR) on nursing workload is not well understood. The objective of this descriptive study was to measure the actual and perceived time that nurses spend on the EMR in the operating room during cesarean births. The investigators found that on average, nurses spent 40% of their intraoperative time on the EMR during cesarean births, and this time burden was distributed across the perioperative period.
AHRQ-funded; HS023506.
Citation: Tan M, Lipman S, Lee H .
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
J Patient Saf 2019 Dec;15(4):e82-e85. doi: 10.1097/pts.0000000000000467..
Keywords: Electronic Health Records (EHRs), Labor and Delivery, Provider: Nurse, Health Information Technology (HIT), Provider, Pregnancy
Krein SL, Kuhn L, Ratz D
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
The authors identified the prevalence of and factors associated with having a designated nurse peripherally inserted central catheter (PICC) team among U.S. acute care hospitals. They found that nurse PICC teams inserted PICCs in more than 60% of U.S. hospitals during the study period. Moreover, certain practices to prevent central line-associated bloodstream infection, including maximum sterile barrier precautions, chlorhexidine gluconate for insertion site antisepsis, and facility-wide insertion checklists were regularly used by a higher percentage of hospitals with nurse PICC teams compared with those without. They concluded that nurse PICC teams play an integral role in PICC use at many hospitals and that use of such teams may promote key practices to prevent complications.
AHRQ-funded; HS022835.
Citation: Krein SL, Kuhn L, Ratz D .
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
J Patient Saf 2019 Dec;15(4):293-95. doi: 10.1097/pts.0000000000000246..
Keywords: Nursing, Teams, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Inpatient Care, Hospitals, Patient Safety, Prevention, Provider: Nurse, Provider
Kang Y, Taylor JO, Osterhage K
Home care nurses' perspectives regarding health information management among older adults.
The purpose of this qualitative study was to determine how home healthcare nurses (HCNs) obtain and provide health information, to describe the perspective of HCNs regarding older adult personal health information (PHI), and to identify the potential role of technology in older adult health information transfer. Researchers conducted and analyzed phone interviews with 17 HCNs from two home healthcare agencies. Results showed these five themes: 1) common practices of obtaining health information; 2) barriers to obtaining health information; 3) ideal ways to obtain and provide health information; 4) use of patient portals; and 5) HCNs' use of technology for health information exchange. Most HCNs reported that it would be difficult for older adult patients to update their PHI without assistance, but HCNs lack the time and resources to assist older adults in PHI management activities.
AHRQ-funded; HS022106.
Citation: Kang Y, Taylor JO, Osterhage K .
Home care nurses' perspectives regarding health information management among older adults.
Home Healthc Now 2019 Nov/Dec;37(6):319-27. doi: 10.1097/nhh.0000000000000796..
Keywords: Home Healthcare, Elderly, Health Information Technology (HIT), Provider: Nurse, Provider
Kelly LA, McHugh MD, Aiken LH
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
The goal of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. Results demonstrated superior nurse work environments in Magnet hospitals compared with non-Magnet hospitals, with better work environments being associated with lower nurse job dissatisfaction and burnout. Three decades of evidence showing superior outcomes for Magnet hospitals place this organizational innovation into a class all of its own as best practice, deserving the attention of hospital leaders, nurses, and the public.
AHRQ-funded; HS017551.
Citation: Kelly LA, McHugh MD, Aiken LH .
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
J Nurs Adm 2019 Oct;49(10S Suppl):S19-s24. doi: 10.1097/nna.0000000000000801..
Keywords: Burnout, Hospitals, Provider, Provider: Nurse, Workforce
White EM, Aiken LH, McHugh MD
Registered nurse burnout, job dissatisfaction, and missed care in nursing homes.
The purpose of this article was to examine the relationship between registered nurse (RN) burnout, job dissatisfaction, and missed care in nursing homes. The investigators concluded that missed nursing care due to inadequate time or resources is common in nursing homes and is associated with RN burnout and job dissatisfaction; they indicated that improved work environments with sufficient staff hold promise for improving care and nurse retention.
AHRQ-funded; HS000011.
Citation: White EM, Aiken LH, McHugh MD .
Registered nurse burnout, job dissatisfaction, and missed care in nursing homes.
J Am Geriatr Soc 2019 Oct;67(10):2065-71. doi: 10.1111/jgs.16051..
Keywords: Provider: Nurse, Provider, Burnout, Nursing Homes, Long-Term Care, Workforce
Manojlovich M, Ameling JM, Forman J
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
This study identified contextual barriers to communication between physicians and nurses that contribute to inappropriate use of catheters and increased risk of health care-associated infections. The researchers conducted individual and small-group semistructured interviewed with physicians and nurses in a progressive care unit of an academic hospital. Common barriers included workflow misalignment between clinicians, issues with electronic medical records and pagers, and strained relationships between clinicians.
AHRQ-funded; HS024385.
Citation: Manojlovich M, Ameling JM, Forman J .
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
Am J Crit Care 2019 Jul;28(4):290-98. doi: 10.4037/ajcc2019372..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Healthcare-Associated Infections (HAIs), Patient Safety, Provider, Provider: Nurse, Provider: Physician, Urinary Tract Infection (UTI), Workflow
Sockolow PS, Bass EJ, Ynag Y
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
This study investigated the availability and quality of information used by nurses in a rural home health care agency during patient admission. Twelve in-home admissions were observed and the nurses were interviewed before and after the admissions process. Content and quality of documents available to the nurses was analyzed and needed documents were not uniformly present. They rarely received visit pattern or medication management information. These results show the need for a high quality electronic health record system.
AHRQ-funded; HS024537.
Citation: Sockolow PS, Bass EJ, Ynag Y .
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
Stud Health Technol Inform 2019 Aug 21;264:798-802. doi: 10.3233/shti190333..
Keywords: Rural Health, Home Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Provider
Kroth PJ, Morioka-Douglas N, Veres S
Association of electronic health record design and use factors with clinician stress and burnout.
The authors sought to determine which electronic health record (EHR) design and use factors are associated with clinician stress and burnout and to identify other sources that contribute to this problem. Surveying ambulatory primary care and subspecialty clinicians from 3 institutions, they found that, although EHR design and use factors are associated with clinician stress and burnout, other challenges, such as chaotic clinic atmospheres and workload control, explain considerably more of the variance in these adverse clinician outcomes.
AHRQ-funded; HS022065.
Citation: Kroth PJ, Morioka-Douglas N, Veres S .
Association of electronic health record design and use factors with clinician stress and burnout.
JAMA Netw Open 2019 Aug 2;2(8):e199609. doi: 10.1001/jamanetworkopen.2019.9609..
Keywords: Burnout, Stress, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider: Clinician, Provider: Physician, Provider: Nurse
Poghosyan L, Ghaffari A, Shaffer J
Nurse practitioner primary care organizational climate questionnaire: item response theory and differential item functioning.
This study evaluated the Nurse Practitioner Primary Care Organization Climate Questionnaire (NP-PCOCQ) and the items on the questionnaire using item response theory (IRT) and also conducted differential item functioning (DIF) analysis. The questionnaire was sent to 278 primary nurse practitioners (NPs) in New York State, and 314 NPs in Massachusetts. Data was collected online in NY and a mail survey was used in MA in 2012. Out of 29 items on the questionnaire, only 5 exhibited DIF. Out of these results, a shortened 24-item questionnaire was developed.
AHRQ-funded; HS020999.
Citation: Poghosyan L, Ghaffari A, Shaffer J .
Nurse practitioner primary care organizational climate questionnaire: item response theory and differential item functioning.
J Clin Nurs 2019 Aug;28(15-16):2934-45. doi: 10.1111/jocn.14895..
Keywords: Primary Care, Provider: Clinician, Provider: Nurse, Provider
Hande K, Christenbery T, Phillippi J
Appreciative advising pilot study: an innovative approach to advising doctor of nursing practice students.
The purpose of this pilot study was to determine the feasibility of a doctor of nursing practice (DNP) appreciative advising model to advise students through the rigors of DNP education and improve student and faculty satisfaction. Faculty were provided with comprehensive guidebooks and received orientation on the model; qualitative responses were analyzed using content analysis. Results showed that the student and faculty participants reported satisfaction with the model and commented that the model allowed for early identification of needs and was helpful and worthwhile. These results suggest that the model may hold promise as a solution to assist students in adjusting to DNP education.
AHRQ-funded; HS024733.
Citation: Hande K, Christenbery T, Phillippi J .
Appreciative advising pilot study: an innovative approach to advising doctor of nursing practice students.
Nurse Educ 2019 Jul/Aug;44(4):187-91. doi: 10.1097/nne.0000000000000593..
Keywords: Provider: Nurse, Nursing, Education: Academic, Education: Continuing Medical Education
Linzer M, Poplau S, Prasad K
Characteristics of health care organizations associated with clinician trust: results from the healthy work place study.
This study examined clinician trust among clinicians in private practices using retrospective cohort data from the Healthy Work Place randomized clinical trial. Thirty-four primary care practices in the Upper Midwest and East Coast were sampled. The study included 165 clinicians with most being physicians, and some advanced practice clinicians (nurse practitioners and physician assistants). Measures of clinician trust included belonging, loyalty, safety focus, sense of trust, and responsibility to clinicians in need. The population surveyed were 87.7% physicians and 52.1% women. Most (63.6%) worked in family medicine and the rest in internal medicine. Greater work control was associated with higher levels of trust. Men were more likely to express loyalty and high trust. Higher trust was associated with greater work satisfaction and leads to better staff retention and lower stress levels.
AHRQ-funded.
Citation: Linzer M, Poplau S, Prasad K .
Characteristics of health care organizations associated with clinician trust: results from the healthy work place study.
JAMA Netw Open 2019 Jun 5;2(6):e196201. doi: 10.1001/jamanetworkopen.2019.6201..
Keywords: Primary Care, Provider, Provider: Clinician, Provider: Nurse, Provider: Physician
Aronson PL, Schaeffer P, Fraenkel L
Physicians' and nurses' perspectives on the decision to perform lumbar punctures on febrile infants </=8 weeks old.
This paper discusses the reasons for wide variation in the decision to perform lumbar punctures (LPs) in febrile infants 8 weeks or less. Semi-structured interviews were conducted with 15 pediatric and general emergency medicine physicians and 8 pediatric emergency medicine nurses at an urban, academic medical center. Five themes emerged from the interviews that included: age of the infant, the physician’s clinical experience, physician’s use of research findings, the physician’s values, and the role of the primary care pediatrician.
AHRQ-funded; HS026006.
Citation: Aronson PL, Schaeffer P, Fraenkel L .
Physicians' and nurses' perspectives on the decision to perform lumbar punctures on febrile infants </=8 weeks old.
Hosp Pediatr 2019 Jun;9(6):405-14. doi: 10.1542/hpeds.2019-0002..
Keywords: Newborns/Infants, Decision Making, Provider: Physician, Provider: Nurse, Provider: Clinician, Provider, Emergency Department, Diagnostic Safety and Quality
Simpson KR, Lyndon A, Spetz J
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Labor and delivery nurses were surveyed to determine if their units adhere to Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines. Labor nurses in selected hospitals in California, Michigan and New Jersey were invited via email to participate in the study. Their nurse leaders facilitated the invitations. A total of 615 labor nurses from 67 hospitals participated. Most nurses did report that staffing guidelines were adhered to. The hospitals with smaller annual birth volumes (500-999 range) were significantly more like to be perceived as compliant than hospitals with 2,500 or more annual births.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Nurs Womens Health 2019 Jun;23(3):217-23. doi: 10.1016/j.nwh.2019.03.003..
Keywords: Care Management, Guidelines, Labor and Delivery, Maternal Care, Patient Safety, Pregnancy, Provider, Provider: Nurse, Women
Hessels AJ, Kelly AM, Chen L
Impact of infectious exposures and outbreaks on nurse and infection preventionist workload.
Researchers evaluated workload increases reported by staff nurses and infection preventionists (IPs) in response to common exposures and outbreaks. Using surveys, they concluded that organisms that are easier to treat and more difficult to spread, such as scabies or lice, can contribute substantially to nursing workload. Additionally, three-quarters of the nurses and one-half of the IPs reported that C difficile adds more than one hour to their daily workload.
AHRQ-funded; HS024915.
Citation: Hessels AJ, Kelly AM, Chen L .
Impact of infectious exposures and outbreaks on nurse and infection preventionist workload.
Am J Infect Control 2019 Jun;47(6):623-27. doi: 10.1016/j.ajic.2019.02.007..
Keywords: Burnout, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Provider: Nurse, Public Health
de Cordova PB, Rogowski J, Riman KA
Effects of public reporting legislation of nurse staffing: a trend analysis.
The authors examined nurse staffing trends after the New Jersey enactment of P.L.1971, c.136 (C.26:2 H-13) on January 24, 2005, mandating that all health care facilities compile, post, and report staffing information. They found that the number of patients per registered nurse decreased for ten specialties, and conclude that this indicates the importance of public reporting in improving patient safety.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Rogowski J, Riman KA .
Effects of public reporting legislation of nurse staffing: a trend analysis.
Policy Polit Nurs Pract 2019 May;20(2):92-104. doi: 10.1177/1527154419832112..
Keywords: Hospitals, Patient Safety, Workforce, Policy, Provider, Provider: Nurse
Mark BA, Patel E
Nurse practitioner scope of practice: what do we know and where do we go?
This article discusses how state-level nurse practitioner (NP) scope of practice (SOP) policies effect access to primary care. In states where SOP policies became less restrictive, patients reported better access to healthcare including increased availability of appointments, greater checkup utilization, decreased emergency visits for ambulatory care, and decreased administrative burden for physicians. There have been a number of studies in states that have restrictive NP SOP policies, and they do not improve quality of care. It was found that states that still had restrictive policies tended to have more political pressure by physician groups than those states and repealed it.
AHRQ-funded; HS000032.
Citation: Mark BA, Patel E .
Nurse practitioner scope of practice: what do we know and where do we go?
West J Nurs Res 2019 Apr;41(4):483-87. doi: 10.1177/0193945918820338..
Keywords: Policy, Primary Care, Provider: Nurse, Provider: Clinician, Provider
Dykes PC, Bogaisky M, Carter EJ
Development and validation of a fall prevention knowledge test.
The authors developed and evaluated a fall prevention knowledge test (FPKT). The 11-item FPKT scale producing statistically significant differences confirmed validity. They recommended that a robust way to assess nurses' knowledge of fall prevention is needed to inform effective educational programs. They concluded that addressing gaps in validated FPKTs provides an opportunity to inform and evaluate effective fall prevention programs.
AHRQ-funded; HS025128; HS023535.
Citation: Dykes PC, Bogaisky M, Carter EJ .
Development and validation of a fall prevention knowledge test.
J Am Geriatr Soc 2019 Jan;67(1):133-38. doi: 10.1111/jgs.15563..
Keywords: Falls, Prevention, Provider: Nurse, Provider, Education: Continuing Medical Education
Kutney-Lee A, Sloane DM, Bowles KH
Electronic health record adoption and nurse reports of usability and quality of care: the role of work environment.
This study assessed the role of electronic health record (EHR) adoption and work environment for nurses. If the EHR system has positive usability ratings it impacts quality of care. Over 12,000 nurses in 353 hospitals were surveyed.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Sloane DM, Bowles KH .
Electronic health record adoption and nurse reports of usability and quality of care: the role of work environment.
Appl Clin Inform 2019 Jan;10(1):129-39. doi: 10.1055/s-0039-1678551..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing, Provider: Nurse, Quality of Care
de Cordova PB, Steck MBW, Vermeesch A
Health policy engagement among graduate nursing students in the United States.
This study researched the availability and requirements for graduate nursing students to take a dedicated health policy course. American Association of College of Nursing (AACN) member institution students were polled and over 75% reported taking a health policy course. There was an equal distribution between master’s and doctoral students.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Steck MBW, Vermeesch A .
Health policy engagement among graduate nursing students in the United States.
Nurs Forum 2019 Jan;54(1):38-44. doi: 10.1111/nuf.12295..
Keywords: Education: Continuing Medical Education, Nursing, Policy, Provider: Nurse
Ricciardi R, Shofer M
AHRQ Author: Ricciardi R, Shofer M
Nurses and patients: Natural partners to advance patient safety.
In this Agency for Healthcare Research and Quality commentary, the authors discuss the nurse-patient partnership and its potential for enhancing communication and improving patient safety practices.
AHRQ-authored.
Citation: Ricciardi R, Shofer M .
Nurses and patients: Natural partners to advance patient safety.
J Nurs Care Qual 2019 Jan/Mar;34(1):1-3. doi: 10.1097/ncq.0000000000000377..
Keywords: Nursing, Provider: Nurse, Patient Safety