National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (2)
- Clostridium difficile Infections (1)
- Communication (1)
- Community-Acquired Infections (1)
- (-) Decision Making (8)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- Guidelines (1)
- (-) Healthcare-Associated Infections (HAIs) (8)
- Healthcare Costs (2)
- Health Information Technology (HIT) (1)
- Infectious Diseases (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Medication (1)
- Nursing (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (3)
- Pneumonia (1)
- Risk (1)
- Stroke (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 8 of 8 Research Studies DisplayedSick-Samuels AC, Linz M, Bergmann J
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
This study describes the development and impact of a clinical decision support algorithm to standardize the use of endotracheal aspirate cultures (EACs) from ventilated PICU patients in the evaluation of suspected ventilator-associated infections. Bacterial growth in EACs does not distinguish bacterial colonization from infection and may lead to overtreatment with antibiotics. The rate of EACs was compared pre- and postintervention. In the preintervention year there were 557 EACs over 5092 ventilator days. After introduction of the algorithm the rate went down to 234 EACs over 3654 ventilator days. There was a 41% decrease in the monthly rate of EACs. This intervention did not affect mortality, readmissions, or length of stay in ventilated PICU patients.
AHRQ-funded; HS025642.
Citation: Sick-Samuels AC, Linz M, Bergmann J .
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-1634..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Clinical Decision Support (CDS), Decision Making, Healthcare-Associated Infections (HAIs), Diagnostic Safety and Quality
Thate JA, Couture B, Schnock KO
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
It is clear that interdisciplinary communication and collaboration have the potential to mitigate healthcare-associated harm, yet there is limited research on how communication through documentation in the patient record can support collaborative decision making. Understanding what information is needed to support collaborative decision making is necessary to design electronic health information systems that facilitate effective communication and, ultimately, safe care. To explore this issue, the investigators focused on information needs related to central venous catheter management and the prevention of central line-associated blood stream infections.
AHRQ-funded; HS0235335.
Citation: Thate JA, Couture B, Schnock KO .
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
Comput Inform Nurs 2020 Nov 2;39(4):208-14. doi: 10.1097/cin.0000000000000683..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Decision Making, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Asti L, Bartsch SM, Umscheid CA
The potential economic value of sputum culture use in patients with community-acquired pneumonia and healthcare-associated pneumonia.
Researchers developed a decision model to determine the economic and clinical value of using sputum cultures in the treatment of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) from the hospital perspective under various conditions. They found that, overall, obtaining sputum cultures does not provide significant clinical or economic benefits for CAP or HCAP patients; however, it can reduce costs and shorten overall length of stay under some circumstances. They recommended that clinicians consider their local conditions when making decisions about sputum culture use.
AHRQ-funded; HS023317.
Citation: Asti L, Bartsch SM, Umscheid CA .
The potential economic value of sputum culture use in patients with community-acquired pneumonia and healthcare-associated pneumonia.
Clin Microbiol Infect 2019 Aug;25(8):1038.e1-38.e9. doi: 10.1016/j.cmi.2018.11.031..
Keywords: Pneumonia, Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Healthcare Costs, Clinical Decision Support (CDS), Decision Making
D'Agata EMC, Tran D, Bautista J
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
In this study, the authors developed a decision analytic model of antimicrobial use on the clinical and economic consequences of implementing a nationwide antimicrobial stewardship program in outpatient dialysis facilities. The authors found that the model suggested that implementation of antimicrobial stewardship programs in outpatient dialysis facilities would result in substantial reductions in infections caused by multidrug-resistant organisms and C. difficile, infection-related deaths, and costs.
AHRQ-funded; R18 HS021666.
Citation: D'Agata EMC, Tran D, Bautista J .
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
Clin J Am Soc Nephrol 2018 Sep 7;13(9):1389-97. doi: 10.2215/cjn.12521117..
Keywords: Antimicrobial Stewardship, Decision Making, Antibiotics, Medication, Healthcare Costs, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs)
Herc E, Patel P, Washer LL
A model to predict central-line-associated bloodstream infection among patients with peripherally inserted central catheters: the MPC Score.
Peripherally inserted central catheters (PICCs) are associated with central-line-associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed. The purpose of this study is to operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate an individual's risk of PICC-CLABSI prior to device placement.
AHRQ-funded; HS022835.
Citation: Herc E, Patel P, Washer LL .
A model to predict central-line-associated bloodstream infection among patients with peripherally inserted central catheters: the MPC Score.
Infect Control Hosp Epidemiol 2017 Oct;38(10):1155-66. doi: 10.1017/ice.2017.167..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Decision Making, Healthcare-Associated Infections (HAIs), Patient Safety
Safdar N, Codispoti N, Purvis S
Patient perspectives on indwelling urinary catheter use in the hospital.
The researchers assessed patient perspectives of indwelling urinary catheters. They recommended implementing educational programs incorporating patient preferences for both health care workers and patients in order to increase the involvement of patients in decision-making regarding urinary catheters, which may lead to a decline in catheter-associated urinary tract infections.
AHRQ-funded; HS023791.
Citation: Safdar N, Codispoti N, Purvis S .
Patient perspectives on indwelling urinary catheter use in the hospital.
Am J Infect Control 2016 Mar;44(3):e23-4. doi: 10.1016/j.ajic.2015.10.011.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Education: Patient and Caregiver, Decision Making, Healthcare-Associated Infections (HAIs), Patient Safety
Meddings J, Saint S, Fowler KE
The Ann Arbor criteria for appropriate urinary catheter use in hospitalized medical patients: results obtained by using the RAND/UCLA Appropriateness Method.
A 15-member multidisciplinary panel used the RAND/UCLA Appropriateness Method to assess the appropriateness of using Foley catheters, intermittent straight catheters, and external condom catheters for hospitalized adults on medical services in 299 scenarios, including urinary retention, incontinence, and wounds. The panel concluded that these new appropriateness criteria can inform large-scale collaborative and bedside efforts to reduce inappropriate urinary catheter use.
AHRQ-funded; 290201000025I; HS019767
Citation: Meddings J, Saint S, Fowler KE .
The Ann Arbor criteria for appropriate urinary catheter use in hospitalized medical patients: results obtained by using the RAND/UCLA Appropriateness Method.
Ann Intern Med. 2015 May 5;162(9 Suppl):S1-34. doi: 10.7326/m14-1304..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Decision Making, Guidelines, Healthcare-Associated Infections (HAIs), Inpatient Care, Patient Safety
Friedant AJ, Gouse BM, Boehme AK
A simple prediction score for developing a hospital-acquired infection after acute ischemic stroke.
The authors sought to develop a simple scoring system for any hospital-acquired infection (HAI). Ranging from 0 to 7, the overall infection score consists of age 70 years or more, history of diabetes, and National Institutes of Health Stroke Scale score. Patients with an infection score of 4 or more were at 5 times greater odds of developing an infection. They concluded that, if validated in other populations, this score could assist providers in predicting infections after ischemic stroke.
AHRQ-funded; HS013852.
Citation: Friedant AJ, Gouse BM, Boehme AK .
A simple prediction score for developing a hospital-acquired infection after acute ischemic stroke.
J Stroke Cerebrovasc Dis 2015 Mar;24(3):680-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.11.014.
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Keywords: Decision Making, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Risk, Stroke