National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (10)
- Ambulatory Care and Surgery (3)
- Antibiotics (7)
- Antimicrobial Stewardship (4)
- Blood Clots (1)
- Burnout (1)
- Cancer (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (5)
- Central Line-Associated Bloodstream Infections (CLABSI) (7)
- Children/Adolescents (6)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (5)
- Communication (1)
- Community-Acquired Infections (2)
- Critical Care (1)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Electronic Health Records (EHRs) (2)
- Emergency Department (1)
- Evidence-Based Practice (3)
- Guidelines (2)
- (-) Healthcare-Associated Infections (HAIs) (54)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (4)
- Health Insurance (1)
- Home Healthcare (2)
- Hospital Discharge (2)
- Hospitalization (4)
- Hospitals (13)
- Implementation (1)
- Infectious Diseases (22)
- Influenza (1)
- Injuries and Wounds (5)
- Inpatient Care (2)
- Kidney Disease and Health (1)
- Long-Term Care (3)
- Medicare (1)
- Medication (7)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (7)
- Newborns/Infants (1)
- Nursing (2)
- Nursing Homes (3)
- Orthopedics (1)
- Outcomes (1)
- Patient Safety (31)
- Payment (2)
- Pneumonia (1)
- Policy (1)
- Practice Patterns (2)
- Prevention (10)
- Primary Care (1)
- Provider (3)
- Provider: Nurse (3)
- Provider: Physician (1)
- Provider Performance (3)
- Public Health (4)
- Public Reporting (1)
- Quality Improvement (4)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (4)
- Respiratory Conditions (3)
- Risk (8)
- Shared Decision Making (1)
- Skin Conditions (1)
- Social Determinants of Health (1)
- Surgery (8)
- Teams (1)
- Urinary Tract Infection (UTI) (5)
- Workflow (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 25 of 54 Research Studies DisplayedFlores EJ, Jue JJ, Giradi G
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
In this pilot study, findings from the 2016 AHRQ EPC report on Clostridioides difficile infection were translated into a treatment pathway and disseminated via a cloud-based platform and electronic health record (EHR). Results indicated that pathways can be an approach for disseminating AHRQ EPC report findings within health care systems, with reports including guideline and pathway syntheses. Embedding hyperlinks to pathway content within the EHR may be a viable and low-effort solution for promoting awareness of evidence-based resources.
AHRQ-funded.
Citation: Flores EJ, Jue JJ, Giradi G .
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
Jt Comm J Qual Patient Saf 2019 Dec;45(12):822-28. doi: 10.1016/j.jcjq.2019.10.002..
Keywords: Implementation, Evidence-Based Practice, Infectious Diseases, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Patel SA, Araujo T, Rodriguez LP
Long peripheral catheters: a retrospective review of major complications.
The risk of infectious and noninfectious complications associated with long peripheral catheters (LPCs) is unknown. In this retrospective study of 539 catheters, the investigators did a retrospective review of major complications. Among other discoveries, they found LPCs were often placed for the indications of difficult access and long-term antibiotics.
AHRQ-funded; HS025891.
Citation: Patel SA, Araujo T, Rodriguez LP .
Long peripheral catheters: a retrospective review of major complications.
J Hosp Med 2019 Dec;14(12):758-60. doi: 10.12788/jhm.3313..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Blood Clots, Infectious Diseases, Risk
Krein SL, Kuhn L, Ratz D
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
The authors identified the prevalence of and factors associated with having a designated nurse peripherally inserted central catheter (PICC) team among U.S. acute care hospitals. They found that nurse PICC teams inserted PICCs in more than 60% of U.S. hospitals during the study period. Moreover, certain practices to prevent central line-associated bloodstream infection, including maximum sterile barrier precautions, chlorhexidine gluconate for insertion site antisepsis, and facility-wide insertion checklists were regularly used by a higher percentage of hospitals with nurse PICC teams compared with those without. They concluded that nurse PICC teams play an integral role in PICC use at many hospitals and that use of such teams may promote key practices to prevent complications.
AHRQ-funded; HS022835.
Citation: Krein SL, Kuhn L, Ratz D .
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
J Patient Saf 2019 Dec;15(4):293-95. doi: 10.1097/pts.0000000000000246..
Keywords: Nursing, Teams, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Inpatient Care, Hospitals, Patient Safety, Prevention, Provider: Nurse, Provider
Chiotos K, Rock C, Schweizer ML
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
This survey compares results with a similar 2013 survey that characterizes contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities. There was decreased frequency of active surveillance for MRSA, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
AHRQ-funded; HS026393.
Citation: Chiotos K, Rock C, Schweizer ML .
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
Infect Control Hosp Epidemiol 2019 Sep;40(9):1046-49. doi: 10.1017/ice.2019.172.
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Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Practice Patterns
Yang H, Tourani R, Zhu Y
Strategies for building robust prediction models using data unavailable at prediction time.
Risk prediction models based on pre- and intraoperative data have been proposed to assess the risk of HAIs at the end of the surgery, but the performance of these models lag behind HAI detection models based on postoperative data. Postoperative data are more predictive than pre- or interoperative data but it is unavailable when the risk models are applied (end of surgery). The objective of this study was to examine whether such data can be used to improve the performance of the risk model.
AHRQ-funded; HS024532.
Citation: Yang H, Tourani R, Zhu Y .
Strategies for building robust prediction models using data unavailable at prediction time.
J Am Med Inform Assoc 2021 Dec 28;29(1):72-79. doi: 10.1093/jamia/ocab229..
Keywords: Healthcare-Associated Infections (HAIs), Risk, Health Information Technology (HIT)
McKinnell JA, Singh RD, Miller LG
The SHIELD Orange County project: multidrug-resistant organism prevalence in 21 nursing homes and long-term acute care facilities in Southern California.
The authors reported baseline multidrug-resistant organism (MDRO) prevalence in 21 nursing homes (NHs) and long-term acute care facilities (LTACs). They found that prevalence of MDROs was 65% in NHs and 80% in LTACs. They concluded that the majority of NH residents and LTAC patients harbor MDROs, and that MDRO status is frequently unknown to the facility. The high MDRO prevalence highlights the need for prevention efforts in NHs/LTACs as part of regional efforts to control MDRO spread.
AHRQ-funded; HS023317.
Citation: McKinnell JA, Singh RD, Miller LG .
The SHIELD Orange County project: multidrug-resistant organism prevalence in 21 nursing homes and long-term acute care facilities in Southern California.
Clin Infect Dis 2019 Oct 15;69(9):1566-73. doi: 10.1093/cid/ciz119.
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Keywords: Nursing Homes, Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Patient Safety
Sheetz KH, Dimick JB, Englesbe MJ
Hospital-acquired condition reduction program is not associated with additional patient safety improvement.
In 2013 the Centers for Medicare and Medicaid Services announced that it would begin levying penalties against hospitals with the highest rates of hospital-acquired conditions through the Hospital-Acquired Condition Reduction Program. This study evaluates whether the program has been successful in improving patient safety or not. The investigators concluded that the program did not improve patient safety in Michigan beyond existing trends.
AHRQ-funded; HS000053; HS026244.
Citation: Sheetz KH, Dimick JB, Englesbe MJ .
Hospital-acquired condition reduction program is not associated with additional patient safety improvement.
Health Aff 2019 Nov;38(11):1858-65. doi: 10.1377/hlthaff.2018.05504..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Provider Performance, Quality Improvement, Quality of Care, Infectious Diseases, Payment
Hsu HE, Wang R, Jentzsch MS
The impact of measurement changes on evaluating hospital performance: the case of catheter-associated urinary tract infections.
Researchers observed that catheter-associated urinary tract infections in 592 hospitals immediately declined after federal value-based incentive program implementation, but found that this was fully attributable to a concurrent surveillance case definition revision. They found that post revision, more hospitals had favorable standardized infection ratios, likely leading to artificial inflation of their performance scores unrelated to changes in patient safety.
AHRQ-funded; HS000063; HS025008; HS018414.
Citation: Hsu HE, Wang R, Jentzsch MS .
The impact of measurement changes on evaluating hospital performance: the case of catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2019 Nov;40(11):1269-71. doi: 10.1017/ice.2019.240..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Provider Performance, Quality Measures, Urinary Tract Infection (UTI)
Caroff DA, Chan C, Kleinman K
Association of open approach vs laparoscopic approach with risk of surgical site infection after colon surgery.
The authors assessed whether laparoscopic colon surgery is associated with a lower surgical site infection rate than open-approach laparoscopy. They found that policy changes that promote surgical education and resources for laparoscopy, especially at low-adoption hospitals, may be associated with reduced colon surgical site infection rates. They recommend support of the development of innovative educational policies to help achieve improvement in patient outcomes and decreased health care use in colon surgery.
AHRQ-funded; HS021424.
Citation: Caroff DA, Chan C, Kleinman K .
Association of open approach vs laparoscopic approach with risk of surgical site infection after colon surgery.
JAMA Netw Open 2019 Oct 2;2(10):e1913570. doi: 10.1001/jamanetworkopen.2019.13570..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Patient Safety, Risk
Qi AC, Peacock K, Luke AA
Associations between social risk factors and surgical site infections after colectomy and abdominal hysterectomy.
The purpose of this study was to determine whether social risk factors, including race/ethnicity, insurance status, and neighborhood income, were associated with higher rates of surgical site infections (SSI) after colectomy or abdominal hysterectomy, 2 surgical procedures for which SSI rates are publicly reported and included in pay-for-performance programs by Medicare and other groups. The investigators report that inconsistent associations between social risk factors and SSIs were found.
AHRQ-funded; HS019455.
Citation: Qi AC, Peacock K, Luke AA .
Associations between social risk factors and surgical site infections after colectomy and abdominal hysterectomy.
JAMA Netw Open 2019 Oct 2;2(10):e1912339. doi: 10.1001/jamanetworkopen.2019.12339..
Keywords: Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Social Determinants of Health
D'Agata EMC, Geffert SF, McTavish R
Acquisition of antimicrobial-resistant bacteria in the absence of antimicrobial exposure: a systematic review and meta-analysis.
This systematic literature review and meta-analysis examined the proportion of patients who acquire antimicrobial-resistant bacteria (ARB) without antimicrobial exposure. The authors conducted a search of Medline, Embase, and the Cochrane library for publications between 2000 and July 2017. They found a total of 4,233 citations and of those 147 underwent full-text review. Ten studies met inclusion criteria with 7 considered to be at low risk of bias and 6 were conducted in the ICU setting. The overall summary estimate of patients who acquired ARB without exposure to antimicrobials ranged from 0% to 57.1%.
AHRQ-funded; HS021666.
Citation: D'Agata EMC, Geffert SF, McTavish R .
Acquisition of antimicrobial-resistant bacteria in the absence of antimicrobial exposure: a systematic review and meta-analysis.
Infect Control Hosp Epidemiol 2019 Oct;40(10):1128-34. doi: 10.1017/ice.2019.208..
Keywords: Infectious Diseases, Healthcare-Associated Infections (HAIs)
Ji W, McKenna C, Ochoa A
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
The authors sought to propose and assess potentially objective, efficient, and reproducible surveillance definitions for non-ventilator hospital-acquired pneumonia (NV-HAP) using routine clinical data stored in electronic health record systems. They found that objective surveillance for NV-HAP using electronically computable definitions that incorporate common clinical criteria is feasible and generates incidence, mortality, and adjusted odds ratios for hospital mortality similar to estimates from manual surveillance. They concluded that these definitions have the potential to facilitate widespread, automated surveillance for NV-HAP and thus inform the development and evaluation of prevention programs.
AHRQ-funded; HS025008.
Citation: Ji W, McKenna C, Ochoa A .
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
JAMA Netw Open 2019 Oct 2;2(10):e1913674. doi: 10.1001/jamanetworkopen.2019.13674..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Respiratory Conditions, Public Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
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.
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), Shared 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