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AHRQ Research Studies Date
Topics
- Antibiotics (1)
- Antimicrobial Stewardship (2)
- Children/Adolescents (2)
- (-) Community-Acquired Infections (10)
- COVID-19 (2)
- Elderly (1)
- Emergency Department (1)
- Family Health and History (1)
- Home Healthcare (4)
- Hospitalization (2)
- Infectious Diseases (7)
- Medication (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Nursing (1)
- Patient Safety (1)
- Pneumonia (2)
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- Provider (2)
- Provider: Nurse (2)
- Public Health (1)
- Respiratory Conditions (1)
- Risk (3)
- Shared Decision Making (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 10 of 10 Research Studies DisplayedAdams V, Song J, Shang J
Infection prevention and control practices in the home environment: examining enablers and barriers to adherence among home health care nurses.
This study’s aim was to examine the impact of individual, home environment, and organization factors on Infection Prevention and Control (IPC) practices in home health care. A survey of 350 nurses across two large home care agencies was conducted to examine the relationship between IPC adherence and these factors. Multiple barriers to IPC practices in patients’ homes were reported including clutter (74.5%), and a dirty environment (70.3%). They also reported limited availability of some IPC supplies including personal protective equipment.
AHRQ-funded; HS024723.
Citation: Adams V, Song J, Shang J .
Infection prevention and control practices in the home environment: examining enablers and barriers to adherence among home health care nurses.
Am J Infect Control 2021 Jun;49(6):721-26. doi: 10.1016/j.ajic.2020.10.021..
Keywords: Home Healthcare, Community-Acquired Infections, Infectious Diseases, Prevention, Provider: Nurse, Provider
Vaughn VM, Gandhi T, Petty LA
Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with COVID-19: a multi-hospital cohort study.
A randomly sampled cohort of 1705 patients hospitalized with COVID-19 was used. Data was collected on early empiric antibacterial therapy within 2 days of hospitalization, empiric antibacterial therapy and community-onset bacterial co-infections. Of the 1705 patients, 56.6% were prescribed early empiric antibacterial therapy, with 3.5% having a confirmed community-onset bacterial infection. Use varied across hospitals, ranging from 27% to 84%. Patients were more likely to receive the therapy if they were older, had more severe illness, had a lobar infiltrate, or were admitted to a for-profit hospital. Over the one-month period empiric antibacterial use decreased.
AHRQ-funded; HS026530; HS026725.
Citation: Vaughn VM, Gandhi T, Petty LA .
Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with COVID-19: a multi-hospital cohort study.
Clin Infect Dis 2021 May 18;72(10):e533-e41. doi: 10.1093/cid/ciaa1239..
Keywords: COVID-19, Infectious Diseases, Community-Acquired Infections, Antimicrobial Stewardship, Antibiotics, Medication, Hospitalization
Russell D, Dowding D, Trifilio M
Individual, social, and environmental factors for infection risk among home healthcare patients: a multi-method study.
This paper is a study of nurse perceptions of individual, social, and environmental factors for infection risk among home healthcare (HHC) patients and also identifies the frequency of environmental barriers to infection prevention and control in HHC. Data were collected in 2017-2018 from qualitative interviews with 50 HHC nurses and structured observations of nurse visits to patients’ homes (n = 400). Perceived infection risk among patients was characterized as being influenced by knowledge of and attitudes towards infection prevention and engagement in hygiene practices, receipt of support from informal caregivers and nurse interventions aimed at cultivating infection control knowledge and practices, and the home environment. Frequent environmental barriers observed during visits to patients included clutter (39.5%), poor lighting (38.8%), dirtiness (28.5%), and pets (17.2%).
AHRQ-funded; HS024723.
Citation: Russell D, Dowding D, Trifilio M .
Individual, social, and environmental factors for infection risk among home healthcare patients: a multi-method study.
Health Soc Care Community 2021 May;29(3):780-88. doi: 10.1111/hsc.13321..
Keywords: Home Healthcare, Community-Acquired Infections, Risk, Provider: Nurse, Provider
O'Donoghue A, Dechen T, O'Donoghue A, Dechen T, Pavlova W W
Reopening businesses and risk of COVID-19 transmission.
In this paper, the authors used anonymized cell-phone data to quantify the potential risk of COVID-19 transmission in business establishments by building a Business Risk Index that measures transmission risk over time. They used two metrics, visits per square foot and the average duration of visits from January 2020 to June 2020. They found that an increase in a county's average Business Risk Index is associated with an increase in positive COVID-19 cases in 1 week. Their risk index provides a way for policymakers and hospital decision-makers to monitor the potential risk of COVID-19 transmission from businesses based on the frequency and density of visits to businesses.
AHRQ-funded; HS024288.
Citation: O'Donoghue A, Dechen T, O'Donoghue A, Dechen T, Pavlova W W .
Reopening businesses and risk of COVID-19 transmission.
NPJ Digit Med 2021 Mar 16;4(1):51. doi: 10.1038/s41746-021-00420-9..
Keywords: COVID-19, Community-Acquired Infections, Public Health, Risk
Haessler S, Lindenauer PK, Zilberberg MD
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
This study examined characteristics and outcomes of patients with positive cultures for pneumonia by site. The authors compared results from blood and respiratory cultures to see if organisms and resistance patterns differed by site. They studied adult patients discharged from July 2010 to June 2015 with principal diagnoses of pneumonia, respiratory failure, acute respiratory distress syndrome, respiratory arrest, or sepsis with a secondary diagnosis of pneumonia. Out of 138,651 hospitalizations of patients with pneumonia, 9.3% yielded positive cultures with 6438 from respiratory culture and 5992 blood cultures, and 45 both respiratory and blood cultures. Isolates from respiratory samples were often more resistant than were isolates from blood. Patients with positive cultures in both sites had higher case-fatality, longer lengths of stay and higher costs than patients who only had one culture site positive. Among respiratory cultures, the most common pathogens identified were Staphylococcus aureus (34%) and Pseudomonas aeruginosa (17%), whereas blood cultures most commonly grew Streptococcus pneumoniae (33%), followed by S. aureus (22%).
AHRQ-funded; HS024277.
Citation: Haessler S, Lindenauer PK, Zilberberg MD .
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
Clin Infect Dis 2020 Oct 23;71(7):1604-12. doi: 10.1093/cid/ciz1049..
Keywords: Pneumonia, Community-Acquired Infections, Respiratory Conditions, Infectious Diseases
Schimmel JJ, Haessler S, Imrey P
Pneumococcal urinary antigen testing in United States hospitals: a missed opportunity for antimicrobial stewardship.
The Infectious Disease Society of America recommends pneumococcal urinary antigen testing (UAT) when identifying pneumococcal infection would allow for antibiotic de-escalation. However, the frequencies of UAT and subsequent antibiotic de-escalation are unknown. The authors conducted this retrospective cohort study of adult patients admitted with community-acquired or healthcare-associated pneumonia to 170 US hospitals in the Premier database from 2010-2015, to describe variation in UAT use, associations of UAT results with antibiotic de-escalation, and associations of de-escalation with outcomes.
AHRQ-funded; HS024277.
Citation: Schimmel JJ, Haessler S, Imrey P .
Pneumococcal urinary antigen testing in United States hospitals: a missed opportunity for antimicrobial stewardship.
Clin Infect Dis 2020 Sep 12;71(6):1427-34. doi: 10.1093/cid/ciz983..
Keywords: Antimicrobial Stewardship, Community-Acquired Infections, Infectious Diseases, Pneumonia
Dowding D, Russell D, Trifilio M
Home care nurses' identification of patients at risk of infection and their risk mitigation strategies: a qualitative interview study.
Investigators sought to understand if and how home care nurses identify patients at high risk of infection and which strategies they use to mitigate that risk. Interviews with fifty nurses were audio recorded and transcribed. Factors identified by the nurses as putting a patient at higher risk of infection included being older, having diabetes, and inadequate nutrition as well as inadequate clinical information available at start of care. The main strategy for infection prevention was patient and caregiver education. Nurses also discussed the importance of their own infection prevention behaviors and the ability to adjust a patient's plan of care according to their infection risk.
AHRQ-funded; HS024723.
Citation: Dowding D, Russell D, Trifilio M .
Home care nurses' identification of patients at risk of infection and their risk mitigation strategies: a qualitative interview study.
Int J Nurs Stud 2020 Jul;107:103617. doi: 10.1016/j.ijnurstu.2020.103617..
Keywords: Home Healthcare, Community-Acquired Infections, Infectious Diseases, Patient Safety, Prevention, Nursing, Shared Decision Making
Hogan PG, Mork RL, Thompson RM
Environmental methicillin-resistant Staphylococcus aureus contamination, persistent colonization, and subsequent skin and soft tissue infection.
This 12-month prospective cohort study examined households contaminated with methicillin-resistant Staphylococcus aureus (MRSA), persistent colonization, and subsequent soft tissue infection (SSTI). Households in St. Louis who had members with community-acquired MRSA SSTI were longitudinally tracked from 2012 to 2015. A baseline visit was conducted at the index patient’s primary home, followed by four quarterly visits over 12 months. With each visit, an interview and serial cultures were collected. Of the 692 participants in 150 households, including 150 children, who completed all 5 samplings; 213 (39%) showed persistent colonization with S. aureus, particularly in the nose. Nine pets (8%) were persistently colonized with S. aureus. Interval SSTI was also associated with MRSA in 76 index patients (53%) and 101 household contacts (19%).
AHRQ-funded; HS021736; HS024269.
Citation: Hogan PG, Mork RL, Thompson RM .
Environmental methicillin-resistant Staphylococcus aureus contamination, persistent colonization, and subsequent skin and soft tissue infection.
JAMA Pediatr 2020 Jun;174(6):552-62. doi: 10.1001/jamapediatrics.2020.0132..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Community-Acquired Infections
Shang J, Russell D, Dowding D
A predictive risk model for infection-related hospitalization among home healthcare patients.
Infection prevention is a high priority for home healthcare (HHC), but tools are lacking to identify patients at highest risk of developing infections. The purpose of this study was to develop and test a predictive risk model to identify HHC patients at risk of an infection-related hospitalization or emergency department visit. A nonexperimental study using secondary data was conducted.
AHRQ-funded; HS024723.
Citation: Shang J, Russell D, Dowding D .
A predictive risk model for infection-related hospitalization among home healthcare patients.
J Healthc Qual 2020 May/Jun;42(3):136-47. doi: 10.1097/jhq.0000000000000214..
Keywords: Elderly, Home Healthcare, Infectious Diseases, Community-Acquired Infections, Risk, Hospitalization, Emergency Department
Mork RL, Hogan PG, Muenks CE
Longitudinal, strain-specific Staphylococcus aureus introduction and transmission events in households of children with community-associated meticillin-resistant S aureus skin and soft tissue infection: a prospective cohort study.
This prospective cohort study examined methods of transmission for methicillin-resistant Staphylococcus aureus (MRSA) in households with otherwise healthy children who have a MRSA infection. From 2012-2015 households in St. Louis with children who had a community-acquired MRSA skin and soft-tissue infection were longitudinally tracked. Children with other health issues were excluded. A baseline visit was conducted at the index patient’s primary home, followed by four quarterly visits over 12 months. With each visit, an interview and serial cultures were collected. Molecular typing was done of those samples to determine the distinct S aureus strain. MRSA recipients were most likely to live in a rental situation, and were more likely to share a bedroom with a strain-colonised individual. The most likely transmission source was shared bath towels. Pets were often recipients, but rarely the sole transmission source. Frequent handwashing decreased the likelihood of novel strains being introduced into the house and emphasizes the importance of hand hygiene.
AHRQ-funded; HS021736; HS024269
Citation: Mork RL, Hogan PG, Muenks CE .
Longitudinal, strain-specific Staphylococcus aureus introduction and transmission events in households of children with community-associated meticillin-resistant S aureus skin and soft tissue infection: a prospective cohort study.
Lancet Infect Dis 2020 Feb;20(2):188-98. doi: 10.1016/s1473-3099(19)30570-5..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Infectious Diseases, Community-Acquired Infections, Prevention, Children/Adolescents, Family Health and History