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Topics
- Clinical Decision Support (CDS) (1)
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- Healthcare-Associated Infections (HAIs) (1)
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- Long-Term Care (3)
- (-) Nursing Homes (6)
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- (-) Pressure Ulcers (6)
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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 DisplayedSanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z .
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
Chen Z, Gleason LJ, Sanghavi P
Accuracy of pressure ulcer events in US nursing home ratings.
This study investigated the accuracy of the government website Nursing Home Compare (NHC) pressure ulcer measures, which are chief indicators of nursing home patient safety. The authors identified hospital admissions for pressure ulcers and linked them to the nursing home-reported data at the patient level using Medicare fee-for-service beneficiaries who were nursing home residents between 2011 and 2017. Percentages of pressure ulcers that were appropriately reported by stage, long-stay versus short-stay status, and race was calculated. Reporting rates were low for both short-stay (70.2%) and long-stay (59.7%) for stage 2-4 pressure ulcer hospitalizations. Black residents experienced more severe pressure ulcers than White residents. Correlations between claims-based measures and NHC ratings were found to be poor.
AHRQ-funded; HS026957.
Citation: Chen Z, Gleason LJ, Sanghavi P .
Accuracy of pressure ulcer events in US nursing home ratings.
Med Care 2022 Oct;60(10):775-83. doi: 10.1097/mlr.0000000000001763.
AHRQ-funded; HS026957..
AHRQ-funded; HS026957..
Keywords: Elderly, Nursing Homes, Long-Term Care, Pressure Ulcers, Quality Measures, Quality of Care, Patient Safety
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
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
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