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 7 of 7 Research Studies DisplayedCho HJ, Feldman LS, Keller S
Choosing Wisely in the COVID-19 era: preventing harm to healthcare workers.
This paper highlights the 5 top recommendations developed for hospitals in the COVID-19 era as part of the Choosing Wisely® campaign. This top 5 list of overuse practices in hospital medicine can lead to harm of both patients and healthcare workers. The recommendations include: 1) Do not obtain nonurgent labs in separate blood draws if they can be batched together; 2) Do not use bronchodilators unless there is active obstructive airway disease; 3) Do not use posteroanterior and lateral chest X-ray (CXR) as initial imaging, use a portable CXR instead; 4) Avoid in-person evaluations in favor of virtual communication unless necessary; and 5) Do not delay goals of care conversations for hospitalized patients who are unlikely to benefit from life-sustaining treatments.
AHRQ-funded; HS025782.
Citation: Cho HJ, Feldman LS, Keller S .
Choosing Wisely in the COVID-19 era: preventing harm to healthcare workers.
J Hosp Med 2020 Jun;15(6):360-62. doi: 10.12788/jhm.3457..
Keywords: COVID-19, Infectious Diseases, Hospitals, Prevention, Public Health, Provider: Health Personnel
Baloh J, Thom KA, Perencevich E
Hand hygiene before donning nonsterile gloves: healthcareworkers' beliefs and practices.
The purpose of this study was to examine the practices and beliefs of health care workers related to the use of nonsterile gloves and associated hand hygiene (HH) before gloving. Gloving and HH practices of health care workers at three large academic hospitals were observed as they entered patient rooms, and interviews were conducted with providers, nurses, and nursing assistants to elicit their beliefs and perceptions of these hygiene practices. While interviewed health care workers reported 100% HH compliance before gloving, observed HH compliance was only 42% and observed gloving before entering contact precaution rooms was 78%. Most health care workers described glove use more often than was necessary, and generally used gloves for their own safety, and sanitized their hands before gloving for patient safety. The authors conclude that HH and glove use are intertwined in clinical practice and should be considered jointly to improve infection prevention improvement efforts.
AHRQ-funded; HS024108.
Citation: Baloh J, Thom KA, Perencevich E .
Hand hygiene before donning nonsterile gloves: healthcareworkers' beliefs and practices.
Am J Infect Control 2019 May;47(5):492-97. doi: 10.1016/j.ajic.2018.11.015..
Keywords: Provider: Clinician, Provider, Provider: Health Personnel, Patient Safety, Prevention
Blanco N, Johnson JK, Sorkin JD
Transmission of resistant Gram-negative bacteria to healthcare personnel gowns and gloves during care of residents in community-based nursing facilities.
The purpose of this study was to estimate the risk of transmission of antibiotic-resistant Gram-negative bacteria (RGNB) to gowns and gloves worn by healthcare personnel when providing care to residents of community-based nursing facilities to identify the types of care and resident characteristics associated with transmission. The investigators found that RGNB transmission to either gloves or gowns occurred during 11% of the 584 interactions. Showering the resident, hygiene or toilet assistance, and wound dressing changes were associated with a high risk of transmission.
AHRQ-funded; HS019979.
Citation: Blanco N, Johnson JK, Sorkin JD .
Transmission of resistant Gram-negative bacteria to healthcare personnel gowns and gloves during care of residents in community-based nursing facilities.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1425-30. doi: 10.1017/ice.2018.247.
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Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Nursing Homes, Prevention, Provider, Provider: Health Personnel
Musuuza JS, Barker A, Ngam C
Assessment of fidelity in interventions to improve hand hygiene of healthcare workers: a systematic review.
The researchers examined fidelity reporting in interventions to improve hand hygiene compliance and assessed 5 measures of intervention fidelity. They found that participant responsiveness and adherence to the intervention were the most frequently unreported fidelity measures, while quality of the delivery was the most frequently reported measure. To facilitate replication and effective implementation, the authors recommended that reporting fidelity should be standard practice when describing results of complex behavioral interventions such as hand hygiene.
AHRQ-funded; HS024039.
Citation: Musuuza JS, Barker A, Ngam C .
Assessment of fidelity in interventions to improve hand hygiene of healthcare workers: a systematic review.
Infect Control Hosp Epidemiol 2016 May;37(5):567-75. doi: 10.1017/ice.2015.341.
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Keywords: Healthcare-Associated Infections (HAIs), Provider: Health Personnel, Patient Safety, Prevention
Heath B, Bernhardt J, Michalski TJ
Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.
The authors described a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. They found that the course addressed an important knowledge gap and recommended engaging nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting.
AHRQ-funded; HS023866.
Citation: Heath B, Bernhardt J, Michalski TJ .
Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.
Am J Infect Control 2016 Mar;44(3):349-51. doi: 10.1016/j.ajic.2015.09.026.
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Keywords: Antimicrobial Stewardship, Provider: Health Personnel, Prevention, Training
Szymczak JE
Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety.
The author examined how clinicians talk about speaking up or not in the face of breaches in infection prevention technique. Mutual focus of attention, interactional path dependence, and the presence of an audience are reasons found that influence the decision to speak up in a clinical setting. This decision is dynamic, highly context-dependent, embedded in the interaction rituals that suffuse everyday work, and constrained by organizational dynamics.
AHRQ-funded; HS020760.
Citation: Szymczak JE .
Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety.
Sociol Health Illn 2016 Feb;38(2):325-39. doi: 10.1111/1467-9566.12371.
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Keywords: Communication, Provider: Health Personnel, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Campbell LJ, Li Q, Li Y
Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
The authors identified nursing home (NH) characteristics that may be associated with employee influenza vaccination rates (EVRs). They concluded that, as NHs generally have low EVRs, it may be necessary to target low-performing facilities to achieve substantial improvements.
AHRQ-funded; HS000044.
Citation: Campbell LJ, Li Q, Li Y .
Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
J Am Med Dir Assoc 2014 Oct;15(10):768-72. doi: 10.1016/j.jamda.2014.06.005.
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Keywords: Provider: Health Personnel, Influenza, Nursing Homes, Prevention, Vaccination