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Search All Research Studies
Topics
- Clinical Decision Support (CDS) (2)
- Communication (1)
- Comparative Effectiveness (2)
- Data (1)
- Decision Making (1)
- Elderly (1)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (4)
- Hospitals (3)
- Implementation (1)
- Injuries and Wounds (1)
- Long-Term Care (2)
- Nursing (2)
- Nursing Homes (4)
- Organizational Change (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (5)
- Policy (1)
- Practice Patterns (1)
- (-) Pressure Ulcers (13)
- (-) Prevention (13)
- Provider (1)
- Provider: Nurse (1)
- Quality Improvement (3)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (1)
- Skin Conditions (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 13 of 13 Research Studies DisplayedBaernholdt M, Yan G, Hinton ID
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
This study looked at the effects of nursing care interventions aimed at preventing pressure ulcers in rural and urban hospitals over a 4-year period. This longitudinal study used unit-level data from the National Database of Nursing Quality Indicators 2010-2013. The authors analyzed 5761 units (332 rural and 5429 urban) in 772 hospitals (89 rural and 683 urban) that reported ulcer rates in two or more quarters. Outcomes from use of a three-care intervention combination was measured with decreases in pressure ulcers shown from any of those interventions (patients receiving skin assessment on admission, receiving risk assessment on admission, and receiving any risk assessment before the pressure ulcer). An increase in RN skill mix and two nurse outcomes (increase in job satisfaction and intent-to-stay) also led to decreases in ulcer rates.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Yan G, Hinton ID .
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
Int J Nurs Stud 2020 May;105:103455. doi: 10.1016/j.ijnurstu.2019.103455..
Keywords: Pressure Ulcers, Prevention, Skin Conditions, Nursing, Practice Patterns, Provider: Nurse, Provider, Quality Indicators (QIs), Quality Measures, Quality of Care
Davidson C, Loganathan S, Bishop L
AHRQ Author: Bergofsky L, Spector W
Scalability of an IT intervention to prevent pressure ulcers in nursing homes.
Researchers assessed the scalability of the On-Time Pressure Ulcer Prevention intervention strategy in nursing homes nationwide. They found that the overall decline in pressure ulcer rates for treatment relative to matched comparison homes was statistically insignificant.
AHRQ-authored; AHRQ-funded; 2332010500023I.
Citation: Davidson C, Loganathan S, Bishop L .
Scalability of an IT intervention to prevent pressure ulcers in nursing homes.
J Am Med Dir Assoc 2019 Jul;20(7):816-21.e2. doi: 10.1016/j.jamda.2019.02.008..
Keywords: Elderly, Health Information Technology (HIT), Nursing Homes, Patient-Centered Outcomes Research, Prevention, Pressure Ulcers
Padula WV, Pronovost PJ, Makic MBF
Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis.
The objective of this study was to analyze the cost-utility of repeated risk-assessments for pressure-injury prevention in all hospital patients or in high-risk groups. Hospitalized adults were classified by Braden Scale scores into five risk levels: very high risk, high risk, moderate risk, at-risk, and minimal risk. The costs of pressure-injury treatment and prevention, and quality-adjusted life years (QALYs) related to pressure injuries were weighted by transition probabilities to calculate the incremental cost-effectiveness ratio. The results of the study indicate that simulating prevention for all patients yielded greater QALYs at higher cost from societal and healthcare sector perspectives. Prevention for all patients was cost-effective in more than 99% of probabilistic simulations. The authors conclude that hospitals should invest in nursing compliance with international prevention guidelines.
AHRQ-funded; HS023710.
Citation: Padula WV, Pronovost PJ, Makic MBF .
Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis.
BMJ Qual Saf 2019 Feb;28(2):132-41. doi: 10.1136/bmjqs-2017-007505..
Keywords: Healthcare Costs, Hospitals, Pressure Ulcers, Prevention
Smith S, Snyder A, McMahon LF
Success in hospital-acquired pressure ulcer prevention: a tale in two data sets.
This study assessed hospital-acquired pressure ulcer (HAPU) incidence, severity, and trends using administrative data for 2009-14 from three states. The HAPU incidence the investigators found was approximately one-twentieth of that found in chart-based surveillance review data. The authors suggest that transitioning from administrative data to chart-based surveillance review to measure HAPUs and accounting for HAPU severity could improve the validity of HAPU measures for assessing the clinical and financial impact of value-based purchasing interventions.
AHRQ-funded; HS018334; HS019767.
Citation: Smith S, Snyder A, McMahon LF .
Success in hospital-acquired pressure ulcer prevention: a tale in two data sets.
Health Aff 2018 Nov;37(11):1787-96. doi: 10.1377/hlthaff.2018.0712.
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Keywords: Data, Healthcare Cost and Utilization Project (HCUP), Pressure Ulcers, Prevention
Wang J, Gong Y
Potential of decision support in preventing pressure ulcers in hospitals.
The development of hospital-acquired pressure ulcers signals low quality of care. To meet the challenges of consistently translating best practices into effective clinical practices and promote effective teamwork communication and interprofessional collaboration, the authors consider the failure of consistent care delivery as loss of information and reveal the opportunities of informatics methods to reinforce information delivery, evidenced by typical cases. They then explain and summarize information-related issues existing at the initial assessment upon hospital admission, routine treatments, and team communication.
AHRQ-funded; HS022895.
Citation: Wang J, Gong Y .
Potential of decision support in preventing pressure ulcers in hospitals.
Stud Health Technol Inform 2017;241:15-20.
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Keywords: Clinical Decision Support (CDS), Decision Making, Hospitals, Patient Safety, Pressure Ulcers, Prevention
Soban LM, Kim L, Yuan AH
Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.
The researchers describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high level.
AHRQ-funded; HS000046.
Citation: Soban LM, Kim L, Yuan AH .
Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.
J Nurs Manag 2017 Sep;25(6):457-67. doi: 10.1111/jonm.12416.
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Keywords: Pressure Ulcers, Prevention, Hospitals, Patient Safety, Implementation, Organizational Change
Padula WV, Valuck RJ, Makic MB
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced, the overall reduction of pressure ulcers (PUs). It found that several internal factors influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns and data sharing among peer institutions.
AHRQ-funded; HS023710.
Citation: Padula WV, Valuck RJ, Makic MB .
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
J Wound Ostomy Continence Nurs 2015 Jul-Aug;42(4):327-30. doi: 10.1097/won.0000000000000145..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Prevention
Alexander GL
Nurse assistant communication strategies about pressure ulcers in nursing homes.
The author explored strategies nursing assistants use to communicate pressure ulcer prevention practices in nursing homes with variable information technology sophistication measures. Three major themes emerged: Passing on Information, Keeping Track of Needs, and Information Access.
AHRQ-funded; HS016862.
Citation: Alexander GL .
Nurse assistant communication strategies about pressure ulcers in nursing homes.
West J Nurs Res 2015 Jul;37(7):984-1004. doi: 10.1177/0193945914555201.
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Keywords: Communication, Health Information Technology (HIT), Nursing Homes, Pressure Ulcers, Prevention
Padula WV, Makic MB, Mishra MK
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
This study was conducted to determine the comparative effectiveness of quality improvement interventions associated with reduced hospital-acquired pressure ulcer rates. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Mishra MK .
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):246-5..
Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Patient Safety, Pressure Ulcers, Prevention, Quality Improvement
Padula WV, Makic MB, Wald HL
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
This study was conducted to define changes in hospital-acquired pressure ulcers (HAPU) incidence and variance since 2008. It found that HAPU incidence rates decreased significantly among 210 University HealthSystems Consortium academic medical centers after the enactment of the CMS nonpayment policy. This suggests that governmental policy was a significant driver of change in clinical practice for wound care and created incentives for preventive efforts on the part of hospitals.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Wald HL .
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):257-63..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Policy, Pressure Ulcers, Prevention, Quality Improvement
Shepherd MM, Wipke-Tevis DD, Alexander GL
Analysis of qualitative interviews about the impact of information technology on pressure ulcer prevention programs: implications for the wound, ostomy and continence nurse.
The purpose of this study was to compare pressure ulcer prevention programs in 2 long-term care facilities with diverse Information Technology Sophistication (ITS), one with high sophistication and one with low sophistication, and to identify implications for the WOC nurse. Its findings suggest that effective strategies for staff education and communication regarding pressure ulcer prevention differ based on the level of ITS within a given facility.
AHRQ-funded; HS016862.
Citation: Shepherd MM, Wipke-Tevis DD, Alexander GL .
Analysis of qualitative interviews about the impact of information technology on pressure ulcer prevention programs: implications for the wound, ostomy and continence nurse.
J Wound Ostomy Continence Nurs 2015 May-Jun;42(3):235-41. doi: 10.1097/won.0000000000000136.
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Keywords: Health Information Technology (HIT), Pressure Ulcers, Prevention, Long-Term Care, Comparative Effectiveness
Olsho LE, Spector WD, Williams CS
AHRQ Author: Spector WD
Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes.
The researchers evaluated the effectiveness of the On-Time Quality Improvement for Long Term Care (On-Time) program in reducing the rate of in-house-acquired pressure ulcers among nursing home residents. They found that On-Time implementation is associated with sizable reductions in pressure ulcer incidence.
AHRQ-authored; AHRQ-funded; 290200600011I.
Citation: Olsho LE, Spector WD, Williams CS .
Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes.
Med Care 2014 Mar;52(3):258-66. doi: 10.1097/mlr.0000000000000080.
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Keywords: Clinical Decision Support (CDS), Long-Term Care, Nursing Homes, Pressure Ulcers, Prevention
Sharkey S, Hudak S, Horn SD
AHRQ Author: Spector W
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
The researchers determined those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level. They found that after at least 9 months of implementation effort, 36% of the nursing homes achieved level III of the On-Time QI-HIT program. They concluded that the learning from On-Time QI offers several lessons associated with facility factors that contribute to high level of implementation of a QI-HIT program in a nursing home.
AHRQ-authored; AHRQ-funded; 29020050020.
Citation: Sharkey S, Hudak S, Horn SD .
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
Adv Skin Wound Care 2013 Feb;26(2):83-92; quiz p.93-4. doi: 10.1097/01.ASW.0000426718.59326.bb.
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Keywords: Health Information Technology (HIT), Nursing Homes, Pressure Ulcers, Prevention, Quality Improvement