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
1 to 25 of 87 Research Studies DisplayedKravchenko OV, Boyce RD, Gomez-Lumbreras A
Drug-drug interaction between dexamethasone and direct-acting oral anticoagulants: a nested case-control study in the national COVID cohort collaborative (N3C).
This study examined whether there is an association between thromboembolotic events (TEEs) and concomitant use of dexamethasone with either apixaban or rivaroxaban (both direct oral anticoagulants or DOACs) during treatment for COVID-19. The authors used data from the National COVID Cohort Collaborative (N3C) to conduct a nested case-control study. Eligible participants were adults over 18 years who were exposed to a DOAC for 10 or more consecutive days and exposure to dexamethasone at least 5 or more consecutive days. The study did not find a discernible association of TEE in patients concomitantly exposed to dexamethasone and a DOAC.
AHRQ-funded; HS025984.
Citation: Kravchenko OV, Boyce RD, Gomez-Lumbreras A .
Drug-drug interaction between dexamethasone and direct-acting oral anticoagulants: a nested case-control study in the national COVID cohort collaborative (N3C).
BMJ Open 2022 Dec 29; 12(12):e066846. doi: 10.1136/bmjopen-2022-066846..
Keywords: COVID-19, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Medication: Safety, Patient Safety
Peng L, Luo G, Walker A
Evaluation of federated learning variations for COVID-19 diagnosis using chest radiographs from 42 US and European hospitals.
The goals of this study were to compare a single-site, COVID-19 computer diagnosis system that used the Federated Averaging (FedAvg) algorithm with 3-client Federated learning (FL) models, and to evaluate the performance of the four FL variations. Researchers leveraged a FL healthcare collaborative that included data from five US and European healthcare systems encompassing 42 hospitals. They concluded that FedAvg could significantly improve generalization of the model in comparison with other personalization FL algorithms--FedProx, FedBN, and FedAMP--but at the cost of poor internal validity.
AHRQ-funded; HS026379.
Citation: Peng L, Luo G, Walker A .
Evaluation of federated learning variations for COVID-19 diagnosis using chest radiographs from 42 US and European hospitals.
J Am Med Inform Assoc 2022 Dec 13;30(1):54-63. doi: 10.1093/jamia/ocac188..
Keywords: COVID-19, Diagnostic Safety and Quality, Imaging, Hospitals
Badaki-Makun O, Levin S, Debraine A
Monocyte distribution width as a pragmatic screen for SARS-CoV-2 or influenza infection.
The purpose of this prospective cohort analysis was to determine the performance of Monocyte distribution width (MDW) and other leukocyte parameters as screening tests for SARS-CoV-2 and influenza infection. Researchers conducted an observational study with a cohort analysis consisting of adult patients who underwent complete blood count (CBC) and SARS-CoV-2 or influenza testing in an Emergency Department (ED) between January 2020 and July 2021. The study concluded that MDW, when available as part of a routine complete blood count (CBC) with differential, could be a useful indicator of SARS-CoV-2 or influenza infection.
AHRQ-funded; HS02664002.
Citation: Badaki-Makun O, Levin S, Debraine A .
Monocyte distribution width as a pragmatic screen for SARS-CoV-2 or influenza infection.
Sci Rep 2022 Dec 13; 12(1):21528. doi: 10.1038/s41598-022-24978-w..
Keywords: COVID-19, Influenza, Respiratory Conditions
Fan CA, Hara-Hubbard KK, Barrington WE
The experience of hate incidents across racial and ethnic groups during the COVID-19 pandemic.
This article investigated the prevalence of hate incidents across racial and ethnic groups and the relationship between race/ethnicity and hate incidents during the first year of the COVID-19 pandemic. National data was taken from the Understanding America Study COVID-19 Longitudinal Survey. The majority of members of all six marginalized racial and ethnic groups reported at least one hate incident; Asian, AI/AN, Black, and Multiracial groups were shown to have significantly higher odds of experiencing each category of hate incident. All marginalized groups had higher odds of receiving poorer service. The authors concluded that the health community must research and treat hate incidents as a public health issue while recognizing the contexts of structural and interpersonal racism in the U.S.
AHRQ-funded; HS013853.
Citation: Fan CA, Hara-Hubbard KK, Barrington WE .
The experience of hate incidents across racial and ethnic groups during the COVID-19 pandemic.
Front Public Health 2022 Dec 12; 10:982029. doi: 10.3389/fpubh.2022.982029..
Keywords: COVID-19, Racial and Ethnic Minorities
Powell KR, Winkler AE, Liu J
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
The objective of this study was to investigate the implementation of telehealth in nursing homes during the COVID-19 pandemic. Researchers conducted a secondary analysis of data from a national survey of nursing home administrative leaders using six survey questions and semi-structured interviews. Their conclusions indicate that training, restructuring teams and tasks, and adaptation of work processes to support communication could improve usability and sustainability of telehealth in nursing homes.
AHRQ-funded; HS02249.
Citation: Powell KR, Winkler AE, Liu J .
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
J Am Geriatr Soc 2022 Dec;70(12):3493-502. doi: 10.1111/jgs.18020..
Keywords: COVID-19, Elderly, Telehealth, Health Information Technology (HIT), Nursing Homes, Implementation
Meyer AND, Singh H, Zimolzak AJ
Cancer evaluations during the COVID-19 pandemic: an observational study using National Veterans Affairs data.
This observational study examined the reasons why fewer cancer diagnoses have been made during the COVID-19 pandemic using electronic health record data from the Department of Veterans Affairs before (March 10, 2019-March 7, 2020) and during (March 8, 2020-March 6, 2021) the pandemic. Electronic triggers were applied to 8,021,406 veterans' electronic health records to identify follow-up delays for abnormal results warranting evaluation for 5 cancers: bladder, breast, colorectal, liver, and lung cancers. Between the prepandemic and pandemic periods, test quantities decreased by 12.6%-27.8%, and proportions of abnormal results lacking follow-up decreased for urinalyses by 0.8%, increased by 2.3% for fecal occult blood tests/fecal immunochemical test and 1.8% for chest imaging, and remained constant for the other diagnostic tests (mammograms for breast cancer and elevated alpha-fetoprotein for liver cancer). This significant decrease in diagnostic testing may have led to reduced cancer rates.
AHRQ-funded; HS027363.
Citation: Meyer AND, Singh H, Zimolzak AJ .
Cancer evaluations during the COVID-19 pandemic: an observational study using National Veterans Affairs data.
Am J Prev Med 2022 Dec;63(6):1026-30. doi: 10.1016/j.amepre.2022.07.004..
Keywords: COVID-19, Cancer, Public Health
Borgatti AC, Crockett KB, Jacob AE
Correlates of psychological distress among adults with obesity during the COVID-19 pandemic.
The objective of this study was to evaluate changes in stress and loneliness among participants with obesity who were engaged in weight loss self-management in the US during COVID-19, and to identify risk factors that may increase psychosocial distress during this period. Participants completed an online survey about social, economic and health behavior changes during COVID-19 and their relationship to changes in perceived stress and loneliness. Results indicated that stress and loneliness increased two months into the COVID-19 pandemic-related shutdown. Factors associated with increased stress and/or loneliness included higher body mass index, social distancing, alcohol intake, and working from home. The authors concluded that ongoing attention to psychosocial well-being among individuals with obesity remains imperative both during the ongoing pandemic and afterwards.
AHRQ-funded; HS013852.
Citation: Borgatti AC, Crockett KB, Jacob AE .
Correlates of psychological distress among adults with obesity during the COVID-19 pandemic.
Psychol Health 2022 Dec; 37(12):1547-64. doi: 10.1080/08870446.2022.2038790..
Keywords: COVID-19, Obesity, Stress, Social Stigma, Behavioral Health
Rosen A, Carter D, Applebaum JR
Critical care clinicians' experiences of patient safety during the COVID-19 pandemic.
The purpose of this mixed methods, multi-institutional study was to explore how the COVID-19 pandemic worsened preexisting issues of patient safety and created new challenges for patient safety within United States intensive care units (ICU.) The researchers conducted a national survey of critical care clinicians to assess their experiences related to patient safety during the pandemic. The survey instrument was distributed via email through the Society of Critical Care Medicine listserv, with results reported as percentages while free-text responses were analyzed and coded for themes. The study found that of the 355 survey responses received, 61% believed that conditions during the pandemic were more hazardous when compared with the period prior to the pandemic. When compared with providers who cared for mostly non-COVID-19 or no COVID-19 patients, the professionals who cared for primarily COVID-19 patients had an increased likelihood of perceiving that care was more hazardous. In the coded free-text responses, providers identified themes in patient safety risks including ventilator-related lung injury, medication and diagnostic errors, oversedation, oxygen device removal, and falls. The study concluded that higher levels of COVID-19 case burden were significantly related with perceptions of a less safe patient care environment by frontline ICU clinicians, and further identified specific hazards in intensive care units.
AHRQ-funded; HS026121.
Citation: Rosen A, Carter D, Applebaum JR .
Critical care clinicians' experiences of patient safety during the COVID-19 pandemic.
J Patient Saf 2022 Dec 1;18(8):e1219-e25. doi: 10.1097/pts.0000000000001060..
Keywords: COVID-19, Patient Safety, Critical Care, Intensive Care Unit (ICU)
Bergman ZR, Tignanelli CJ, Gould R
Factors associated with mortality in patients with COVID-19 receiving prolonged ventilatory support.
This study examined outcomes for COVID-19 patients who required mechanical ventilation from March 2020 through December 2021 across a system of 11 hospitals. A cohort of 600 patients were included, with in-hospital mortality of 40.3%. Increased age, prolonged ventilation, receiving corticosteroids, and being non-English speaking were associated with mortality. Intubations lasting longer than 21 days had a lower in-hospital mortality of 25.7%.
AHRQ-funded; HS026379.
Citation: Bergman ZR, Tignanelli CJ, Gould R .
Factors associated with mortality in patients with COVID-19 receiving prolonged ventilatory support.
Surg Infect 2022 Dec;23(10):893-901. doi: 10.1089/sur.2022.195..
Keywords: COVID-19, Mortality, Respiratory Conditions
Crnich CJ
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
This paper provides an overview of nursing home (NH) infection and control, reviews the 2016 CMS changes to federal regulations, and proposes recommendations to sustain improvements. COVID-19 put further pressure on nursing homes who were already strained by rising numbers of infections from C. difficile and multidrug-resistant organisms. The author puts out a call for reimagining infection prevention and control using the Systems Engineering Initiative for Patient Safety framework. Additional recommendations are made to enhance NH infection prevention and control programs in the areas of people, tasks, tools, organization, built environment, and external environment.
AHRQ-funded; HS022465.
Citation: Crnich CJ .
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
J Am Med Dir Assoc 2022 Dec;23(12):1909-15. doi: 10.1016/j.jamda.2022.10.022..
Keywords: Elderly, COVID-19, Public Health, Infectious Diseases, Nursing Homes, Healthcare-Associated Infections (HAIs), Prevention
Levinson Z, Cantor J, Williams MV
The association of strained ICU capacity with hospital patient racial and ethnic composition and federal relief during the COVID-19 pandemic.
Investigators sought to identify the association between strained intensive care unit (ICU) capacity during the COVID-19 pandemic and hospital racial and ethnic patient composition, federal pandemic relief, and other hospital characteristics. They found that hospitals with large Black patient shares experienced greater strain during the pandemic. These hospitals received more federal relief; however, funding was not targeted overall toward hospitals with high ICU occupancy rates.
AHRQ-funded; HS024067.
Citation: Levinson Z, Cantor J, Williams MV .
The association of strained ICU capacity with hospital patient racial and ethnic composition and federal relief during the COVID-19 pandemic.
Health Serv Res 2022 Dec;57(Suppl 2):279-90. doi: 10.1111/1475-6773.14028..
Keywords: COVID-19, Intensive Care Unit (ICU), Critical Care, Racial and Ethnic Minorities, Hospitals
Krauss DM, Molefe A, Hung L
AHRQ Author: Henderson S, Miller M
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
Holtrop JS, Davis MM
Primary care research is hard to do during COVID-19: challenges and solutions.
This study examined challenges in conducting primary care research during the COVID-19 pandemic. The authors used their experience on over 15 individual projects during the pandemic. They identified 3 key challenges to conducting primary care research: (1) practice delivery trickle-down effects, (2) limited/changing resources and procedures for research, and (3) a generally tense milieu in US society during the pandemic. They presented strategies, informed by a set of questions, to help researchers decide how to address these challenges observed during our studies. They encouraged normalization and self-compassion; and encouraged researchers and funders to embrace pragmatic and adaptive research designs as the circumstances with COVID-19 evolve over time.
AHRQ-funded; HS027080.
Citation: Holtrop JS, Davis MM .
Primary care research is hard to do during COVID-19: challenges and solutions.
Ann Fam Med 2022 Nov-Dec; 20(6):568-72. doi: 10.1370/afm.2889..
Keywords: COVID-19, Primary Care, Health Services Research (HSR), Research Methodologies
Wu W, Bhatraju PK, Cobb N
Radiographic findings and association with clinical severity and outcomes in critically ill patients with COVID-19.
Investigators sought to describe evolution and severity of radiographic findings and to assess association with disease severity and outcomes in critically ill COVID-19 patients. They found that evolution of radiographic features indicates rapid disease progression and correlates with requirement for invasive MV or vasopressors but not mortality, which suggests potential non-pulmonary pathways to death in COVID-19.
AHRQ-funded; HS026369.
Citation: Wu W, Bhatraju PK, Cobb N .
Radiographic findings and association with clinical severity and outcomes in critically ill patients with COVID-19.
Curr Probl Diagn Radiol 2022 Nov-Dec;51(6):884-91. doi: 10.1067/j.cpradiol.2022.04.002..
Keywords: COVID-19, Critical Care, Outcomes
Shover CL, Rosen A, Mata J
Engaging same-day peer ambassadors to increase coronavirus disease 2019 vaccination among people experiencing unsheltered homelessness in Los Angeles County: a hybrid feasibility-evaluation study.
This study’s goal was to evaluate the feasibility and acceptability of engaging unhoused peer ambassadors (PAs) in COVID-19 vaccination efforts to reach people experiencing unsheltered homelessness in Los Angeles County. A total of 117 PAs were enrolled at 103 events, participating for an average of 2 hours. Findings showed that 197 additional people were vaccinated over 167 PA hours, accounting for >25% of all vaccines given at these events, indicating that recruiting same-day unhoused PAs is a feasible, acceptable, and preliminarily effective technique to increase COVID-19 vaccination in unsheltered settings.
AHRQ-funded; HS026407.
Citation: Shover CL, Rosen A, Mata J .
Engaging same-day peer ambassadors to increase coronavirus disease 2019 vaccination among people experiencing unsheltered homelessness in Los Angeles County: a hybrid feasibility-evaluation study.
J Infect Dis 2022 Oct 7;226(suppl 3):S346-s52. doi: 10.1093/infdis/jiac291..
Keywords: COVID-19, Vaccination, Vulnerable Populations, Public Health
Qin CX, Auerbach SR, Charnaya O
Antibody response to three SARS-CoV-2 mRNA vaccines in adolescent solid organ transplant recipients.
The purpose of this observational cohort study was to assess whether a third SARS-CoV-2 vaccine would improve immunogenicity in adolescent solid organ transplant recipients (SOTRs), and to report the antibody response and safety of a third mRNA vaccine dose (D3) in adolescent SOTRs. Forty-two participants received three BNT162b2 doses and one received three mRNA-1273 doses. Participants were 6-13 years from transplant (median 10 [IQR]), and heart transplant was the most common procedure, in 41.9% of the participants. 9.3% of participants reported pre-D1 SARS-CoV-2 infections and 9.3% reported breakthrough infections. The study found that 88.4% of adolescent SOTRs had positive antibody responses 1 month post-D3, an increase from 63–73% post-D2. 54.5% of participants with prior negative responses seroconverted and 100% with positive responses increased or remained at maximum titer. Titers remained stable 3 months post-D3. There were no vaccine-related adverse events and four breakthrough infections. The researchers concluded that although this was a convenience sample, the results suggest there is an antibody response benefit to a third SARS-CoV-2 vaccine in adolescent SOTRs.
AHRQ-funded; HS026510.
Citation: Qin CX, Auerbach SR, Charnaya O .
Antibody response to three SARS-CoV-2 mRNA vaccines in adolescent solid organ transplant recipients.
Am J Transplant 2022 Oct;22(10):2481-83. doi: 10.1111/ajt.17085..
Keywords: Children/Adolescents, COVID-19, Vaccination, Transplantation
Lobach DF, Boxwala A, Kashyap N
AHRQ Author: Lomotan EA, Harrison MI, Dymek C, Swiger J
Integrating a patient engagement app into an electronic health record-enabled workflow using interoperability standards.
The authors sought to use interoperability standards to integrate the COVID-19 Tracker, a patient mobile application, with an EHR. Their clinical decision support integration project benefited from a standards-based approach, but they encountered challenges due to issues concerning implementation and experience of the standards-based application programming interface, Health Level 7 Fast Healthcare Interoperability Resources (FHIR) in the EHR. The authors concluded that FHIR standards may provide a promising mechanism for overcoming barriers in the integration of patient engagement apps with EHRs, but that expansion of available FHIR resources will improve workflow integration.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation: Lobach DF, Boxwala A, Kashyap N .
Integrating a patient engagement app into an electronic health record-enabled workflow using interoperability standards.
Appl Clin Inform 2022 Oct;13(5):1163-71. doi: 10.1055/s-0042-1758736..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Workflow, COVID-19
Richmond J, Sanderson M, Shrubsole MJ
Psychosocial impact of COVID-19 among adults in the southeastern United States.
The authors investigated factors associated with depressive and anxiety symptoms during the COVID-19 pandemic. Using data from the Southern Community Cohort Study (SCCS), their results overall suggested that individuals in fair/poor health, living alone, and/or experiencing decreased physical activity and vegetable/fruit consumption have higher risk of depressive and anxiety symptoms. They recommended clinical and public health interventions to support individuals experiencing depression and anxiety during the COVID-19 pandemic.
AHRQ-funded; HS026122.
Citation: Richmond J, Sanderson M, Shrubsole MJ .
Psychosocial impact of COVID-19 among adults in the southeastern United States.
Prev Med 2022 Oct;163:107191. doi: 10.1016/j.ypmed.2022.107191..
Keywords: COVID-19, Anxiety, Depression, Behavioral Health, Public Health
Redwood R, Schulz LT, Pop-Vicas A
A perfect storm: COVID-19 and antimicrobial resistance.
The purpose of this article was to discuss key factors that contributed to the impact of the COVID-19 pandemic on antimicrobial resistance (AMR) with an emphasis on lessons learned and next steps. The authors report that the pandemic strained healthcare systems worldwide and disrupted standard infection control and antimicrobial stewardship practices, which are essential to limit the spread of multidrug-resistant organisms and decrease selective pressure related to inappropriate or unnecessary antimicrobial therapy. Disruptions to these practices are compounded by the disproportionately long hospital and intensive care unit stays observed in critically ill COVID-19 patients, leading to secondary bacterial infections that are notoriously difficult to treat and increase the use of broad-spectrum antibiotics, which can drive resistance. The article further states that the pandemic has led to shortages in personal protective equipment, increased workload, and staffing issues, all of which have disrupted routine antimicrobial stewardship activities. The article concludes that COVID-19 pandemic has highlighted the need to develop new therapeutic interventions for infectious diseases that do not rely solely on antibiotics, and stresses the importance of incorporating the lessons learned from the COVID-19 pandemic into future efforts to combat AMR.
AHRQ-funded; HS028669.
Citation: Redwood R, Schulz LT, Pop-Vicas A .
A perfect storm: COVID-19 and antimicrobial resistance.
EMJ, Microbiol Infect Dis 2022 Sep; 2022. doi: 10.33590/emjmicrobiolinfectdis/22-00082..
Keywords: COVID-19, Antimicrobial Stewardship, Antibiotics, Medication
Griffith KN, Asfaw DA, Childers RG
Changes in US veterans' access to specialty care during the COVID-19 pandemic.
This research letter examined changes in US veterans’ access to specialty care during the COVID-19 pandemic through October 2021. The Veterans Health Administration (VHA) completed 14,516,937 internal referrals and purchased an additional 9,904,132 referrals to community-based specialists during the study period. Before the pandemic VHA specialists completed a mean 452,148 referrals each month. Volume dropped starting in March 2020 and did not fully until recover until March 2021. Peak decline was in April 2020 by 70.7% to 132,481 referrals. Community care referrals declined by 32.9% in June 2020, but rebounded thereafter and exceeded the prepandemic baseline by March 2021. Waits for VHA specialists began rising in June 2020, peaked in July 2020 and returned to prepandemic levels by spring 2021. Mean waits for community specialists peaked in June 2020 and returned to prepandemic baseline levels by August 2020.
AHRQ-funded; HS026395.
Citation: Griffith KN, Asfaw DA, Childers RG .
Changes in US veterans' access to specialty care during the COVID-19 pandemic.
JAMA Netw Open 2022 Sep;5(9):e2232515. doi: 10.1001/jamanetworkopen.2022.32515..
Keywords: COVID-19, Access to Care
Shankar LG, Habich M, Rosenman M
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Investigators described pediatric mental health emergency department (ED) visit rates and visit characteristics before and during the COVID-19 pandemic. They found that mental health ED visit rates by children increased during the COVID-19 pandemic.
AHRQ-funded; HS026385.
Citation: Shankar LG, Habich M, Rosenman M .
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Acad Pediatr 2022 Sep-Oct;22(7):1127-32. doi: 10.1016/j.acap.2022.05.022..
Keywords: COVID-19, Children/Adolescents, Emergency Department, Behavioral Health, Healthcare Utilization, Public Health
Beetham T, Fiellin DA, Busch SH
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
This study surveyed physicians who provide opioid use disorder (OUD) treatment on their preferences and practices regarding telehealth that have evolved during the COVID-19 pandemic. A total of 1141 physicians who were publicly listed buprenorphine-prescribing physicians were surveyed. Most respondents found telehealth to be effective, with 54% who found it more effective than expected. Overall, 85% were in favor of temporary telehealth flexibility being permanently extended, and 77% would be likely to use telehealth after the COVID-19 pandemic is over.
AHRQ-funded; HS017589.
Citation: Beetham T, Fiellin DA, Busch SH .
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
Am J Manag Care 2022 Sep;28(9):456-63. doi: 10.37765/ajmc.2022.89221..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Opioids, Substance Abuse, Behavioral Health, Medication
Dikranian L, Barry S, Ata A
Sars-CoV-2 with concurrent respiratory viral infection as a risk factor for a higher level of care in hospitalized pediatric patients.
This study’s objective was to evaluate if the presence of concurrent respiratory viral infections in pediatric patients admitted to the hospital with SARS-CoV-2 was associated with an increased rate of ICU level of care. Data from 67 participating hospitals was provided through The Society of Critical Care Medicine Discovery Network Viral Infection and Respiratory Illness Universal Study database. A total of 922 patients were included, with 391 requiring ICU level care and 31 having concurrent non-SARS-CoV-2 viral coinfection. After accounting for age, positive blood culture, positive sputum culture, preexisting chronic medical conditions, the presence of a viral respiratory coinfection was associated with increased need for ICU care.
AHRQ-funded; HS026485.
Citation: Dikranian L, Barry S, Ata A .
Sars-CoV-2 with concurrent respiratory viral infection as a risk factor for a higher level of care in hospitalized pediatric patients.
Pediatr Emerg Care 2022 Sep;38(9):472-76. doi: 10.1097/pec.0000000000002814..
Keywords: COVID-19, Children/Adolescents, Respiratory Conditions, Risk
Adams C, Chamberlain A, Wang Y
The role of staff in transmission of SARS-CoV-2 in long-term care facilities.
The purpose of this study was to assess the role of long-term care facility (LTCF) staff in transmission of the SARS-CoV-2 virus. From March 2020 to September the researchers evaluated residents and staff of 60 LTCFs in Georgia. The study found that after vaccines were first distributed to LTCFs in December 202, case counts, outbreak size and duration, and time-varying reproduction number [R(t)] declined rapidly. Staff cases were six times more infectious than resident cases, and unvaccinated resident cases were more infectious than vaccinated resident cases. The researchers concluded that staff were the primary drivers of COVID-19 transmission in LTCFs and vaccines slowed the transmission of the virus and contributed to a reduction in cases in LTCFs.
AHRQ-funded; HS025987.
Citation: Adams C, Chamberlain A, Wang Y .
The role of staff in transmission of SARS-CoV-2 in long-term care facilities.
Epidemiology 2022 Sep 1;33(5):669-77. doi: 10.1097/ede.0000000000001510..
Keywords: COVID-19, Respiratory Conditions, Long-Term Care, Public Health
Jin DP, Samuel S, Bowden K
Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge.
The purpose of this study was to examine the use of training in ICU-specific electronic health record (EHR) workflows prior to redeployment of certified registered nurse anesthetists (CRNAs) as ICU clinicians during the COVID-19 surge. The researchers utilized clinical informatics (CI) fellows to lead a multidisciplinary team to deploy a customized HER curriculum consisting of in-person classes and online video modules. Eighteen CRNAs participated, with 15 completing surveys immediately after the in-person training session, and 12 participants completing a post-deployment survey. The study found that all respondents of the post-training survey thought the training was useful and improved their EHR skills. Of the 12 participants who completed the post-deployment survey, all said that the training both increased their comfort in the ICU and that the concepts learned would be useful in their anesthesia role, and 91% indicated the training prepared them to work in the ICU with minimal guidance. The researchers concluded that CI fellows are uniquely prepared to deliver EHR training for clinician deployment in operational crisis response.
AHRQ-funded; HS02373.
Citation: Jin DP, Samuel S, Bowden K .
Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge.
Appl Clin Inform 2022 Aug 29;13(5):949-55. doi: 10.1055/a-1933-1798..
Keywords: COVID-19, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health, Training, Workforce