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- Ambulatory Care and Surgery (1)
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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 10 of 10 Research Studies DisplayedJones K, Mantey J, Washer L
When planning meets reality: COVID-19 interpandemic survey of Michigan nursing homes.
This survey examined conditions at Michigan nursing homes (NHs) during the COVID-19 pandemic period. This survey evaluated preparedness, staffing, testing, and adaptations made due to COVID. Of 452 Michigan NHs contacted via email, 145 opened the survey of those,143 responded from May 1-12, 2020. Two-thirds reported shortages of personal protective equipment. Half lacked sufficient testing resources with only 36% able to test residents and staff when needed. A majority (55%) experienced staffing shortages, with 63% experiencing resignations with front-line clinical staff more likely to resign. Facilities showed rapid adaptation, with 78% creating COVID-19 units to care for patients on site. To reduce isolation, most NHs facilitated communication via phone calls, videoconferencing, and window visits. The majority continued to provide normal required therapies (90%).
AHRQ-funded; HS025451.
Citation: Jones K, Mantey J, Washer L .
When planning meets reality: COVID-19 interpandemic survey of Michigan nursing homes.
Am J Infect Control 2021 Nov;49(11):1343-49. doi: 10.1016/j.ajic.2021.03.016..
Keywords: COVID-19, Nursing Homes, Public Health, Emergency Preparedness
Applebury DE, Robinson EJ, Gold JA
Pilot testing of simulation in the evaluation of a novel, rapidly deployable electronic health record for use in disaster intensive care.
This purpose of this study was to present the application of simulation to assess a quickly scalable hub-and-spoke model for Electronic Health Record (EHR) system deployment and monitoring, utilizing asynchronous training. The researchers modified existing commercial EHR products to function as the entry point from a simulated hospital and a separate system for tele-ICU support and data monitoring. A modular video-based curriculum was developed for asynchronous training of users. The curriculum's effectiveness was evaluated through the completion of standard ICU documentation tasks in a high-fidelity simulation. Additional endpoints included EHR navigation assessment, user satisfaction (Net Promoter), system usability (System Usability Scale-SUS), and cognitive load (NASA-TLX). The study found that 5 participants achieved a 100% task completion rate in all domains, except for ventilator data (91%). The systems demonstrated high satisfaction, satisfactory usability, and acceptable cognitive load, with higher cognitive loads correlating to the number of screens used.
AHRQ-funded; HS023793.
Citation: Applebury DE, Robinson EJ, Gold JA .
Pilot testing of simulation in the evaluation of a novel, rapidly deployable electronic health record for use in disaster intensive care.
Disaster Med Public Health Prep 2021 Oct 22; 17:e51. doi: 10.1017/dmp.2021.302..
Keywords: COVID-19, Emergency Preparedness, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health, Intensive Care Unit (ICU), Critical Care
Chelen JSC, White DB, Zaza S
US ventilator allocation and patient triage policies in anticipation of the COVID-19 surge.
Researchers assessed policy preparedness and substantive triage criteria within existing policies using a cross-sectional survey distributed to public health personnel and healthcare providers between March 23 and April 23, 2020. They found that their sample of policies reflected organizational strategies of exemplar-based policy development and the use of objective criteria in triage decisions, either before or instead of clinical judgment, to support ethical distribution of resources.
AHRQ-funded; HS024075.
Citation: Chelen JSC, White DB, Zaza S .
US ventilator allocation and patient triage policies in anticipation of the COVID-19 surge.
Health Secur 2021 Sep-Oct;19(5):459-67. doi: 10.1089/hs.2020.0166..
Keywords: COVID-19, Public Health, Emergency Preparedness, Policy
Barry CL, Anderson KE, Han H
Change over time in public support for social distancing, mask wearing, and contact tracing to combat the COVID-19 pandemic among US adults, April to November 2020.
This study examined changes over time in attitudes towards social distancing, mask wearing, and contact tracing to combat the COVID-19 pandemic among US adults, April to November 2020. Surveys of a nationally representative cohort of US adults were conducted in April, July, and November 2020. Support for social distancing dropped from 89% in April to 79% in July but remained stable in November at 78%. In July and November, more than 75% of respondents supported mask wearing and nearly as many supported contact tracing. Support differences were most pronounced by age, partisanship, and trust in science. Higher support for contact tracing was independently predicted by having a more fluid worldview.
AHRQ-funded; HS000029.
Citation: Barry CL, Anderson KE, Han H .
Change over time in public support for social distancing, mask wearing, and contact tracing to combat the COVID-19 pandemic among US adults, April to November 2020.
Am J Public Health 2021 May;111(5):937-48. doi: 10.2105/ajph.2020.306148..
Keywords: COVID-19, Public Health, Emergency Preparedness, Infectious Diseases
Shuman CJ, Costa DK
Stepping in, stepping up, and stepping out: competencies for intensive care unit nursing leaders during disasters, emergencies, and outbreaks.
In this paper, the authors discuss competencies for intensive care unit nursing leaders during disasters, emergencies, and outbreaks. They draw on the recent example of COVID-19s substantially burdened intensive care units and nursing staff. Informed by extant literature, American Organization of Nurse Leaders--identified competencies, and expert opinion, the authors suggest 3 areas of focused skill development to ensure leaders, especially leaders in ICU settings, are prepared for future crises.
AHRQ-funded; HS024552.
Citation: Shuman CJ, Costa DK .
Stepping in, stepping up, and stepping out: competencies for intensive care unit nursing leaders during disasters, emergencies, and outbreaks.
Am J Crit Care 2020 Sep 1;29(5):403-06. doi: 10.4037/ajcc2020421..
Keywords: Critical Care, Provider: Nurse, Nursing, COVID-19, Emergency Preparedness
Auerbach A, O'Leary KJ, Greysen SR
Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers.
The authors sought to characterize inpatient adaptations to care for non-ICU COVID-19 patients. They found that the COVID-19 pandemic has required medical wards to rapidly adapt with expanding use of respiratory isolation units and use of technology emerging as critical approaches. Reports of unrecognized or delayed diagnoses highlight how such adaptations may produce potential adverse effects on care.
AHRQ-funded; HS026383; HS026215; HS027369.
Citation: Auerbach A, O'Leary KJ, Greysen SR .
Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers.
J Hosp Med 2020 Aug;15(8):483-88. doi: 10.12788/jhm.3476..
Keywords: COVID-19, Emergency Preparedness, Hospitals, Public Health, Healthcare Delivery, Inpatient Care
Abrams EM, Greenhawt M
Risk communication during COVID-19.
This article focuses on ways the healthcare community can best communicate risk of COVID-19 to the public. Poor risk communication results in hoarding behavior which can lead to lack of medications and personal protective equipment. Utilizing social media channels to ensure an ongoing consistent media presence is one potential way to ensure appropriate risk communication. Including all stakeholders in broader public health messaging is also important.
AHRQ-funded; HS024599.
Citation: Abrams EM, Greenhawt M .
Risk communication during COVID-19.
J Allergy Clin Immunol Pract 2020 Jun;8(6):1791-94. doi: 10.1016/j.jaip.2020.04.012..
Keywords: COVID-19, Communication, Risk, Public Health, Emergency Preparedness
Jones KM, Mantey J, Mills JP
COVID-19 preparedness in Michigan nursing homes.
The objectives of this study were to understand preparedness among Michigan nursing homes (NHs) in the midst of an ongoing pandemic and to compare with a 2007 survey on pandemic influenza preparedness in Michigan NHs. Findings showed that, in 2020, NHs were able to make policy and procedure changes within 1 week in response to urgent guidance from CMS and the CDC, which likely helped the facilities prepare for the COVID-19 pandemic. Most NHs had a dedicated staff member responsible for preparedness and were willing to accept patients from hospitals to assist in their surge capacity planning, particularly for non-COVID patients. NHs did express concerns about staffing shortages and PPE supply constraints as cases rose.
AHRQ-funded; HS025451.
Citation: Jones KM, Mantey J, Mills JP .
COVID-19 preparedness in Michigan nursing homes.
J Am Geriatr Soc 2020 May;68(5):937-39. doi: 10.1111/jgs.16490..
Keywords: COVID-19, Elderly, Nursing Homes, Long-Term Care, Emergency Preparedness, Public Health
Shaker MS, Oppenheimer J, Grayson M
COVID-19: pandemic contingency planning for the allergy and immunology clinic.
In the event of a global infectious pandemic, drastic measures may be needed that limit or require adjustment of ambulatory allergy services. However, no rationale for how to prioritize service shut down and patient care exists. A consensus-based ad-hoc expert panel of allergy/immunology specialists from the United States and Canada developed a service and patient prioritization schematic to temporarily triage allergy/immunology services. This paper describes the process, recommendations and feedback.
AHRQ-funded; HS024599.
Citation: Shaker MS, Oppenheimer J, Grayson M .
COVID-19: pandemic contingency planning for the allergy and immunology clinic.
J Allergy Clin Immunol Pract 2020 May;8(5):1477-88.e5. doi: 10.1016/j.jaip.2020.03.012..
Keywords: COVID-19, Respiratory Conditions, Emergency Preparedness, Public Health, Healthcare Delivery, Ambulatory Care and Surgery, Infectious Diseases
Steuart R, Huang FS, Schaffzin JK
Finding the value in personal protective equipment for hospitalized patients during a pandemic and beyond.
Innovative protocols have been conceptualized and used to conserve PPE in hospitals. Conservation protocols often fail to identify missed opportunities to improve the value of personal protective equipment (PPE) that already exist in hospital care. By defining the value of inpatient PPE, hospitals can identify opportunities for value improvement. Changes implemented now will maximize PPE value and preserve supply during this pandemic and beyond. In this article, the authors discuss the value in PPE for hospitalized patients during a pandemic and beyond.
AHRQ-funded; HS025138.
Citation: Steuart R, Huang FS, Schaffzin JK .
Finding the value in personal protective equipment for hospitalized patients during a pandemic and beyond.
J Hosp Med 2020 May;15(5):295-98. doi: 10.12788/jhm.3429..
Keywords: COVID-19, Emergency Preparedness, Public Health, Hospitals, Patient Safety