National Healthcare Quality and Disparities Report
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Topics
- (-) Antibiotics (6)
- Antimicrobial Stewardship (4)
- Clostridium difficile Infections (1)
- Elderly (2)
- Evidence-Based Practice (1)
- Hospitals (1)
- Long-Term Care (2)
- (-) Medication (6)
- Medication: Safety (1)
- Mortality (1)
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- Sepsis (1)
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- 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 DisplayedTamma PD, Miller MA, Dullabh P
AHRQ Author: Miller MA
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
Regulatory agencies and professional organizations recommend antibiotic stewardship programs (ASPs) in US hospitals. The optimal approach to establish robust, sustainable ASPs across diverse hospitals is unknown. The purpose of this study was to assess whether the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use was associated with reductions in antibiotic use across US hospitals. The investigators concluded that AHRQ Safety Program appeared to enable diverse hospitals to establish ASPs and teach frontline clinicians to self-steward their antibiotic use.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Tamma PD, Miller MA, Dullabh P .
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
JAMA Netw Open 2021 Feb;4(2):e210235. doi: 10.1001/jamanetworkopen.2021.0235..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Shared Decision Making, Clostridium difficile Infections, Patient Safety, Quality Improvement, Quality of Care, Hospitals
Hanlon JT, Perera S, Schweon S
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
This study evaluated the impact of an educational quality improvement initiative on the appropriateness of antibiotic prescribing restricted to uncomplicated cystitis in older noncatheterized nursing home residents. This 1-year case-control study used 25 participating nursing homes that were randomized to the intervention or usual care group by strata that included state, urban/rural status, bed size, and geographic separation. A total of 75 cases of cystitis were found in the intervention groups and 92 in the control groups. The intervention group had a nonsignificant 21% reduction in the risk of antibiotic prescribing. There was a favorable comparison in appropriateness of duration. However, the intervention group had more problems with drug-drug interactions than the control group (8% vs 1%). There were also more problems with dosage in the intervention group. Both groups had similar rates of problems with choice or effectiveness (44% vs 45%). The most common antibiotic class that was prescribed inappropriately was quinolones.
AHRQ-funded; R18 HS023779.
Citation: Hanlon JT, Perera S, Schweon S .
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
J Am Med Dir Assoc 2021 Jan;22(1):173-77. doi: 10.1016/j.jamda.2020.07.040..
Keywords: Elderly, Nursing Homes, Long-Term Care, Antibiotics, Medication, Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Shared Decision Making
Nace DA, Hanlon JT, Crnich CJ
A multifaceted antimicrobial stewardship program for the treatment of uncomplicated cystitis in nursing home residents.
This study describes the result of implementing a multifaceted antimicrobial stewardship program to reduce antibiotic use in nursing homes for urinary tract infections that are unlikely cystitis. Reduction in antibiotic use decreases incidence of Clostridioides difficile (C difficile) infections, as well as adverse drug reactions and antimicrobial drug resistance. This one-year case-control study included 12 intervention nursing homes and 13 control group nursing homes. The intervention nursing homes received a 1-hour introductory webinar, pocket-sized educational cards, tools for system change, and educational clinical vignettes addressing the diagnosis and treatment of suspected uncomplicated cystitis. Additionally, they received a monthly coaching call as well as a quarterly feedback report. In the intervention nursing homes, fewer unlikely cystitis cases were treated with antibiotics and C difficile infection rates were also lower. There was no increase in all-cause hospitalizations or deaths due to the intervention.
AHRQ-funded; HS023779.
Citation: Nace DA, Hanlon JT, Crnich CJ .
A multifaceted antimicrobial stewardship program for the treatment of uncomplicated cystitis in nursing home residents.
JAMA Intern Med 2020 Jul;180(7):944-51. doi: 10.1001/jamainternmed.2020.1256..
Keywords: Antimicrobial Stewardship, Antibiotics, Nursing Homes, Elderly, Quality Improvement, Quality of Care, Medication
Simpson KR, Lyndon A, Spetz J
A 2-year pragmatic trial of antibiotic stewardship in 27 community nursing homes.
The purpose of this study was to determine associations between missed nursing care and nurse staffing during labor and birth, and exclusive breast milk feeding at hospital discharge. Exclusive breast milk feeding is a national quality indicator of inpatient maternity care. Nurses have substantial responsibility for direct support of infant feeding during the childbirth hospitalization. The investigators indicate that the results support exclusive breast milk feeding as a nurse-sensitive quality indicator.
AHRQ-funded; HS022846.
Citation: Simpson KR, Lyndon A, Spetz J .
A 2-year pragmatic trial of antibiotic stewardship in 27 community nursing homes.
J Am Geriatr Soc 2020 Jan;68(1):46-54. doi: 10.1111/jgs.16059..
Keywords: Antibiotics, Medication, Antimicrobial Stewardship, Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care
Weinberger J, Rhee C, Klompas M
A critical analysis of the literature on time-to-antibiotics in suspected sepsis.
The Surviving Sepsis Campaign recommends immediate antibiotics for all patients with suspected sepsis and septic shock, ideally within 1 hour of recognition. An accurate understanding of the precise relationship between time-to-antibiotics and mortality for patients with possible sepsis is therefore critical. In this study, the investigators elaborate on potential sources of bias and try to distill a better understanding of what the true relationship between time-to-antibiotics and mortality may be for patients with suspected sepsis or septic shock.
AHRQ-funded; HS025008.
Citation: Weinberger J, Rhee C, Klompas M .
A critical analysis of the literature on time-to-antibiotics in suspected sepsis.
J Infect Dis 2020 Jul 21;222(Suppl 2):S110-s18. doi: 10.1093/infdis/jiaa146..
Keywords: Sepsis, Antibiotics, Medication, Antimicrobial Stewardship, Quality Improvement, Quality of Care, Mortality
Ban KA, Gibbons MM, Ko CY
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving
This evidence review was conducted for AHRQ in partnership with the American College of Surgeons and the Johns Hopkins Armstrong Institute for Patient Safety and Quality who have developed the Safety Program for Improving Surgical Care and Recovery (ISCR). This national effort will disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. This evidence-based review is focused on improving patient safety of anesthesiology for colorectal (CR) surgery. Components reviewed included carbohydrate loading, reduced fasting, multimodal preanesthesia medicine, antibiotic prophylaxis, normothermia, blood transfusion, intraoperative fluid management/goal-directed fluid therapy, a standardized intraoperative anesthesia pathway, and standard postoperative multimodal analgesic regiments. The results of this review will be used to develop an evidence-based CR protocol for implementation.
AHRQ-funded; 233201500020I.
Citation: Ban KA, Gibbons MM, Ko CY .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving
Anesth Analg 2019 May;128(5):879-89. doi: 10.1213/ane.0000000000003366..
Keywords: Evidence-Based Practice, Surgery, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Antibiotics, Medication, Medication: Safety