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AHRQ Research Studies Date
Topics
- Adverse Events (4)
- Behavioral Health (1)
- Brain Injury (1)
- Care Management (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (2)
- Chronic Conditions (2)
- Communication (1)
- (-) Critical Care (17)
- Decision Making (1)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Costs (2)
- (-) Intensive Care Unit (ICU) (17)
- Medical Errors (1)
- Medication (2)
- Neurological Disorders (3)
- Newborns/Infants (1)
- Nursing (1)
- Organizational Change (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (5)
- Prevention (2)
- Provider Performance (1)
- Quality Improvement (1)
- Quality of Life (1)
- Respiratory Conditions (2)
- Teams (1)
- Training (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 17 of 17 Research Studies DisplayedBarbash IJ
Cognitive impairment, anesthesia, and critical illness: learning from the past to gain perspective on the future.
This study examined the link between cognitive impairment, ICU admission and anesthesia. The author’s hypothesis was that patients with cognitive impairment would be more likely to undergo surgical procedures. However, analysis using data from the Mayo Clinical Study on Aging on 1,977 cognitive normal patients, 387 patients with mild cognitive impairment (MCI), and 72 patients with established dementia found that patients with MCI were more likely to undergo anesthesia and those with dementia were less likely to undergo procedural anesthesia. The author hypothesizes this may be linked to impaired decision-making of the patient and the risk-benefit analysis of performing surgery on patients with established dementia. However, ICU admissions were increased in patients with MCI and dementia.
AHRQ-funded; HS025455.
Citation: Barbash IJ .
Cognitive impairment, anesthesia, and critical illness: learning from the past to gain perspective on the future.
Mayo Clin Proc 2018 Nov;93(11):1537-39. doi: 10.1016/j.mayocp.2018.09.007..
Keywords: Adverse Events, Critical Care, Medication, Intensive Care Unit (ICU), Neurological Disorders
Stolldorf DP, Dietrich MS, Chidume T
Nurse-initiated mobilization practices in 2 community intensive care units: a pilot study.
The purposes of this study were to describe nurse-led mobilization practices in 2 community hospital ICUs and to report differences and similarities between the 2 settings. The investigators found that differences in patient characteristics and nurse-led mobilization activities were observed between ICUs. After controlling for patient characteristics, they found statistically significant differences in nurse-led mobilization activities between the 2 units, suggesting that factors other than patient characteristics may explain differences in nurse-led mobilization practices.
AHRQ-funded; HS025486.
Citation: Stolldorf DP, Dietrich MS, Chidume T .
Nurse-initiated mobilization practices in 2 community intensive care units: a pilot study.
Dimens Crit Care Nurs 2018 Nov/Dec;37(6):318-23. doi: 10.1097/dcc.0000000000000320..
Keywords: Critical Care, Intensive Care Unit (ICU)
Bergl PA, Nanchal RS, Singh H
Diagnostic error in the critically ill: defining the problem and exploring next steps to advance intensive care unit safety.
Despite progress in ICU safety, diagnostic errors remain largely unexplored and under-studied in critical care. Compared to other safety problems, diagnostic errors are more difficult to identify and, due to the intricacies of the diagnostic process, are more difficult to unravel. This paper discusses diagnostic error in critically ill patients, defines the problem and explores next steps to advance ICU safety.
AHRQ-funded; HS022087.
Citation: Bergl PA, Nanchal RS, Singh H .
Diagnostic error in the critically ill: defining the problem and exploring next steps to advance intensive care unit safety.
Ann Am Thorac Soc 2018 Aug;15(8):903-07. doi: 10.1513/AnnalsATS.201801-068PS..
Keywords: Adverse Events, Critical Care, Diagnostic Safety and Quality, Intensive Care Unit (ICU), Medical Errors, Patient Safety
Sobotka SA, Peters S, Pinto NP
Neurodevelopmental disorders in the PICU population.
Attention deficit hyperactivity disorder (ADHD), affecting 11% of children and adolescents, increases risk for injury and may predispose children to illness. However, the prevalence of ADHD and other developmental disorders in the pediatric intensive care unit (PICU) has not been previously studied. In this study, the investigators performed a single-center, prospective cohort study of children aged 6 to 12 years who were hospitalized in the PICU from May through August 2016.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Peters S, Pinto NP .
Neurodevelopmental disorders in the PICU population.
Clin Pediatr 2018 Jul;57(8):913-19. doi: 10.1177/0009922817737080..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Behavioral Health
Boyle WA, Murray DJ, Beyatte MB
Simulation-based assessment of critical care "front-line" providers.
The researchers developed a standardized simulation method to assess clinical skills of ICU providers. Their simulation assessments yielded reasonably reliable measures of Critical Care Medicine decision-making skills. Despite a wide range of performance, those with more ICU training and experience performed better, providing evidence to support the validity of the scores.
AHRQ-funded; HS018734; HS022265.
Citation: Boyle WA, Murray DJ, Beyatte MB .
Simulation-based assessment of critical care "front-line" providers.
Crit Care Med 2018 Jun;46(6):e516-e22. doi: 10.1097/ccm.0000000000003073.
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Keywords: Critical Care, Decision Making, Intensive Care Unit (ICU), Provider Performance, Training
Mahmoud L, Zullo AR, Thompson BB
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Researchers conducted a retrospective cohort study of 1197 mechanically ventilated patients admitted to a 12-bed neurocritical care unit (NCCU) over four years in order to evaluate the effect of an analgesia-based sedation protocol on medication use and costs in the NCCU. The protocol resulted in increased in fentanyl use and decreased in propofol use, but their findings indicate no effect on healthcare utilization, healthcare costs, or in-hospital mortality. Based on these results, the researchers suggest that similar NCCUs should consider using population-specific protocols to manage analgesia and sedation.
AHRQ-funded; HS022998.
Citation: Mahmoud L, Zullo AR, Thompson BB .
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Brain Inj 2018;32(7):941-47. doi: 10.1080/02699052.2018.1469167..
Keywords: Care Management, Brain Injury, Critical Care, Healthcare Costs, Intensive Care Unit (ICU), Medication, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research
Costa DK, Valley TS, Miller MA
AHRQ Author: Miller MA
ICU team composition and its association with ABCDE implementation in a quality collaborative.
Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. This study found that ABCDE implementation was associated with frequent involvement of team members, suggesting a need for role articulation and coordination.
AHRQ-authored; AHRQ-funded; HS024552.
Citation: Costa DK, Valley TS, Miller MA .
ICU team composition and its association with ABCDE implementation in a quality collaborative.
J Crit Care 2018 Apr;44:1-6. doi: 10.1016/j.jcrc.2017.09.180.
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Keywords: Critical Care, Intensive Care Unit (ICU), Patient Safety, Quality Improvement, Teams
Wang S, Hammes J, Khan S
Improving Recovery and Outcomes Every Day after the ICU (IMPROVE): study protocol for a randomized controlled trial.
The Improving Recovery and Outcomes Every Day after the ICU (IMPROVE) trial is an ongoing clinical trial which evaluates the efficacy of a combined physical exercise and cognitive training on cognitive function among ICU survivors 50 years and older who experienced delirium during an ICU stay. This article describes the study protocol for IMPROVE.
AHRQ-funded; HS024384.
Citation: Wang S, Hammes J, Khan S .
Improving Recovery and Outcomes Every Day after the ICU (IMPROVE): study protocol for a randomized controlled trial.
Trials 2018 Mar 27;19(1):196. doi: 10.1186/s13063-018-2569-8.
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Keywords: Critical Care, Elderly, Intensive Care Unit (ICU), Neurological Disorders, Patient-Centered Outcomes Research
Khan S, Biju A, Wang S
Mobile critical care recovery program (m-CCRP) for acute respiratory failure survivors: study protocol for a randomized controlled trial.
The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. The researchers will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation to one of two arms - m-CCRP intervention versus attention control. Their primary aim is to assess the efficacy of m-CCRP in improving the quality of life of acute respiratory failure survivors at 12 months
AHRQ-funded; HS024384.
Citation: Khan S, Biju A, Wang S .
Mobile critical care recovery program (m-CCRP) for acute respiratory failure survivors: study protocol for a randomized controlled trial.
Trials 2018 Feb 7;19(1):94. doi: 10.1186/s13063-018-2449-2.
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Keywords: Critical Care, Intensive Care Unit (ICU), Quality of Life, Respiratory Conditions, Respiratory Conditions
Kojima T, Laverriere EK, Owen EB
Clinical impact of external laryngeal manipulation during laryngoscopy on tracheal intubation success in critically ill children.
In this retrospective observational study, the objective was to evaluate the association between external laryngeal manipulation use and initial tracheal intubation attempt success in pediatric ICUs. The investigators found that external laryngeal manipulation during direct laryngoscopy was associated with lower initial tracheal intubation attempt success in critically ill children, even after adjusting for underlying differences in patient factors and provider levels. They asserted that the indiscriminate use of external laryngeal manipulation cannot be recommended.
AHRQ-funded; HS024511.
Citation: Kojima T, Laverriere EK, Owen EB .
Clinical impact of external laryngeal manipulation during laryngoscopy on tracheal intubation success in critically ill children.
Pediatr Crit Care Med 2018 Feb;19(2):106-14. doi: 10.1097/pcc.0000000000001373..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Children/Adolescents, Respiratory Conditions
Rehder KJ, Giuliano JS, Jr., Napolitano N
Increased occurrence of tracheal intubation-associated events during nights and weekends in the PICU.
Little is known about how the incidence of tracheal intubation-associated events is affected by the time of day, day of the week, or presence of in-hospital attending-level intensivists. After analyzing 5,096 tracheal intubation courses from the prospective multicenter National Emergency Airway Registry for Children, the researchers found that a higher occurrence of tracheal intubation-associated events was observed during nights and weekends, due primarily to emergent intubations.
AHRQ-funded; HS022464; HS021583.
Citation: Rehder KJ, Giuliano JS, Jr., Napolitano N .
Increased occurrence of tracheal intubation-associated events during nights and weekends in the PICU.
Crit Care Med 2015 Dec;43(12):2668-74. doi: 10.1097/ccm.0000000000001313.
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Keywords: Newborns/Infants, Intensive Care Unit (ICU), Adverse Events, Patient Safety, Critical Care
Kerlin MP, Cooke CR
Understanding costs when seeking value in critical care.
The authors discuss a study by Gershengorn and colleagues about daily ICU costs in five ICUs within a single medical center. They argue that although the authors should be commended on advancing the understanding of ICU costs, we should also recognize that efforts to reduce ICU length of stay will necessarily be insufficient to make a real dent in our health care economy.
AHRQ-funded; HS020672.
Citation: Kerlin MP, Cooke CR .
Understanding costs when seeking value in critical care.
Ann Am Thorac Soc 2015 Dec;12(12):1743-4. doi: 10.1513/AnnalsATS.201510-660ED.
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Keywords: Critical Care, Healthcare Costs, Intensive Care Unit (ICU)
Croft LD, Harris AD, Pineles L
The effect of universal glove and gown use on adverse events in intensive care unit patients.
The researchers assessed if wearing gloves and gowns during all patient contact in the intensive care unit (ICU) changes adverse event rates. They found that in ICUs where healthcare workers donned gloves and gowns for all patient contact, patients were no more likely to experience adverse events than in control ICUs. Concerns of adverse events resulting from universal glove and gown use were not supported.
AHRQ-funded; 29020060001.
Citation: Croft LD, Harris AD, Pineles L .
The effect of universal glove and gown use on adverse events in intensive care unit patients.
Clin Infect Dis 2015 Aug 15;61(4):545-53. doi: 10.1093/cid/civ315..
Keywords: Patient Safety, Intensive Care Unit (ICU), Adverse Events, Healthcare-Associated Infections (HAIs), Critical Care
Kiyoshi-Teo H, Blegen M
Influence of institutional guidelines on oral hygiene practices in intensive care units.
The purpose of this study was to explore how characteristics of institutional guidelines for oral hygiene influence nurses’ oral hygiene practices and perceptions of that practice. It concluded that the content and dissemination method of institutional guidelines on oral hygiene do influence the oral hygiene practices of critical care nurses.
AHRQ-funded; HS018879.
Citation: Kiyoshi-Teo H, Blegen M .
Influence of institutional guidelines on oral hygiene practices in intensive care units.
Am J Crit Care 2015 Jul;24(4):309-18. doi: 10.4037/ajcc2015920..
Keywords: Intensive Care Unit (ICU), Nursing, Critical Care, Prevention, Guidelines
Edwards JD, Vasilevskis EE, Yoo EJ
Adults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units.
The purpose of the study is to compare demographics, intensive care unit (ICU) admission characteristics, and ICU outcomes among adults with childhood-onset chronic conditions (COCCs) admitted to US pediatric and adult ICUs. It found that adults with COCCs admitted to pediatric units were significantly more likely to be younger, have lower functional status, and be nontrauma patients than those in adult units.
AHRQ-funded; HS017716.
Citation: Edwards JD, Vasilevskis EE, Yoo EJ .
Adults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units.
J Crit Care 2015 Feb;30(1):201-6. doi: 10.1016/j.jcrc.2014.10.016..
Keywords: Intensive Care Unit (ICU), Chronic Conditions, Critical Care
Sjoding MW, Cooke CR
Chronic critical illness: a growing legacy of successful advances in critical care*.
As the population ages, and advances in critical care continue to improve survival among the most severely ill patients, many assert that the incidence of chronic critical illness (CCI) will continue to rise. The authors discuss an article (Kahn, et al) in the same issue that highlights the growing incidence of CCI and the problems it poses.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Cooke CR .
Chronic critical illness: a growing legacy of successful advances in critical care*.
Crit Care Med 2015 Feb;43(2):476-7. doi: 10.1097/ccm.0000000000000780..
Keywords: Critical Care, Chronic Conditions, Intensive Care Unit (ICU)
Rangachari P, Madaio M, Rethemeyer RK
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
There are gaps in understanding the mechanisms by which top-down communications enable practice change. The authors sought to address these gaps in order to help identify evidence-based management strategies for successful practice change at the unit level. They found that both intensive care units studied experienced substantially improved outcomes and indicated a statistically significant increase in proactive communications. Early in the study, champions emerged within each unit to initiate process improvements. The authors concluded that the study helped to identify evidence-based management strategies for successful practice change at the unit level.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
Health Care Manage Rev 2015 Jan-Mar;40(1):65-78. doi: 10.1097/hmr.0000000000000001.
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Keywords: Intensive Care Unit (ICU), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Critical Care, Communication, Evidence-Based Practice, Organizational Change, Prevention, Patient Safety