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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Antibiotics (7)
- (-) Antimicrobial Stewardship (20)
- Clostridium difficile Infections (1)
- Critical Care (1)
- Education: Continuing Medical Education (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (11)
- Healthcare Costs (1)
- Imaging (1)
- Infectious Diseases (7)
- Intensive Care Unit (ICU) (1)
- Medication (6)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (5)
- Neonatal Intensive Care Unit (NICU) (2)
- Newborns/Infants (3)
- Nursing Homes (1)
- Patient Safety (12)
- Patient Self-Management (1)
- Practice Patterns (1)
- (-) Prevention (20)
- Provider: Health Personnel (1)
- Registries (1)
- Surgery (2)
- Training (1)
- 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 20 of 20 Research Studies DisplayedSafdar N, Parmasad V, Brown R
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interventions are effective in CDI control, but there is little evidence regarding the most effective AS interventions. In this paper the investigators describe their multisite, stepped-wedge, cluster, effectiveness-implementation clinical trial.
AHRQ-funded; R01 HS026226.
Citation: Safdar N, Parmasad V, Brown R .
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
BMJ Open 2021 Jun 29;11(6):e046480. doi: 10.1136/bmjopen-2020-046480..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Antimicrobial Stewardship, Antibiotics, Medication, Prevention
Chiotos K, Rock C, Schweizer ML
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
This survey compares results with a similar 2013 survey that characterizes contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities. There was decreased frequency of active surveillance for MRSA, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
AHRQ-funded; HS026393.
Citation: Chiotos K, Rock C, Schweizer ML .
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
Infect Control Hosp Epidemiol 2019 Sep;40(9):1046-49. doi: 10.1017/ice.2019.172.
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Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Practice Patterns
Smith TC, Davis MF, Heaney CD
Pig movement and antimicrobial use drive transmission of livestock-associated staphylococcus aureus CC398.
Staphylococcus aureus was originally considered a hospital-associated organism, but new classes of methicillin-resistant strains have emerged outside of the hospital setting, including among livestock. This article discusses a recent study which examined the transportation of pigs on over 200 farms; the authors of this article contend that the results of the study demonstrate the importance of cooperation between occupational health services, genomics, veterinary medicine, and farmers in understanding the epidemiology of MRSAs as related to livestock.
AHRQ-funded; HS019966.
Citation: Smith TC, Davis MF, Heaney CD .
Pig movement and antimicrobial use drive transmission of livestock-associated staphylococcus aureus CC398.
MBio 2018 Dec 11;9(6). doi: 10.1128/mBio.02459-18..
Keywords: Antimicrobial Stewardship, Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Patient Safety, Prevention
Varda BK, Finkelstein JB, Wang HH
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
This study examined whether the routine use of continuous antibiotic prophylaxis (CAP) before initial postnatal imaging is effective to prevent urinary tract infection (UTI) in infants with a history of antenatal urinary tract dilation (AUTD). A single-institution, retrospective cohort study of infants with a history of AUTD was conducted. A random sample of 500 infants was selected with six excluded for other congenital anomalies. Of the 494 remaining, 157 (32%) received CAP. There was no difference found in UTI incidence among those treated with CAP and those who were not.
AHRQ-funded; HS000063.
Citation: Varda BK, Finkelstein JB, Wang HH .
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
J Pediatr Urol 2018 Dec;14(6):539.e1-39.e6. doi: 10.1016/j.jpurol.2018.04.022..
Keywords: Antibiotics, Antimicrobial Stewardship, Urinary Tract Infection (UTI), Newborns/Infants, Imaging, Medication, Prevention
D'Agata EMC, Lindberg CC, Lindberg CM
The positive effects of an antimicrobial stewardship program targeting outpatient hemodialysis facilities.
The purpose of this study was to quantify the effect of an antimicrobial stewardship program in reducing antimicrobial prescribing. Implementation of the antimicrobial stewardship program was associated with a 6% monthly reduction in antimicrobial doses per 100 patient months during the intervention period (P=.02). The investigators found that within 6 hemodialysis facilities, implementation of an antimicrobial stewardship was associated with a decline in antimicrobial prescribing with no negative effects.
AHRQ-funded; HS021666.
Citation: D'Agata EMC, Lindberg CC, Lindberg CM .
The positive effects of an antimicrobial stewardship program targeting outpatient hemodialysis facilities.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1400-05. doi: 10.1017/ice.2018.237..
Keywords: Antibiotics, Antimicrobial Stewardship, Prevention, Medication, Medication
Kline SE, Sanstead EC, Johnson JR
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
In this study, the investigators developed a decision analytic model to evaluate the impact of a preoperative Staphylococcus aureus decolonization bundle on surgical site infections (SSIs), health-care-associated costs (HCACs), and deaths due to SSI. The investigators predict that the treat-all strategy would be the most effective and cost-saving strategy for preventing SSIs. However, they concluded that because this strategy might select more extensively for mupirocin-resistant S. aureus and cause more medication adverse effects than the test-and-treat approach or the SOC, additional studies are needed to define its comparative benefits and harms.
AHRQ-funded; HS022912.
Citation: Kline SE, Sanstead EC, Johnson JR .
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
Infect Control Hosp Epidemiol 2018 Nov;39(11):1340-46. doi: 10.1017/ice.2018.228..
Keywords: Surgery, Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention, Healthcare Costs
Kline SE, Neaton JD, Lynfield R
Randomized controlled trial of a self-administered five-day antiseptic bundle versus usual disinfectant soap showers for preoperative eradication of Staphylococcus aureus colonization.
The objective of this study was to determine the efficacy in eradicating Staphylococcus aureus (SA) carriage of a 5-day preoperative decolonization bundle compared to 2 disinfectant soap showers, with both regimens self-administered at home. The investigators concluded that an outpatient preoperative antiseptic decolonization bundle aimed at 4 body sites was significantly more effective in eradicating SA than the usual disinfectant showers (ie, the control).
AHRQ-funded; HS022912.
Citation: Kline SE, Neaton JD, Lynfield R .
Randomized controlled trial of a self-administered five-day antiseptic bundle versus usual disinfectant soap showers for preoperative eradication of Staphylococcus aureus colonization.
Infect Control Hosp Epidemiol 2018 Sep;39(9):1049-57. doi: 10.1017/ice.2018.151..
Keywords: Antimicrobial Stewardship, Infectious Diseases, Patient Self-Management, Prevention, Surgery, Patient Safety
Anderson DJ, Addison R, Lokhnygina Y
The Antimicrobial Scrub Contamination and Transmission (ASCOT) trial: a three-arm, blinded, randomized controlled trial with crossover design to determine the efficacy of antimicrobial-impregnated scrubs in preventing healthcare provider contamination.
The objective of the study was to determine whether antimicrobial-impregnated textiles decrease the acquisition of pathogens by healthcare provider (HCP) clothing. The authors found that antimicrobial-impregnated scrubs were not effective at reducing HCP contamination. They indicated, however, that the environment was an important source of HCP clothing contamination.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Addison R, Lokhnygina Y .
The Antimicrobial Scrub Contamination and Transmission (ASCOT) trial: a three-arm, blinded, randomized controlled trial with crossover design to determine the efficacy of antimicrobial-impregnated scrubs in preventing healthcare provider contamination.
Infect Control Hosp Epidemiol 2017 Oct;38(10):1147-54. doi: 10.1017/ice.2017.181..
Keywords: Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Barker AK, Ngam C, Musuuza JS
Reducing Clostridium difficile in the inpatient setting: a systematic review of the adherence to and effectiveness of C. difficile prevention bundles.
Researchers conducted a systematic review to examine the components of Clostridium difficile infection (CDI) prevention bundles, their implementation processes, and their impact on CDI rates. They concluded that given the lack of randomized controlled trials in the literature, assessing a causal relationship between bundled interventions and CDI rates is currently impossible.
AHRQ-funded; HS023791.
Citation: Barker AK, Ngam C, Musuuza JS .
Reducing Clostridium difficile in the inpatient setting: a systematic review of the adherence to and effectiveness of C. difficile prevention bundles.
Infect Control Hosp Epidemiol 2017 Jun;38(6):639-50. doi: 10.1017/ice.2017.7.
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Keywords: Antimicrobial Stewardship, Guidelines, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Moehring RW, Anderson DJ, Cochran RL
Expert consensus on metrics to assess the impact of patient-level antimicrobial stewardship interventions in acute-care settings.
Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. Researchers used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. On a 9-point Likert scale, six metrics were rated >6 in all criteria and fourteen metrics rated >6 in all criteria except feasibility.
AHRQ-funded; HS023866.
Citation: Moehring RW, Anderson DJ, Cochran RL .
Expert consensus on metrics to assess the impact of patient-level antimicrobial stewardship interventions in acute-care settings.
Clin Infect Dis 2017 Feb 1;64(3):377-83. doi: 10.1093/cid/ciw787.
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Keywords: Critical Care, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Trautner BW, Greene MT, Krein SL
Infection prevention and antimicrobial stewardship knowledge for selected infections among nursing home personnel.
This study assessed knowledge about infection prevention among nursing home personnel and identified gaps potentially addressable through a quality improvement collaborative. It found that, while 99.1 percent of licensed personnel recognized the definition of asymptomatic bacteriuria, only 36.1 percent knew that pyuria could not distinguish a urinary tract infection from asymptomatic bacteriuria.
AHRQ-funded; 290201000025I.
Citation: Trautner BW, Greene MT, Krein SL .
Infection prevention and antimicrobial stewardship knowledge for selected infections among nursing home personnel.
Infect Control Hosp Epidemiol 2017 Jan;38(1):83-88. doi: 10.1017/ice.2016.228.
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Keywords: Antimicrobial Stewardship, Education: Continuing Medical Education, Healthcare-Associated Infections (HAIs), Nursing Homes, Prevention, Patient Safety
Burnham CA, Hogan PG, Wallace MA
Topical decolonization does not eradicate the skin microbiota of community-dwelling or hospitalized adults.
The authors compared microbial communities and levels of richness and diversity in community-dwelling subjects and in intensive care unit patients before and after the use of topical decolonization protocols. They found a reduction in S. aureus without eradicating endogenous microbiota.
AHRQ-funded; HS021736; HS024269.
Citation: Burnham CA, Hogan PG, Wallace MA .
Topical decolonization does not eradicate the skin microbiota of community-dwelling or hospitalized adults.
Antimicrob Agents Chemother 2016 Dec;60(12):7303-12. doi: 10.1128/aac.01289-16.
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Keywords: Antimicrobial Stewardship, Antibiotics, Infectious Diseases, Prevention, Patient Safety
Reich PJ, Boyle MG, Hogan PG
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Methicillin-resistant Staphylococcus aureus (MRSA) infections cause significant morbidity and mortality in neonatal intensive care units (NICUs). The researchers characterized the clinical and molecular epidemiology of MRSA strains colonizing NICU patients. They found that community-acquired MRSA strains are prominent in the NICU and associated with distinct risk factors.
AHRQ-funded; HS021736; HS024269.
Citation: Reich PJ, Boyle MG, Hogan PG .
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Clin Microbiol Infect 2016 Jul;22(7):645.e1-8. doi: 10.1016/j.cmi.2016.04.013.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Neonatal Intensive Care Unit (NICU), Patient Safety, Prevention, Antimicrobial Stewardship, Newborns/Infants, Healthcare-Associated Infections (HAIs)
Wares JR, Lawson B, Shemin D
Evaluating infection prevention strategies in out-patient dialysis units using agent-based modeling.
The researchers hypothesized that targeting patients receiving antimicrobial treatment would more effectively reduce transmission and acquisition of multidrug-resistant organisms (MDRO) and further that environmental contamination plays a role in the dissemination of MDRO in the dialysis unit. They found that reducing antimicrobial treatment markedly reduces overall colonization rates and also the levels of environmental contamination in the dialysis unit. They suggested that improving the environmental decontamination efficacy between patient dialysis treatments as an effective method for reducing colonization and contamination rates.
AHRQ-funded; HS021666.
Citation: Wares JR, Lawson B, Shemin D .
Evaluating infection prevention strategies in out-patient dialysis units using agent-based modeling.
PLoS One 2016 May 19;11(5):e0153820. doi: 10.1371/journal.pone.0153820.
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Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Healthcare-Associated Infections (HAIs), Prevention, Ambulatory Care and Surgery, Infectious Diseases
Heath B, Bernhardt J, Michalski TJ
Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.
The authors described a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. They found that the course addressed an important knowledge gap and recommended engaging nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting.
AHRQ-funded; HS023866.
Citation: Heath B, Bernhardt J, Michalski TJ .
Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.
Am J Infect Control 2016 Mar;44(3):349-51. doi: 10.1016/j.ajic.2015.09.026.
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Keywords: Antimicrobial Stewardship, Provider: Health Personnel, Prevention, Training
Alvarez E, Uslan DZ, Malloy T
It is time to revise our approach to registering antimicrobial agents for health care settings.
This paper discusses antimicrobial surfaces, such as copper alloy, for the prevention of healthcare-associated infections. The authors address the current process for registering antimicrobial products, flaws in the registration requirements, and the need for evidence-based approaches to reduce healthcare-associated infections.
AHRQ-funded; HS021188.
Citation: Alvarez E, Uslan DZ, Malloy T .
It is time to revise our approach to registering antimicrobial agents for health care settings.
Am J Infect Control 2016 Feb;44(2):228-32. doi: 10.1016/j.ajic.2015.09.015.
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Keywords: Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Prevention, Evidence-Based Practice, Registries
Russell D, Beekmann SE, Polgreen PM
Routine use of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus: Which way is the pendulum swinging?
This study assessed the state of utilization of contact precautions (CP) as well as adjunctive measures to reduce the risk of transmission for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus in US hospitals. It found that the most widely used trigger for initiation of CP for both pathogens was positive clinical culture. Practices for discontinuation of isolation varied widely. Evidence-based guidelines regarding CP and horizontal interventions are needed.
AHRQ-funded; HS021188.
Citation: Russell D, Beekmann SE, Polgreen PM .
Routine use of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus: Which way is the pendulum swinging?
Infect Control Hosp Epidemiol 2016 Jan;37(1):36-40. doi: 10.1017/ice.2015.246.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Antimicrobial Stewardship, Patient Safety
Milstone AM, Koontz DW, Voskertchian A
Treating parents to reduce NICU transmission of Staphylococcus aureus (TREAT PARENTS) trial: protocol of a multisite randomised, double-blind, placebo-controlled trial.
This study looks to measure the effect of treating parents with short course intranasal mupirocin and topical chlorhexidine antisepsis on acquisition of S. aureus colonisation and infection in neonates. The primary outcome will be neonatal acquisition of an S. aureus strain that is concordant to the parental baseline S. aureus strain.
AHRQ-funded; HS022872.
Citation: Milstone AM, Koontz DW, Voskertchian A .
Treating parents to reduce NICU transmission of Staphylococcus aureus (TREAT PARENTS) trial: protocol of a multisite randomised, double-blind, placebo-controlled trial.
BMJ Open 2015 Sep 09;5(9):e009274. doi: 10.1136/bmjopen-2015-009274.
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Keywords: Healthcare-Associated Infections (HAIs), Newborns/Infants, Antimicrobial Stewardship, Prevention, Neonatal Intensive Care Unit (NICU)
Creech CB, Al-Zubeidi DN, Fritz SA
Prevention of recurrent staphylococcal skin infections.
Staphylococcus aureus infections pose a significant health burden. As S aureus colonization is associated with subsequent infection, decolonization is recommended for patients with recurrent skin and soft tissue infections or in settings of ongoing transmission. S aureus infections often cluster within households, and asymptomatic carriers serve as reservoirs for transmission; therefore, a household approach to decolonization is more effective than measures performed by individuals alone.
AHRQ-funded; HS021736.
Citation: Creech CB, Al-Zubeidi DN, Fritz SA .
Prevention of recurrent staphylococcal skin infections.
Infect Dis Clin North Am 2015 Sep;29(3):429-64. doi: 10.1016/j.idc.2015.05.007.
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Keywords: Prevention, Methicillin-Resistant Staphylococcus aureus (MRSA), Antimicrobial Stewardship, Patient Safety
Hamilton KW, Gerber JS, Moehring R
Point-of-prescription interventions to improve antimicrobial stewardship.
The purpose of this review was to discuss interventions focusing on antimicrobial prescribing at the point of prescription as well as a pilot project to engage unit-based healthcare providers in antimicrobial stewardship.
AHRQ-funded; HS023866.
Citation: Hamilton KW, Gerber JS, Moehring R .
Point-of-prescription interventions to improve antimicrobial stewardship.
Clin Infect Dis 2015 Apr 15;60(8):1252-8. doi: 10.1093/cid/civ018.
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Keywords: Antimicrobial Stewardship, Infectious Diseases, Medication, Patient Safety, Prevention