National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Cardiovascular Conditions (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Healthcare-Associated Infections (HAIs) (2)
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- (-) Hospitals (10)
- Inpatient Care (3)
- (-) Nursing (10)
- Patient-Centered Healthcare (1)
- Patient Experience (1)
- Patient Safety (4)
- Prevention (1)
- Provider (2)
- Provider: Nurse (4)
- Quality Improvement (1)
- Quality Measures (1)
- Sepsis (1)
- Shared Decision Making (1)
- Surgery (1)
- Teams (1)
- Urinary Tract Infection (UTI) (1)
- 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 10 of 10 Research Studies DisplayedHansen CJ, Rayo MF, Patterson ES
Perceptually discriminating the highest priority alarms reduces response time: a retrospective pre-post study at four hospitals.
Emergency alarms are the most urgent of hospital alarms, necessitating immediate attention and action to address a dangerous situation. These alarms are triggered by clinicians and have greater positive predictive value (PPV). High-priority alarms are different from emergency alarms, are automatically triggered, and have lower PPV. The purpose of this retrospective pre-post study was to decrease nurse response time for emergency alarms and high-priority alarms by improving the discernability between emergency alarms and all other alarms, as well as by suppressing redundant and false alarms in a secondary alarm notification system (SANS). The researchers analyzed data 15 months prior to and 25 months after a SANS redesign was implemented in four hospitals. For emergency alarms, the researchers integrated digitized human speech features to distinguish the emergency alarms from the automatically triggered alarms, leaving their onset and escalation pathways unaltered. The researchers suppressed some of the automatically triggered alarms by delaying their initial onset and escalation by 20 seconds. The study found that response time for emergency alarms decreased at all hospitals ad the improvements were sustained. The use of automatically triggered alarms decreased 25.0%. Response time for the three automatically triggered cardiac alarms increased at the four hospitals.
AHRQ-funded; HS024379.
Citation: Hansen CJ, Rayo MF, Patterson ES .
Perceptually discriminating the highest priority alarms reduces response time: a retrospective pre-post study at four hospitals.
Hum Factors 2023 Jun; 65(4):636-50. doi: 10.1177/00187208211032870..
Keywords: Hospitals, Nursing
Lasater KB, Sloane DM, McHugh MD
Evaluation of hospital nurse-to-patient staffing ratios and sepsis bundles on patient outcomes.
Despite nurses' responsibilities in recognition and treatment of sepsis, little evidence documents whether patient-to-nurse staffing ratios are associated with clinical outcomes for patients with sepsis. Using linked data sources from 2017 including MEDPAR patient claims, Hospital Compare, American Hospital Association, and a large survey of nurses, the investigators estimated the effect of hospital patient-to-nurse staffing ratios and adherence to the Early Management Bundle for patients with Severe Sepsis/Septic Shock SEP-1 sepsis bundles on patients' odds of in-hospital and 60-day mortality, readmission, and length of stay.
AHRQ-funded; HS026232.
Citation: Lasater KB, Sloane DM, McHugh MD .
Evaluation of hospital nurse-to-patient staffing ratios and sepsis bundles on patient outcomes.
Am J Infect Control 2021 Jul;49(7):868-73. doi: 10.1016/j.ajic.2020.12.002..
Keywords: Sepsis, Nursing, Provider: Nurse, Inpatient Care, Hospitals
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
Manojlovich M, Frankel RM, Harrod M
Formative evaluation of the video reflexive ethnography method, as applied to the physician-nurse dyad.
Poor communication between physicians and nurses continues to contributor to adverse events in the hospital setting. This article evaluates the use of video reflexive ethnography (VRE) as a means of improving communication and improving patient safety, and concludes that video-record communication between physicians and nurses during patient care rounds is feasible and acceptable.
AHRQ-funded; HS024760.
Citation: Manojlovich M, Frankel RM, Harrod M .
Formative evaluation of the video reflexive ethnography method, as applied to the physician-nurse dyad.
BMJ Qual Saf 2019 Feb;28(2):160-66. doi: 10.1136/bmjqs-2017-007728..
Keywords: Adverse Events, Communication, Hospitals, Nursing, Patient Safety
Al Danaf J, Chang BH, Shaear M
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
This paper reported on rounding interventions employed at high performing hospitals, and provided three case studies on how proactive nurse rounding was successfully implemented to improve patient-centredness. The investigators concluded that proactive rounding interventions are a feasible approach to help surface and address hospitalized patients' needs in a timely manner.
AHRQ-funded; HS021921.
Citation: Al Danaf J, Chang BH, Shaear M .
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
J Nurs Manag 2018 Jul;26(5):540-47. doi: 10.1111/jonm.12580..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitalization, Hospitals, Inpatient Care, Nursing, Patient-Centered Healthcare, Patient Experience, Quality Improvement
Bayramzadeh S, Joseph A, San D
The impact of operating room layout on circulating nurse's work patterns and flow disruptions: a behavioral mapping study.
The purpose of this study was to assess how the adjacencies of functionally different areas within operating rooms (ORs) can influence the circulating nurse's (CN) workflow patterns and disruptions. The investigators video recorded and thematically coded a convenience sample of 25 surgeries for CN's activities, locations, and flow disruptions. The investigators suggest that optimum adjacencies should be considered while designing ORs such that they are more efficient and safer.
AHRQ-funded; HS024380.
Citation: Bayramzadeh S, Joseph A, San D .
The impact of operating room layout on circulating nurse's work patterns and flow disruptions: a behavioral mapping study.
HERD 2018 Jul;11(3):124-38. doi: 10.1177/1937586717751124..
Keywords: Surgery, Workflow, Hospitals, Nursing, Provider: Nurse, Provider, Patient Safety
Grundy Q
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
The author analyzed the ways that committee members constructed and evaluated a case for a product's value, concluding that purchasing committees need unique support that emphasizes local contexts and expertise, while maintaining rigor and minimizing bias. Grundy proposed a guiding framework to support this decision-making.
AHRQ-funded; HS022383.
Citation: Grundy Q .
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
Soc Sci Med 2016 Sep;165:82-91. doi: 10.1016/j.socscimed.2016.07.042.
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Keywords: Shared Decision Making, Healthcare Costs, Hospitals, Nursing
Connor JA, Larson C, Baird J
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
The authors aimed to identify and develop standardized measures representative of pediatric nursing care of the cardiovascular patient for benchmarking within freestanding children's hospitals. The Consortium of Congenital Cardiac Care-Measurement of Nursing Practice members developed quality measures within working groups and then individually critiqued all drafted measures. The process resulted in 10 measures eligible for testing. The Consortium will continue with implementation and testing of each measure, supporting the development of benchmarks and the evaluation of the association of the measures with patient outcomes.
AHRQ-funded; HS000063.
Citation: Connor JA, Larson C, Baird J .
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
J Pediatr Nurs 2016 Sep-Oct;31(5):471-7. doi: 10.1016/j.pedn.2016.04.010.
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Keywords: Children/Adolescents, Cardiovascular Conditions, Nursing, Quality Measures, Hospitals
Schondelmeyer AC, Brady PW, Landrigan CP
Alarm fatigue: clearing the air.
The authors discuss an article in the same issue of the Journal of Hospital Medicine by Paine and colleagues that sets out to review the small but growing body of literature addressing physiologic monitor alarms and interventions that have tried to address alarm fatigue. They conclude that the review demonstrates that the great majority of alarms do not help clinicians and likely contribute to alarm fatigue.
AHRQ-funded; HS023827.
Citation: Schondelmeyer AC, Brady PW, Landrigan CP .
Alarm fatigue: clearing the air.
J Hosp Med 2016 Feb;11(2):153-4. doi: 10.1002/jhm.2521.
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Keywords: Patient Safety, Nursing, Adverse Events, Hospitals
Jones K, Sibai J, Battjes R
How and when nurses collect urine cultures on catheterized patients: a survey of 5 hospitals.
Obtaining a specimen for urine culture is a key element in evaluating for catheter-associated urinary tract infections (CAUTIs). Nurses at 5 hospitals completed a survey regarding their knowledge, training, and practices of appropriate reasons for obtaining urine cultures. The researchers concluded that important opportunities exist for nurses to optimize the decisions to obtain urine cultures and the process for obtaining them.
AHRQ-funded; 290201000025I; 29032001T.
Citation: Jones K, Sibai J, Battjes R .
How and when nurses collect urine cultures on catheterized patients: a survey of 5 hospitals.
Am J Infect Control 2016 Feb;44(2):173-6. doi: 10.1016/j.ajic.2015.09.003.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Hospitals, Nursing, Provider: Nurse, Urinary Tract Infection (UTI)