National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (48)
- Ambulatory Care and Surgery (8)
- Antibiotics (7)
- Antimicrobial Stewardship (2)
- Cancer (3)
- Cancer: Breast Cancer (2)
- Cardiovascular Conditions (6)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children/Adolescents (7)
- Clostridium difficile Infections (1)
- Comparative Effectiveness (2)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Data (2)
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- Digestive Disease and Health (1)
- Elderly (2)
- Electronic Health Records (EHRs) (6)
- Evidence-Based Practice (3)
- Guidelines (1)
- (-) Healthcare-Associated Infections (HAIs) (85)
- Healthcare Cost and Utilization Project (HCUP) (2)
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- Health Information Technology (HIT) (9)
- Health Insurance (1)
- Heart Disease and Health (2)
- Hospital Discharge (2)
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- Patient-Centered Outcomes Research (4)
- Patient Safety (47)
- Patient Self-Management (1)
- Payment (3)
- Pneumonia (2)
- Practice Patterns (1)
- Pregnancy (1)
- Prevention (16)
- Provider Performance (3)
- Public Health (2)
- Quality Improvement (11)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (15)
- Registries (2)
- Risk (18)
- Sepsis (1)
- Social Determinants of Health (1)
- (-) Surgery (85)
- Surveys on Patient Safety Culture (1)
- Telehealth (3)
- Transplantation (1)
- Urinary Tract Infection (UTI) (2)
- Women (4)
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 85 Research Studies DisplayedLiu S, Matvekas A, Naimi T
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
This study’s objective was to use algorithms that repurpose radiologic data into body composition (morphomics) to aid in informing dosing decisions for the antibiotic cefazolin for patients undergoing colorectal surgery who have obesity. This prospective study measured cefazolin plasma, fat, and colon tissue concentrations in these patients to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in 21 morbidly obese patients (body mass index ≥35 kg/m2 with one or more co-morbid conditions). Morphomics and pharmacokinetic data were available in 58 patients with a median weight of 95.9 kg and and 55 years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 for the PopPK model and 0.060 for the PBPK model. Covariates of cefazolin exposure were identified as the estimated creatinine clearance (eCL(cr) ) and body depth at the third lumbar vertebra (body depth_L3). The authors concluded that kidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. They advised that data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
AHRQ-funded; HS027183.
Citation: Liu S, Matvekas A, Naimi T .
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Pharmacotherapy 2024 Jan; 44(1):77-86. doi: 10.1002/phar.2878..
Keywords: Surgery, Antibiotics, Medication, Prevention, Obesity, Healthcare-Associated Infections (HAIs)
Ye S, Li D, Yu T
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Researchers investigated the effect of surgical volume on the accuracy of identifying poorly performing hospitals. Their research was based on the standardized infection ratio, and they applied their proposed method to data from HCA Healthcare from 2014-2016 on surgical site infections in colon surgery patients. They concluded that minimum surgical volumes and predicted events criteria are required to make hospital evaluation reliable, and that these criteria may vary by overall prevalence and between-hospital variability.
AHRQ-funded; HS027791.
Citation: Ye S, Li D, Yu T .
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Sci Rep 2023 May 10; 13(1):7624. doi: 10.1038/s41598-023-33937-y..
Keywords: Hospitals, Surgery, Healthcare-Associated Infections (HAIs), Provider Performance, Quality of Care
Baker AW, Ilieş I, Benneyan JC
Early recognition and response to increases in surgical site infections using optimised statistical process control charts - the early 2RIS trial: a multicentre stepped wedge cluster randomised controlled trial.
This study compared outcomes of traditional surgical site infection (SSI) surveillance versus optimized statistical control process (SPC) surveillance post-surgery. The authors conducted a stepped wedge cluster randomized trial of patients who underwent any of 13 types of common surgical procedures across 29 community hospitals in the Southeastern United States. They divided the 13 procedures into six clusters. The study period was from March 2016 through February 2020 with 204,233 unique patients undergoing 237,704 surgical procedures. SSIs occurred more frequently in patients assigned control surveillance (1171 procedures) compared to 781 procedures that received the intervention. More formal investigations were also generated from control surveillance – 74 formal investigations versus 24. Multiple best practice deficiencies were identified from optimized SPC surveillance as well.
AHRQ-funded; HS023821.
Citation: Baker AW, Ilieş I, Benneyan JC .
Early recognition and response to increases in surgical site infections using optimised statistical process control charts - the early 2RIS trial: a multicentre stepped wedge cluster randomised controlled trial.
EClinicalMedicine 2022 Dec;54:101698. doi: 10.1016/j.eclinm.2022.101698..
Keywords: Surgery, Healthcare-Associated Infections (HAIs)
Warren DK, Peacock KM, Nickel KB
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
The authors investigated factors associated with post-discharge prophylactic antibiotic use after mastectomy with and without immediate reconstruction and the impact on surgical-site infection (SSI). They found that anti-methicillin-sensitive Staphylococcus aureus antibiotics were associated with decreased risk of SSI for patients who had mastectomy only and those who had mastectomy with immediate reconstruction. They concluded that the high numbers needed to treat suggest that potential benefits of post-discharge antibiotics should be weighed against potential harms associated with antibiotic overuse.
AHRQ-funded; HS019455.
Citation: Warren DK, Peacock KM, Nickel KB .
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
Infect Control Hosp Epidemiol 2022 Oct;43(10):1382-88. doi: 10.1017/ice.2021.400..
Keywords: Antibiotics, Cancer: Breast Cancer, Cancer, Medication, Surgery, Healthcare-Associated Infections (HAIs), Prevention, Women, Practice Patterns
Schlick CJR, Huang R, Brajcich BC
Unbundling bundles: evaluating the association of individual colorectal surgical site infection reduction bundle elements on infection rates in a statewide collaborative.
The purpose of this study was to evaluate the association of individual surgical site infection reduction bundle elements with infection rates. Focusing on patients who had elective colorectal resections at participating hospitals from 2016 to 2017, findings showed that bundle elements had varying association with infection reduction. Recommendations included implementation of colorectal surgical site infection reduction bundles in order to focus on the specific elements associated with low surgical site infections.
AHRQ-funded; HS024516.
Citation: Schlick CJR, Huang R, Brajcich BC .
Unbundling bundles: evaluating the association of individual colorectal surgical site infection reduction bundle elements on infection rates in a statewide collaborative.
Dis Colon Rectum 2022 Aug;65(8):1052-61. doi: 10.1097/dcr.0000000000002223..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care
Skube SJ, Hu Z, Simon GJ
Accelerating surgical site infection abstraction with a semi-automated machine-learning approach.
The purpose of this study was to test a supervised machine learning algorithm developed for testing surgical site infection (SSI) on performing semi-automated SSI abstraction, and to demonstrate that a semi-automated approach to health data abstraction provides a high level of accuracy and significant efficiencies. The researchers evaluated data from 6,188 patients in a 2011-2013 dataset and 5,132 patients in a 2015-2015 dataset. The study concluded that very good performance is achieved using the semi-automated machine learning-aided SSI abstraction, which also accelerates the abstraction process.
AHRQ-funded; HS024532.
Citation: Skube SJ, Hu Z, Simon GJ .
Accelerating surgical site infection abstraction with a semi-automated machine-learning approach.
Ann Surg 2022 Jul 1;276(1):180-85. doi: 10.1097/sla.0000000000004354..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Health Information Technology (HIT)
Eisenberg MT, Block AM, Vopat ML
Rates of infection after ACL reconstruction in pediatric and adolescent patients: a MarketScan database study of 44,501 patients.
This study’s objective was to describe and analyze the rates of surgical site infections after anterior cruciate ligament (ACL) surgery in pediatric patients. The Truven Health Analytics MarketScan Commercial Claims and Encounters database was used to access data for privately insured individuals aged 5 to 30 years old. ACL reconstruction operation records were accessed for operations performed from 2006 to 2018. The database identified 44,501 individuals up to 18 years old, and 63,495 individuals aged 18 to 30 years old that underwent arthroscopic ACL reconstruction. No differences in infection rates were found between the two groups. However, among patients younger than 18 years, patients below 15 years old had a significantly lower infection rate at 0.37% compared with adolescents 15 to 17 years old at 0.55%. Among young adults, males had a higher infection rate than females, while no differences were observed in the pediatric and adolescent population.
AHRQ-funded; HS019455.
Citation: Eisenberg MT, Block AM, Vopat ML .
Rates of infection after ACL reconstruction in pediatric and adolescent patients: a MarketScan database study of 44,501 patients.
J Pediatr Orthop 2022 Apr;42(4):e362-e66. doi: 10.1097/bpo.0000000000002080..
Keywords: Children/Adolescents, Surgery, Orthopedics, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds
Ernest EC, Hellar A, Varallo J
Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention.
This study evaluated the impact of a multicomponent safe surgery intervention in Tanzania to reduce surgical site infection (SSI) rates and mortality after caesarean sections (CS). The authors used the WHO Surgical Safety Checklist (SSC) to measure WHO SSC utilization, SSI rates, and CS-related perioperative mortality rates (POMRs) before and 18 months after implementation. The SSC utilization rate for CS increased from 3.7% to 95.1%, which decreased the proportion of women with SSI after CS from 14% during baseline to 1%. CS-related POMR decreased by 38.5% after implementation of safe surgery interventions as well.
AHRQ-funded; HS024235.
Citation: Ernest EC, Hellar A, Varallo J .
Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention.
BMJ Glob Health 2021 Dec;6(12). doi: 10.1136/bmjgh-2021-006788..
Keywords: Maternal Care, Pregnancy, Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Adverse Events, Patient Safety
Bucher BT, Yang M, Arndorfer J
Changes in the accuracy of administrative data for the detection of surgical site infections.
The authors performed a retrospective analysis of the changes in accuracy of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes for colectomy and hysterectomy surgical site infection surveillance. They found no significant change in the accuracy of these codes following the transition from ICD-CM ninth edition to tenth edition codes.
AHRQ-funded; HS025776.
Citation: Bucher BT, Yang M, Arndorfer J .
Changes in the accuracy of administrative data for the detection of surgical site infections.
Infect Control Hosp Epidemiol 2021 Sep;42(9):1128-30. doi: 10.1017/ice.2020.1346..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Diagnostic Safety and Quality
Zhu Y, Simon GJ, Wick EC
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
Surgical complications have tremendous consequences and costs. Complication detection is important for quality improvement, but traditional manual chart review is burdensome. Automated mechanisms are needed to make this more efficient. The purpose of the study was to understand the generalizability of a machine learning algorithm between sites; automated surgical site infection (SSI) detection algorithms developed at one center were tested at another distinct center.
AHRQ-funded; HS024532.
Citation: Zhu Y, Simon GJ, Wick EC .
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
J Am Coll Surg 2021 Jun;232(6):963-71.e1. doi: 10.1016/j.jamcollsurg.2021.03.026..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Brajcic BC, Ko CY, Liu JB
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
This paper describes the protocol for an upcoming multicenter randomized surgical trial to evaluate choice of prophylactic antibiotics for pancreaticoduodenectomy. The rationale and methodology of the trial evaluating piperacillin-tazobactam compared to cefoxitin for surgical site infection prevention is described. The study will utilize a clinical registry for data collection.
AHRQ-funded; HS000078.
Citation: Brajcic BC, Ko CY, Liu JB .
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
J Surg Oncol 2021 May;123(6):1387-94. doi: 10.1002/jso.26402..
Keywords: Cancer, Antibiotics, Medication, Prevention, Surgery, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Evidence-Based Practice
O'Hara NN, Mullins CD, Slobogean GP
Association of postoperative infections after fractures with long-term income among adults.
This retrospective cohort study evaluated the association between postoperative infection in patients with surgically treated fractures and long-term income loss. Out of 11,673 adults who underwent surgery to treat fractures of the extremities or pelvis from 2003-2016, a total of 3.5% had a postoperative infection. These infections were associated with a $6080 annual decrease in household income in the 6 years after injury. There was a 6.6% increase in the risk of catastrophic wage loss within 2 years of the fracture and a 45% increase in the odds of receiving Social Security benefits. However, postoperative infections were not associated with an increase in the value of the Social Security benefits received.
AHRQ-funded; HS027218.
Citation: O'Hara NN, Mullins CD, Slobogean GP .
Association of postoperative infections after fractures with long-term income among adults.
JAMA Netw Open 2021 Apr;4(4):e216673. doi: 10.1001/jamanetworkopen.2021.6673..
Keywords: Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Adverse Events, Healthcare Costs
Aasen DM, Bronsert Rozeboom, PD
Relationships between predischarge and postdischarge infectious complications, length of stay, and unplanned readmissions in the ACS NSQIP database.
This study looked at the relationships between predischarge and postdischarge infectious complications, length of stay, and unplanned hospital readmissions after surgery. Data from the American College of Surgeons National Surgical Quality Improvement database from 2012 to 2017 across nine surgical specialties was used to analyze 30-day postoperative infectious complications including sepsis, surgical site infections, pneumonia, and urinary tract infections. Postoperative infectious complications were identified in 5.2% of cases, of which 59.8% were postdischarge. The specific postdischarge complications identified were 73.4% of surgical site infections, 34.9% of sepsis cases, 26.5% of pneumonia cases, and 53.2% of urinary tract infections. These postoperative infections were associated with an increased risk of readmission. Most infections were diagnosed postdischarge. The trend towards shorter length of stays postoperation also contribute to the increase in infections detected after discharge and the rate of unplanned related postoperative readmissions.
AHRQ-funded; HS026019.
Citation: Aasen DM, Bronsert Rozeboom, PD .
Relationships between predischarge and postdischarge infectious complications, length of stay, and unplanned readmissions in the ACS NSQIP database.
Surgery 2021 Feb;169(2):325-32. doi: 10.1016/j.surg.2020.08.009..
Keywords: Hospital Readmissions, Adverse Events, Healthcare-Associated Infections (HAIs), Infectious Diseases, Quality Improvement, Quality of Care, Surgery
Rinke ML, Oyeku SO, Ford WJH
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This retrospective case control study estimated additional costs associated with pediatric ambulatory central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery. The authors concluded that ambulatory HAI in pediatric patients were associated with significant additional costs.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Ford WJH .
Costs of ambulatory pediatric healthcare-associated infections: Central-line-associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs).
Infect Control Hosp Epidemiol 2020 Nov;41(11):1292-97. doi: 10.1017/ice.2020.305..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Ambulatory Care and Surgery, Healthcare Costs, Surgery
Anderson DJ, Ilieş I, Foy K
Early recognition and response to increases in surgical site infections using optimized statistical process control charts-the Early 2RIS Trial: a multicenter cluster randomized controlled trial with stepped wedge design.
This paper discusses the study protocol that was used to conduct the Early 2RIS Trial, which was a multicenter cluster randomized controlled trial from 2016 to 2020 to reduce surgical site infection (SSI) rates. The trial was performed in 29 hospitals in the Duke Infection Control Outreach Network (DICON) and 105 clusters over 4 years. All patients who underwent one of 13 targeted procedures at study hospitals were included. Six clusters were identified: cardiac, orthopedic, gastrointestinal, OB-GYN, vascular, and spinal. Clusters were randomized to intervention, and also underwent surveillance and feedback using optimized SPC charts. Surveillance data feedback was provided to all clusters, regardless of allocation or type of surveillance. The goal was to lower SSI through SPC intervention compared to traditional surveillance and feedback alone.
AHRQ-funded; HS023821.
Citation: Anderson DJ, Ilieş I, Foy K .
Early recognition and response to increases in surgical site infections using optimized statistical process control charts-the Early 2RIS Trial: a multicenter cluster randomized controlled trial with stepped wedge design.
Trials 2020 Oct 28;21(1):894. doi: 10.1186/s13063-020-04802-4..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety
Bucher BT, Shi J, Ferraro JP
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
The authors presented the development and validation of a portable natural language processing (NLP) approach for automated surveillance of surgical site infections (SSIs). Patient clinical text notes from EHRs following surgical procedures from two independent healthcare systems were abstracted. The authors found that automated surveillance of SSIs can be achieved using NLP of clinical notes with high sensitivity and specificity.
AHRQ-funded; HS025776.
Citation: Bucher BT, Shi J, Ferraro JP .
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
Ann Surg 2020 Oct;272(4):629-36. doi: 10.1097/sla.0000000000004133..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
De Roo AC, Hendren S, Ameling JM
Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.
Researchers applied Michigan Appropriate Perioperative criteria to statewide registry data to identify improvement targets for urinary catheter use. They found that perioperative urinary catheter use was appropriate for most simple abdominal procedures, but duration of use varied in all categories.
AHRQ-funded; HS019767; HS024385; HS018334; HS000053.
Citation: De Roo AC, Hendren S, Ameling JM .
Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.
Am J Surg 2020 Sep;220(3):706-13. doi: 10.1016/j.amjsurg.2020.01.008..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Patient Safety, Surgery, Prevention, Adverse Events
Sheetz KH, Ryan A
Accuracy of quality measurement for the hospital acquired conditions reduction program.
Accuracy of quality measurement for the hospital acquired conditions reduction program.
AHRQ-funded; HS026244; HS000053.
Citation: Sheetz KH, Ryan A .
Accuracy of quality measurement for the hospital acquired conditions reduction program.
BMJ Qual Saf 2020 Jul;29(7):605-07. doi: 10.1136/bmjqs-2019-009747..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Quality Measures, Quality Improvement, Quality of Care, Surgery, Infectious Diseases
Ilieş I, Anderson DJ, Salem J
Large-scale empirical optimisation of statistical control charts to detect clinically relevant increases in surgical site infection rates.
Researchers sought to determine which statistical process control chart types and design parameters maximized the detection of clinically relevant surgical site infection (SSI) rate increases while minimizing false alarms. Statistically significant SSI rate increases (signals) at individual hospitals were identified using 50 different statistical process control chart variations; blinded epidemiologists evaluated the clinical significance of 2709 representative signals of potential outbreaks and rated them as requiring action or no action. The researchers concluded that an optimized combination of two moving average charts had the best performance for identifying clinically relevant small but sustained above-network SSI rates and large short-term individual hospital increases.
AHRQ-funded; HS023821.
Citation: Ilieş I, Anderson DJ, Salem J .
Large-scale empirical optimisation of statistical control charts to detect clinically relevant increases in surgical site infection rates.
BMJ Qual Saf 2020 Jun;29(6):472-81. doi: 10.1136/bmjqs-2018-008976..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Patient Safety
Baker AW, Nehls N, Ilies I
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
This study analyzed the use of optimized dual statistical process control (SPC) charts to predict surgical site infection (SSI) outbreaks. The researchers retrospectively applied an optimized pair of moving average (MA) SPC charts to all 30 SSI outbreaks previously identified and investigated from 2007 to 2015 in the Duke Infection Control Outreach Network (DICON), which is a network of more than 50 community hospitals. The dual MA SPC chart approach detected all 30 outbreaks at a median of 16 months prior to traditional surveillance detection.
AHRQ-funded; HS23821.
Citation: Baker AW, Nehls N, Ilies I .
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
BMJ Qual Saf 2020 Jun;29(6):517-20. doi: 10.1136/bmjqs-2019-010586..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Hospitals, Public Health, Infectious Diseases
Alfred M, Catchpole K, Huffer E
Work systems analysis of sterile processing: decontamination.
This study examined the work of sterile processing departments (SPDs) from a systems perspective. This paper reports the results of a work systems analysis that sought to identify the complex multilevel interdependencies that create performance variation and identify potential improvement interactions. The analysis was conducted at a 700-bed academic hospital with two reprocessing facilities decontaminating approximately 23,000 units each month. Mixed methods, including 56 hours of observations of work was done, as well as formal and informal interviews with relevant stakeholders and analysis of data collected about the system. The authors identified 21 different performance shaping factors, 30 potential failures, 16 types of process variance, and 10 outcome variances in decontamination. Approximately 2% of trays were returned to decontamination from assembly with 1% of surgical cases having decontamination problems.
AHRQ-funded; HS025538.
Citation: Alfred M, Catchpole K, Huffer E .
Work systems analysis of sterile processing: decontamination.
BMJ Qual Saf 2020 Apr;29(4):320-28. doi: 10.1136/bmjqs-2019-009422..
Keywords: Patient Safety, Quality Improvement, Quality of Care, Prevention, Surgery, Healthcare-Associated Infections (HAIs)
Lander DP, Durakovic N, Kallogjeri D
Incidence of infectious complications following cochlear implantation in children and adults.
The goal of this study was to determine the incidence and timing of infectious complications following cochlear implantation. Results showed low rates of infectious complications in cochlear implant recipients, and meningitis was exceedingly rare. Children aged 1 and 2 years experienced infectious complications more frequently than older children, with benefits of early implantation on language development outweighing the risk. Recommendations included increased vigilance by physicians when caring for young children early after implantation and children with prior implant infections.
AHRQ-funded; HS019455.
Citation: Lander DP, Durakovic N, Kallogjeri D .
Incidence of infectious complications following cochlear implantation in children and adults.
JAMA 2020 Jan 14;323(2):182-83. doi: 10.1001/jama.2019.18611..
Keywords: Children/Adolescents, Adverse Events, Surgery, Healthcare-Associated Infections (HAIs)
Chandanabhumma PP, Fetters MD, Pagani FD
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
This paper discusses an ongoing AHRQ-funded study to understand and address variation in health care-associated infections (HAIs) after durable ventricular assist device (VAD) implantation surgery. This procedure is used only on patients with advanced heart failure who have a poor 1-year estimated survival rate. This is a sequential mixed methods study which is conducting a systematic review of HAI prevention studies, and an in-depth quantitative analyses using administration claims, in-depth clinical data, and organizational surveys of VAD centers. The last aim is to develop and disseminate a best practices toolkit for HAI prevention. Data analysis is currently underway.
AHRQ-funded; HS026003.
Citation: Chandanabhumma PP, Fetters MD, Pagani FD .
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
JMIR Res Protoc 2020 Jan 7;9(1):e14701. doi: 10.2196/14701..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Medical Devices, Prevention, Heart Disease and Health, Cardiovascular Conditions, Adverse Events
Song J, Tark A, Larson EL
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Pocket hematoma is a common adverse event following the insertion of cardiovascular implantable electronic devices (CIEDs), but the risk of wound infections associated with a pocket hematoma is unclear. The objective of this integrative review was to examine the relationship between pocket hematoma and risk of wound infection in a CIED population.
AHRQ-funded; HS024915.
Citation: Song J, Tark A, Larson EL .
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Heart Lung 2020 Jan-Feb;49(1):92-98. doi: 10.1016/j.hrtlng.2019.09.009..
Keywords: Medical Devices, Cardiovascular Conditions, Surgery, Adverse Events, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk