National Healthcare Quality and Disparities Report
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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
126 to 150 of 420 Research Studies DisplayedMcGee MF, Kreutzer L, Quinn CM
Leveraging a comprehensive program to implement a colorectal surgical site infection reduction bundle in a statewide quality improvement collaborative.
This study’s objective was examine the implementation and associated clinical outcomes of a comprehensive colorectal surgical site infection (SSI) reduction bundle in a large statewide quality improvement collaborative. This multifaceted bundle includes guided implementation, data feedback, mentorship, process improvement training/coaching, and targeted-implementation toolkits. Bundle adherence outcomes were examined pre- and post-implementation. Among 32 hospitals, there was a 2.4-fold relative increase in patients completing at least 75% of bundle elements. The largest gains were in wound closure re-gowning/re-gloving, use of clean closing instruments, and preoperative chlorhexidine bathing. Adherence showed a significant decrease in superficial SSI rates.
AHRQ-funded; HS024516.
Citation: McGee MF, Kreutzer L, Quinn CM .
Leveraging a comprehensive program to implement a colorectal surgical site infection reduction bundle in a statewide quality improvement collaborative.
Ann Surg 2019 Oct;270(4):701-11. doi: 10.1097/sla.0000000000003524..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Quality Improvement, Quality of Care
Manojlovich M, Ameling JM, Forman J
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
This study identified contextual barriers to communication between physicians and nurses that contribute to inappropriate use of catheters and increased risk of health care-associated infections. The researchers conducted individual and small-group semistructured interviewed with physicians and nurses in a progressive care unit of an academic hospital. Common barriers included workflow misalignment between clinicians, issues with electronic medical records and pagers, and strained relationships between clinicians.
AHRQ-funded; HS024385.
Citation: Manojlovich M, Ameling JM, Forman J .
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
Am J Crit Care 2019 Jul;28(4):290-98. doi: 10.4037/ajcc2019372..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Healthcare-Associated Infections (HAIs), Patient Safety, Provider, Provider: Nurse, Provider: Physician, Urinary Tract Infection (UTI), Workflow
Khamash DF, Voskertchian A, Tamma PD
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
This retrospective observational study looked at pediatric clinical cultures between 2005 and 2017 that grew Staphylococcus aureus culture and their trends in antibiotic resistance. Methicillin resistance declined but clindamycin and trimethoprim-sulfamethoxazole resistance increased significantly.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Tamma PD .
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
J Pediatric Infect Dis Soc 2019 Sep 25;8(4):351-53. doi: 10.1093/jpids/piy062..
Keywords: Children/Adolescents, Antibiotics, Medication, Healthcare-Associated Infections (HAIs), Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA)
Khamash DF, Voskertchian A, Tamma PD
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
This retrospective observational study looked at pediatric clinical cultures between 2005 and 2017 that grew Staphylococcus aureus culture and their trends in antibiotic resistance. Methicillin resistance declined but clindamycin and trimethoprim-sulfamethoxazole resistance increased significantly.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Tamma PD .
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
J Pediatric Infect Dis Soc 2019 Sep 25;8(4):351-53. doi: 10.1093/jpids/piy062..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Antibiotics, Medication
Chopra V, Kaatz S, Swaminathan L
Variation in use and outcomes related to midline catheters: results from a multicentre pilot study.
This study examined complication rates from placement of midline vascular catheters. They have become more common in use recently. Complications were analyzed using medical records from hospitalized patients in 12 hospitals from January 2017 to February 2018. Most midline catheters were placed in general ward settings for difficult intravenous access. About half were removed within 5 days of insertion. Major or minor complications occurred in 10.3% of midlines with minor complications accounting for 71% of all adverse events. These minor complications included dislodgement, leaking, and infiltration. Major complications included occlusion, upper-extremity DVT and BSI. Use of midlines and outcomes varied widely across hospitals.
AHRQ-funded; HS025891.
Citation: Chopra V, Kaatz S, Swaminathan L .
Variation in use and outcomes related to midline catheters: results from a multicentre pilot study.
BMJ Qual Saf 2019 Sep;28(9):714-20. doi: 10.1136/bmjqs-2018-008554..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases, Adverse Events, Practice Patterns, Outcomes, Hospitals
Tourani R, Murphree DH, Melton-Meaux G
The value of aggregated high-resolution intraoperative data for predicting post-surgical infectious complications at two independent sites.
Surgical procedures carry the risk of postoperative infectious complications, which can be severe, expensive, and morbid. A growing body of evidence indicates that high-resolution intraoperative data can be predictive of these complications. However, these studies are often contradictory in their findings. In this work, data and models from two independent institutions, Mayo Clinic and University of Minnesota-affiliated Fairview Health Services, were directly compared using a common set of definitions for the variables and outcomes.
AHRQ-funded; HS024532.
Citation: Tourani R, Murphree DH, Melton-Meaux G .
The value of aggregated high-resolution intraoperative data for predicting post-surgical infectious complications at two independent sites.
Stud Health Technol Inform 2019 Aug 21;264:398-402. doi: 10.3233/shti190251..
Keywords: Surgery, Adverse Events, Risk, Infectious Diseases, Healthcare-Associated Infections (HAIs)
Anderson DJ, Watson S, Moehring RW
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Watson S, Moehring RW .
Feasibility of core antimicrobial stewardship interventions in community hospitals.
The purpose of this study was to determine the feasibility and results of implementing 2 core stewardship intervention strategies in community hospitals. The two antimicrobial stewardship strategies targeted vancomycin hydrochloride, piperacillin-tazobactam, and the antipseudomonal carbapenems on formulary at the study hospitals: (1) modified preauthorization (PA), in which the prescriber had to receive pharmacist approval for continued use of the antibiotic after the first dose, and (2) postprescription audit and review (PPR), in which the pharmacist would engage the prescriber about antibiotic appropriateness after 72 hours of therapy..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Hospitals, Infectious Diseases, Medication, Patient Safety
Libertucci J, Bassis CM, Cassone M
Bacteria detected in both urine and open wounds in nursing home residents: a pilot study.
Researchers sought to determine if bacterial species colonizing open wounds are also found in the urine. Their pilot study of nursing home residents provided evidence that bacterial species identified within the urine can also be identified in open wounds in the same patient at one point in time. They recommended further studies to investigate if these species are of the same lineage and if the urinary microbiota are able to seed colonization of open wounds below the umbilicus.
AHRQ-funded; HS019767.
Citation: Libertucci J, Bassis CM, Cassone M .
Bacteria detected in both urine and open wounds in nursing home residents: a pilot study.
mSphere 2019 Aug 28;4(4). doi: 10.1128/mSphere.00463-19..
Keywords: Elderly, Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Patient Safety
Hefner JL, Fareed N, Walker DM
Central line infections in United States hospitals: an exploration of variation in central line device days and infection rates across hospitals that serve highly complex patient populations.
Am J Infect Control 2019 Aug;47(8):1032-34. doi: 10.1016/j.ajic.2018.12.001.
The authors’ descriptive analyses show a wide distribution in rates of central line device days and central line-associated bloodstream infections for a given standardized infection ratio among 215 US hospitals serving highly complex patient populations. They established that the standardized infection ratio masks hospital-level variation in device use and associated patient safety.
The authors’ descriptive analyses show a wide distribution in rates of central line device days and central line-associated bloodstream infections for a given standardized infection ratio among 215 US hospitals serving highly complex patient populations. They established that the standardized infection ratio masks hospital-level variation in device use and associated patient safety.
AHRQ-funded; HS024958.
Citation: Hefner JL, Fareed N, Walker DM .
Central line infections in United States hospitals: an exploration of variation in central line device days and infection rates across hospitals that serve highly complex patient populations.
Am J Infect Control 2019 Aug;47(8):1032-34. doi: 10.1016/j.ajic.2018.12.001..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety
Kates AE, Zimbric ML, Mitchell K
The impact of chlorhexidine gluconate on the skin microbiota of children and adults: a pilot study.
The authors examined the effect of chlorhexidine gluconate bathing on the skin microbiota of adult and pediatric patients. They observed no differences in pediatric patients, but multiple genera of bacteria were observed to be significantly less abundant in adults. They recommended further research to determine long-term impact.
AHRQ-funded; HS024039.
Citation: Kates AE, Zimbric ML, Mitchell K .
The impact of chlorhexidine gluconate on the skin microbiota of children and adults: a pilot study.
Am J Infect Control 2019 Aug;47(8):1014-16. doi: 10.1016/j.ajic.2019.01.024..
Keywords: Children/Adolescents, Skin Conditions, Healthcare-Associated Infections (HAIs), Prevention, Patient Safety
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
Elman MR, Williams CD, Bearden DT
Healthcare-associated urinary tract infections with onset post hospital discharge.
The objective of this study was to measure the incidence of potentially healthcare-associated (HA), community-onset (CO) urinary tract infection (UTI) in a retrospective cohort of hospitalized patients. Among 3,273 patients at risk for potentially HA-CO UTI, results found that the incidence of HA-CO UTI in the 30 days post discharge was 29.8 per 1,000 patients; independent risk factors included paraplegia, quadriplegia, indwelling catheter during index hospitalization, prior piperacillin-tazobactam prescription, prior penicillin class prescription, and private insurance. The authors conclude that HA-CO UTI may be common within 30 days following hospital discharge, and that their data suggests that surveillance efforts may need to be expanded to capture the full burden to patients and to better inform antibiotic prescribing decisions for patients with a history of hospitalization.
AHRQ-funded; HS020970.
Citation: Elman MR, Williams CD, Bearden DT .
Healthcare-associated urinary tract infections with onset post hospital discharge.
Infect Control Hosp Epidemiol 2019 Aug;40(8):863-71. doi: 10.1017/ice.2019.148..
Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Hospital Discharge, Hospitalization, Urinary Tract Infection (UTI)
Musuuza JS, Hundt AS, Carayon P
Implementation of a Clostridioides difficile prevention bundle: understanding common, unique, and conflicting work system barriers and facilitators for subprocess design.
This study assessed the factors that should be considered when designing subprocesses of a Clostridioides difficile (C. difficile) prevention bundle. Three focus groups were conducted with environmental services staff, physicians and nurses to assess their perspectives on the prevention bundle and barriers to implementation. Common barriers included inconsistencies in knowledge and practice of CD management procedures; increased workload; poor setup of aspects of the physical environment; and inconsistencies in CD documentation. There were also unique barriers in different hospital environments. The authors recommend a systems engineering approach to help holistically identify factors that influence successful implementation of subprocesses of the CD infection prevention bundle.
AHRQ-funded; HS023791.
Citation: Musuuza JS, Hundt AS, Carayon P .
Implementation of a Clostridioides difficile prevention bundle: understanding common, unique, and conflicting work system barriers and facilitators for subprocess design.
Infect Control Hosp Epidemiol 2019 Aug;40(8):880-88. doi: 10.1017/ice.2019.150..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Sankaran R, Sukul D, Nuliyalu U
Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study.
This study evaluated the association between hospital penalization in the US Hospital Acquired Condition Reduction Program (HACRP) and changes in clinical outcomes. Out of the total of 724 hospitals were penalized in fiscal year 2015, 708 were included in the study. The majority of the penalized hospitals were large teaching institutions and have a greater share of low-income patients than non-penalized hospitals. After penalization, there was a non-significant change in hospital acquired conditions, 30-day readmission rates, and 30-day mortality. This might mean that disparities in care could be exacerbated.
AHRQ-funded; HS026244.
Citation: Sankaran R, Sukul D, Nuliyalu U .
Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study.
BMJ 2019 Jul 3;366:l4109. doi: 10.1136/bmj.l4109..
Keywords: Health Insurance, Healthcare-Associated Infections (HAIs), Hospitals, Medicare, Patient Safety, Provider Performance, Payment, Quality of Care, Quality Indicators (QIs)
Paje D, Rogers MAM, Conlon A
Use of peripherally inserted central catheters in patients with advanced chronic kidney disease: a prospective cohort study.
Existing guidelines, including Choosing Wisely recommendations, endorse avoiding placement of peripherally inserted central catheters (PICCs) in patients with chronic kidney disease (CKD). The purpose of this study was to describe the frequency of and characteristics associated with PICC use in hospitalized patients with stage 3b or greater CKD (glomerular filtration rate [GFR] <45 mL/min/1.73 m2).
AHRQ-funded; HS025891.
Citation: Paje D, Rogers MAM, Conlon A .
Use of peripherally inserted central catheters in patients with advanced chronic kidney disease: a prospective cohort study.
Ann Intern Med 2019 Jul 2;171(1):10-18. doi: 10.7326/m18-2937..
Keywords: Kidney Disease and Health, Guidelines, Evidence-Based Practice, Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Liang SY, Jansson DR, Hogan PG
Emergency department environmental contamination with methicillin-Resistant Staphylococcus aureus after care of colonized patients.
This study examined transmission of Methicillin-resistant Staphylococcus aureus (MRSA) in emergency departments (EDs) after care of colonized patients. The effect of MRSA infected patients’ visits to emergency rooms was studied after patients’ discharge and before environmental disinfection. Cultures from 5 anatomic sites were obtained and also from ED rooms. Nineteen of the 25 ED rooms that were occupied by MRSA-colonized patients contained greater than or equal to 1 MRSA-contaminated environmental surface. The room was more likely to be contaminated if there was more than 1 body site colonized on a patient. The strain was matched with the patient in 16 of the 19 ED rooms where MRSA was recovered. This study emphasized the importance of environmental surface disinfection to reduce MRSA transmission in EDs.
AHRQ-funded; HS021736; HS024269.
Citation: Liang SY, Jansson DR, Hogan PG .
Emergency department environmental contamination with methicillin-Resistant Staphylococcus aureus after care of colonized patients.
Ann Emerg Med 2019 Jul;74(1):50-55. doi: 10.1016/j.annemergmed.2018.12.014..
Keywords: Emergency Department, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs)
Feemster K, Localio R, Grundmeier R
Incidence of healthcare-associated influenza-like illness after a primary care encounter among young children.
The authors evaluated whether exposure to a pediatric clinic visit was associated with subsequent influenza-like illness (ILI) using electronic health record data. They found that pediatric clinic visits during a respiratory virus season were significantly associated with an increased incidence of subsequent ILI among children aged 2 to 6 years but not among those aged less than 2 years. They concluded that their findings support the hypothesis that respiratory virus transmission in a pediatric clinic can result in healthcare-associated ILI in young children.
AHRQ-funded; HS020939.
Citation: Feemster K, Localio R, Grundmeier R .
Incidence of healthcare-associated influenza-like illness after a primary care encounter among young children.
J Pediatric Infect Dis Soc 2019 Jul 1;8(3):191-96. doi: 10.1093/jpids/piy023..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Infectious Diseases, Influenza, Primary Care, Healthcare Delivery, Ambulatory Care and Surgery, Respiratory Conditions
Krein SL, Saint S, Trautner BW
Patient-reported complications related to peripherally inserted central catheters: a multicentre prospective cohort study.
The objective of this study was to systematically elicit and characterize peripherally inserted central catheter-related complications as experienced by patients during and after hospitalization. Results showed that over 60% of patients reported signs or symptoms of a possible complication or adverse effect after peripherally inserted central catheter placement. Bothersome complications from the patient perspective were more common than those that typically rise to the level of healthcare provider attention or concern. Recommendations included an understanding of the patient experience in order to provide safe and effective care.
AHRQ-funded; HS025891.
Citation: Krein SL, Saint S, Trautner BW .
Patient-reported complications related to peripherally inserted central catheters: a multicentre prospective cohort study.
BMJ Qual Saf 2019 Jul;28(7):574-81. doi: 10.1136/bmjqs-2018-008726..
Keywords: Adverse Events, Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases
Chai PR, Zhang H, Jambaulikar GD
An Internet of things buttons to measure and respond to restroom cleanliness in a hospital setting: descriptive study.
AHRQ-funded; HS024538; HS024713.
Citation: Chai PR, Zhang H, Jambaulikar GD .
An Internet of things buttons to measure and respond to restroom cleanliness in a hospital setting: descriptive study.
J Med Internet Res 2019 Jun 19;21(6):e13588. doi: 10.2196/13588..
Keywords: Hospitals, Health Information Technology (HIT), Patient Safety, Healthcare-Associated Infections (HAIs)
Misch EA, Safdar N
Clostridioides difficile infection in the stem cell transplant and hematologic malignancy population.
This article describes a study underway with patients who have undergone a stem cell transplant due to a hematologic malignancy who subsequently contracted a Clostridioides difficile (CD) infection. A new treatment for CD infection is the use of a fecal microbiota transplant (FMT), but it has not been widely adopted in transplant patients because of safety concerns. A randomized controlled trial of FMT in transplant patients is now underway.
AHRQ-funded; HS026226; HS025713.
Citation: Misch EA, Safdar N .
Clostridioides difficile infection in the stem cell transplant and hematologic malignancy population.
Infect Dis Clin North Am 2019 Jun;33(2):447-66. doi: 10.1016/j.idc.2019.02.010..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Cancer
Hessels AJ, Kelly AM, Chen L
Impact of infectious exposures and outbreaks on nurse and infection preventionist workload.
Researchers evaluated workload increases reported by staff nurses and infection preventionists (IPs) in response to common exposures and outbreaks. Using surveys, they concluded that organisms that are easier to treat and more difficult to spread, such as scabies or lice, can contribute substantially to nursing workload. Additionally, three-quarters of the nurses and one-half of the IPs reported that C difficile adds more than one hour to their daily workload.
AHRQ-funded; HS024915.
Citation: Hessels AJ, Kelly AM, Chen L .
Impact of infectious exposures and outbreaks on nurse and infection preventionist workload.
Am J Infect Control 2019 Jun;47(6):623-27. doi: 10.1016/j.ajic.2019.02.007..
Keywords: Burnout, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Provider: Nurse, Public Health
Caroff DA, Menchaca JT, Zhang Z
Oral vancomycin prophylaxis during systemic antibiotic exposure to prevent Clostridiodes difficile infection relapses.
This study’s goal was to determine if giving hospitalized patients oral vancomycin along with systematic antibiotics prevents relapse of Cloistridioides difficile infection (CDI). The results show that the outcome was not statistically significant, although it may help patients who have only had 1 prior CDI episode.
AHRQ-funded; HS025008.
Citation: Caroff DA, Menchaca JT, Zhang Z .
Oral vancomycin prophylaxis during systemic antibiotic exposure to prevent Clostridiodes difficile infection relapses.
Infect Control Hosp Epidemiol 2019 Jun;40(6):662-67. doi: 10.1017/ice.2019.88..
Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Prevention
Keller SC, Alexander M, Williams D
Perspectives on central-line-associated bloodstream infection surveillance in home infusion therapy.
This study examined in the differences between 3 professional society members who provide home infusion services in diagnosing and defining central-line-associated bloodstream infections (CLABSIs). The three societies surveyed were members of the Infusion Nurses Society (INS), the National Home Infusion Association (NHIA), and the Society for Healthcare Epidemiology of America Research Network (SRN). The INS is a 6000-member global organization of main nurses who work in all practice settings including home infusion. The NHIA is a 400-member trade organization focused on providing infusion products and services in the home, and SRN is a network of 111 healthcare institutions that collaborate on research to prevent healthcare-associated infections and antibiotic resistance. There was a difference in the criteria used for defining a CLABSI with home testing, and their use of the Association for Professionals in Infection Control/Healthcare Infection Control Practices Advisory Committee (APIC-HICPAC) criteria. Although some perspective was gained from a wide variety of professionals, there was a low response rate, which suggests the possibility of response bias.
AHRQ-funded; HS025782.
Citation: Keller SC, Alexander M, Williams D .
Perspectives on central-line-associated bloodstream infection surveillance in home infusion therapy.
Infect Control Hosp Epidemiol 2019 Jun;40(6):729-31. doi: 10.1017/ice.2019.90..
Keywords: Home Healthcare, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety
Musuuza JS, Guru PK, O'Horo JC
The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis.
This review and meta-analysis examined the effect of chlorhexidine gluconate (CHG) bathing on reducing hospital-acquired bloodstream infections (HABSIs) and also assessed fidelity to the implementation of this intervention. The literature research included randomized controlled trials, cluster randomized trials, and quasi-experimental studies that evaluated the effect of CHG bathing versus a non-CHG comparator; studies involving pediatric patients, pre-surgical CHG use, and those without a non-CHG comparison arm were excluded. Outcomes were HABSIs, patient-centered outcomes, and implementation fidelity assessed through five elements: adherence, exposure or dose, quality of delivery, participant responsiveness, and program differentiation. The findings indicate that patient bathing with CHG significantly reduced the incidence of HABSIs in both ICU and non-ICU settings. Many studies, however, did not report fidelity to intervention or patient-centered outcomes.
AHRQ-funded; HS024039.
Citation: Musuuza JS, Guru PK, O'Horo JC .
The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis.
BMC Infect Dis 2019 May 14;19(1):416. doi: 10.1186/s12879-019-4002-7..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention
Calderwood MS, Yokoe DS, Murphy MV
Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty.
The authors assessed the effect of a multistate quality improvement campaign to promote the adoption of evidence-based surgical site infection (SSI) prevention practices. Rates of SSI among Medicare beneficiaries undergoing hip and knee arthroplasty during pre-intervention and post-intervention in five states included in a multistate trial of the Project JOINTS campaign and five matched comparison states were analyzed. The authors found a larger reduction of SSI rates following hip and knee arthroplasty in intervention states than in the matched control states.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Yokoe DS, Murphy MV .
Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty.
BMJ Qual Saf 2019 May;28(5):374-81. doi: 10.1136/bmjqs-2018-007982..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Orthopedics, Quality Improvement, Quality of Care, Evidence-Based Practice, Prevention, Patient Safety