National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (15)
- Antibiotics (2)
- Antimicrobial Stewardship (3)
- Arthritis (2)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (4)
- Central Line-Associated Bloodstream Infections (CLABSI) (6)
- Children/Adolescents (4)
- Clostridium difficile Infections (6)
- Communication (2)
- Comparative Effectiveness (5)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Critical Care (2)
- Data (2)
- Decision Making (2)
- Diagnostic Safety and Quality (2)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (5)
- Genetics (2)
- Guidelines (2)
- (-) Healthcare-Associated Infections (HAIs) (59)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospitals (5)
- Injuries and Wounds (10)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (5)
- Kidney Disease and Health (1)
- Long-Term Care (3)
- Medicare (3)
- Medication (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (4)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Nursing (2)
- Nursing Homes (3)
- Organizational Change (1)
- Orthopedics (2)
- Outcomes (2)
- Patient-Centered Outcomes Research (5)
- Patient Safety (36)
- Payment (1)
- Policy (2)
- Practice Patterns (1)
- Pressure Ulcers (5)
- Prevention (15)
- Provider Performance (1)
- Quality Improvement (2)
- Quality of Care (6)
- Registries (1)
- Risk (9)
- Screening (1)
- Stroke (1)
- Surgery (10)
- Transplantation (2)
- Treatments (1)
- Urinary Tract Infection (UTI) (3)
- Women (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 59 Research Studies DisplayedMurray MT, Neu N, Cohen B
Developing case definitions for health care-associated infections for pediatric long-term care facilities.
The researchers performed a pilot study to assess the utility of the Society for Healthcare Epidemiology of America/CDC surveillance case definitions for children in pediatric long-term care facilities (pLTCFs). They concluded that the current surveillance definitions for healthcare-acquired infections in adult long-term care appear to have limited utility for the pLTC population.
AHRQ-funded; HS021470.
Citation: Murray MT, Neu N, Cohen B .
Developing case definitions for health care-associated infections for pediatric long-term care facilities.
Clin Pediatr 2015 Dec;54(14):1380-2. doi: 10.1177/0009922815599379..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Patient Safety, Children/Adolescents
Dicks KV, Baker AW, Durkin MJ
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
The purpose of this paper was to determine the association between shorter operative duration and surgical site infection (SSI) and also between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties. The researchers concluded that short operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in their analysis.
AHRQ-funded; HS023866.
Citation: Dicks KV, Baker AW, Durkin MJ .
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
Infect Control Hosp Epidemiol 2015 Dec;36(12):1431-6. doi: 10.1017/ice.2015.222.
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Keywords: Healthcare-Associated Infections (HAIs), Orthopedics, Patient Safety, Adverse Events, Surgery, Injuries and Wounds
Chopra V, Saint S
Vascular catheter infections: time to get technical.
Combining technical and socioadaptive factors within a bundle of best practices has substantially reduced catheter-related bloodstream infections in the past decade, but which elements of this bundle are most responsible for reducing catheter infections? Although a key technical solution should become the standard of care to prevent vascular catheter infections, the authors recommended getting even more technical to prevent other health-care-associated infections.
AHRQ-funded; HS022835.
Citation: Chopra V, Saint S .
Vascular catheter infections: time to get technical.
Lancet 2015 Nov 21;386(10008):2034-36. doi: 10.1016/s0140-6736(15)00245-7.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Donnelly JP, Wang HE, Locke JE
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
The researchers examined hospital-onset Clostridium difficile infection (CDI) from 2012 to 2014 among transplant recipients in the University HealthSystem Consortium, which includes academic medical center-affiliated hospitals in the United States. They found that factors associated with CDI among transplant recipients included transplant type, risk of mortality, comorbidities, and inpatient complications.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Wang HE, Locke JE .
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
Am J Transplant 2015 Nov;15(11):2970-7. doi: 10.1111/ajt.13491.
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Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Transplantation, Adverse Events, Mortality
Polage CR, Gyorke CE, Kennedy MA
Overdiagnosis of Clostridium difficile infection in the molecular test era.
This study determined the natural history and need for treatment of patients who are toxin immunoassay negative and polymerase chain reaction (PCR) positive (Tox−/PCR+) for Clostridium difficile Infection ( CDI). They found that among hospitalized adults with suspected CDI, virtually all CDI-related complications and deaths occurred in patients with positive toxin immunoassay test results.
AHRQ-funded; HS022236.
Citation: Polage CR, Gyorke CE, Kennedy MA .
Overdiagnosis of Clostridium difficile infection in the molecular test era.
JAMA Intern Med 2015 Nov;175(11):1792-801. doi: 10.1001/jamainternmed.2015.4114..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Genetics
Likosky DS, Wallace AS, Prager RL
Sources of variation in hospital-level infection rates after coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons Adult Heart Surgery Database.
This descriptive study characterized the hospital-level variability in healthcare-acquired infection (HAI) rates across hospitals participating in The Society of Thoracic Surgeons Adult Cardiac Surgery Database. It found substantial hospital-level variation exists in postoperative HAIs among patients undergoing coronary artery bypass graft surgery, driven predominantly by pneumonia.
AHRQ-funded; HS022535; HS022909.
Citation: Likosky DS, Wallace AS, Prager RL .
Sources of variation in hospital-level infection rates after coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons Adult Heart Surgery Database.
Ann Thorac Surg 2015 Nov;100(5):1570-5; discussion 75-6. doi: 10.1016/j.athoracsur.2015.05.015.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Injuries and Wounds, Registries
Han JH, Sullivan N, Leas BF
Cleaning hospital room surfaces to prevent health care-associated infections: a technical brief.
The authors review the evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness. Their review of the literature indicates an increased interest in environmental cleaning and disinfecting for the prevention of HAIs. However, there are many limitations in the current evidence base.
AHRQ-funded; 290201200011I.
Citation: Han JH, Sullivan N, Leas BF .
Cleaning hospital room surfaces to prevent health care-associated infections: a technical brief.
Ann Intern Med 2015 Oct 20;163(8):598-607. doi: 10.7326/m15-1192..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Healthcare-Associated Infections (HAIs), Patient Safety
Rangachari P, Madaio M, Rethemeyer RK
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
The authors investigated the challenge of consistent implementation of evidence-based infection prevention practices at the unit level. Their results showed that the interventions cumulatively had a significant desired impact on central catheter use and helped validate the theoretical literature and identify evidence-based management strategies for practice change at the unit level. Further, periodic top-down communications have the potential to modify interprofessional knowledge exchanges and enable practice change at the unit level, leading to significantly improved outcomes and reduced costs.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
Health Care Manage Rev 2015 Oct-Dec;40(4):324-36. doi: 10.1097/hmr.0000000000000038.
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Keywords: Communication, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Children/Adolescents, Prevention
Yanagizawa-Drott L, Kurland L, Schuur JD
Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey.
This study aimed to estimate the extent to which Swedish EDs have adopted evidence-based measures to prevent healthcare-associated infections (HAIs). It found that thirty-nine percent of EDs participate in a project to improve hand hygiene compliance. Staff hand hygiene compliance rates were audited at least monthly in 45 percent of EDs. Forty-three percent reported a compliance rate of 80 percent or more.
AHRQ-funded; HS021616; HS020013.
Citation: Yanagizawa-Drott L, Kurland L, Schuur JD .
Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey.
Eur J Emerg Med 2015 Oct;22(5):338-42. doi: 10.1097/mej.0000000000000159..
Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare-Associated Infections (HAIs), Prevention, Risk
Wiseman JT, Fernandes-Taylor S, Barnes ML
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
This study explored the factors that lead to postdischarge surgical site infections (SSI), investigated the differences between risk factors for in-hospital vs postdischarge SSI, and developed a scoring system to identify patients who might benefit from postdischarge monitoring of their wounds. In a comparative analysis, it found that comorbidities were the primary driver of postdischarge SSI, whereas in-hospital factors (operative time, emergency case status) and complications predicted in-hospital SSI.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
J Vasc Surg 2015 Oct;62(4):1023-31.e5. doi: 10.1016/j.jvs.2015.04.453..
Keywords: Surgery, Hospital Discharge, Healthcare-Associated Infections (HAIs), Patient Safety, Injuries and Wounds, Adverse Events
Caya T, Musuuza J, Yanke E
Using a systems engineering initiative for patient safety to evaluate a hospital-wide daily chlorhexidine bathing intervention.
The researchers undertook a systems engineering approach to evaluate housewide implementation of daily chlorhexidine bathing. They performed direct observations of the bathing process and conducted provider and patient surveys. The main outcome was compliance with bathing using a checklist. Fifty-seven percent of baths had full compliance with the chlorhexidine bathing protocol. Additional time was the main barrier.
AHRQ-funded; HS024039.
Citation: Caya T, Musuuza J, Yanke E .
Using a systems engineering initiative for patient safety to evaluate a hospital-wide daily chlorhexidine bathing intervention.
J Nurs Care Qual 2015 Oct-Dec;30(4):337-44. doi: 10.1097/ncq.0000000000000129..
Keywords: Patient Safety, Prevention, Healthcare-Associated Infections (HAIs)
Milstone AM, Koontz DW, Voskertchian A
Treating parents to reduce NICU transmission of Staphylococcus aureus (TREAT PARENTS) trial: protocol of a multisite randomised, double-blind, placebo-controlled trial.
This study looks to measure the effect of treating parents with short course intranasal mupirocin and topical chlorhexidine antisepsis on acquisition of S. aureus colonisation and infection in neonates. The primary outcome will be neonatal acquisition of an S. aureus strain that is concordant to the parental baseline S. aureus strain.
AHRQ-funded; HS022872.
Citation: Milstone AM, Koontz DW, Voskertchian A .
Treating parents to reduce NICU transmission of Staphylococcus aureus (TREAT PARENTS) trial: protocol of a multisite randomised, double-blind, placebo-controlled trial.
BMJ Open 2015 Sep 09;5(9):e009274. doi: 10.1136/bmjopen-2015-009274.
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Keywords: Healthcare-Associated Infections (HAIs), Newborns/Infants, Antimicrobial Stewardship, Prevention, Neonatal Intensive Care Unit (NICU)
Page DB, Donnelly JP, Wang HE
Community-, healthcare-, and hospital-acquired severe sepsis hospitalizations in the University HealthSystem Consortium.
The researchers sought to compare and contrast community-acquired severe sepsis, healthcare-associated severe sepsis, and hospital-acquired severe sepsis hospitalizations in a national hospital sample. They found that hospital-acquired severe sepsis was associated with both higher mortality and resource utilization than community-acquired severe sepsis and healthcare-associated severe sepsis.
AHRQ-funded; HS013852.
Citation: Page DB, Donnelly JP, Wang HE .
Community-, healthcare-, and hospital-acquired severe sepsis hospitalizations in the University HealthSystem Consortium.
Crit Care Med 2015 Sep;43(9):1945-51. doi: 10.1097/ccm.0000000000001164..
Keywords: Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Hospitalization
Theodoro D, Olsen MA, Warren DK
Emergency department central line-associated bloodstream infections (CLABSI) incidence in the era of prevention practices.
The incidence of central line–associated bloodstream infections (CLABSI) attributed to central venous catheters (CVCs) inserted in the emergency department (ED) is not widely reported. The goal of this study was to report the incidence of ED CLABSI. It concluded that the CLABSI rates in this academic medical center ED were in the range of those reported by the ICU.
AHRQ-funded; HS018092; HS019455.
Citation: Theodoro D, Olsen MA, Warren DK .
Emergency department central line-associated bloodstream infections (CLABSI) incidence in the era of prevention practices.
Acad Emerg Med 2015 Sep;22(9):1048-55. doi: 10.1111/acem.12744..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Emergency Department, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Prevention
Chopra V, Montoya A, Joshi D
Peripherally inserted central catheter use in skilled nursing facilities: a pilot study.
The purpose of this study was to describe patterns of use, care practices, and outcomes related to peripherally inserted central catheter (PICC) use in skilled nursing facilities (SNFs). The most common indication for PICC use was intravenous antibiotic delivery. The average PICC dwell time was 43 days, and most devices were single-lumen PICCs. Major and minor complications were common and occurred in 11 (20 percent) and 18 (32 percent) participants, respectively.
AHRQ-funded; HS022835; HS019979.
Citation: Chopra V, Montoya A, Joshi D .
Peripherally inserted central catheter use in skilled nursing facilities: a pilot study.
J Am Geriatr Soc 2015 Sep;63(9):1894-9. doi: 10.1111/jgs.13600..
Keywords: Adverse Events, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Nursing Homes, Patient Safety
Durkin MJ, Dicks KV, Baker AW
Seasonal variation of common surgical site infections: does season matter?
The researchers evaluated seasonal variation in the rate of surgical site infections (SSI) following commonly performed surgical procedures. Using data from the Duke Infection Control Outreach Network, they found that the rate of SSI following commonly performed surgical procedures was higher during the summer compared with the remainder of the year.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Seasonal variation of common surgical site infections: does season matter?
Infect Control Hosp Epidemiol 2015 Sep;36(9):1011-6. doi: 10.1017/ice.2015.121.
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Keywords: Adverse Events, Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Injuries and Wounds
van Mourik MS, van Duijn PJ, Moons KG
Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review.
The researchers conducted a systematic review evaluating the diagnostic accuracy of administrative data for the detection of HAI. They concluded that administrative data had limited and highly variable accuracy for the detection of HAI, and their judicious use for internal surveillance efforts and external quality assessment is recommended.
AHRQ-funded; HS018414.
Citation: van Mourik MS, van Duijn PJ, Moons KG .
Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review.
BMJ Open 2015 Aug 27;5(8):e008424. doi: 10.1136/bmjopen-2015-008424..
Keywords: Healthcare-Associated Infections (HAIs), Data, Patient Safety, Quality of Care
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
Slayton RB, Toth D, Lee BY
Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities - United States.
The researchers analyzed data from CDC's National Healthcare Safety Network and Emerging Infections Program to project the number of health care-associated infections (HAIs) from antibiotic-resistant bacteria or C. difficile both with and without a large scale national intervention that would include interrupting transmission and improved antibiotic stewardship. They found that, with effective action now, more than half a million antibiotic-resistant HAIs could be prevented over 5 years and that a coordinated approach to interrupting transmission is more effective than historical independent facility-based efforts.
AHRQ-funded; HS023317.
Citation: Slayton RB, Toth D, Lee BY .
Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities - United States.
MMWR Morb Mortal Wkly Rep 2015 Aug 7;64(30):826-31.
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Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Mody L, Crnich C
Effects of excessive antibiotic use in nursing homes.
This research commentary discussed effects of excessive antibiotic use in nursing homes (NH), including Clostridium difficile infection, adverse drug reactions, and an increased risk of colonization and infection with multidrug-resistant organisms. The authors recommended that antibiotic improvement teams tailor their improvement efforts based on a locally generated needs assessment.
AHRQ-funded; HS022465.
Citation: Mody L, Crnich C .
Effects of excessive antibiotic use in nursing homes.
JAMA Intern Med 2015 Aug;175(8):1339-41. doi: 10.1001/jamainternmed.2015.2774.
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Keywords: Adverse Drug Events (ADE), Antibiotics, Practice Patterns, Nursing Homes, Healthcare-Associated Infections (HAIs)
Pierce RA, Lessler J, Milstone AM
Expanding the statistical toolbox: analytic approaches for cohort studies with healthcare-associated infectious outcomes.
This review intends to convey the scope of available statistical methodology to better understand the process of pathogen acquisition or HAI development. It determined that despite the range of methods available, logistic regression remains the dominant statistical approach in use. Poisson regression, survival methods, and mechanistic (mathematical) models remain underutilized.
AHRQ-funded; HS022872.
Citation: Pierce RA, Lessler J, Milstone AM .
Expanding the statistical toolbox: analytic approaches for cohort studies with healthcare-associated infectious outcomes.
Curr Opin Infect Dis 2015 Aug;28(4):384-91. doi: 10.1097/qco.0000000000000179..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Outcomes, Patient Safety
Kawai AT, Calderwood MS, Jin R
Impact of the Centers for Medicare and Medicaid services hospital-acquired conditions policy on billing rates for 2 targeted healthcare-associated infections.
The 2008 Centers for Medicare & Medicaid Services (CMS) hospital-acquired conditions policy limited additional payment for conditions deemed reasonably preventable. This study examined whether this policy was associated with decreases in billing rates for 2 targeted conditions, vascular catheter-associated infections (VCAI) and catheter-associated urinary tract infections (CAUTI). The CMS policy appears to have been associated with immediate reductions in billing rates for VCAI and CAUTI, followed by a slight decreasing trend or leveling-off in rates.
AHRQ-funded; HS018414.
Citation: Kawai AT, Calderwood MS, Jin R .
Impact of the Centers for Medicare and Medicaid services hospital-acquired conditions policy on billing rates for 2 targeted healthcare-associated infections.
Infect Control Hosp Epidemiol 2015 Aug;36(8):871-7. doi: 10.1017/ice.2015.86.
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Keywords: Healthcare-Associated Infections (HAIs), Policy, Medicare, Payment, Hospitals, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare Costs
Rajaram R, Chung JW, Kinnier CV
Hospital characteristics associated with penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program.
The purpose of this study was to examine the characteristics of hospitals penalized by the Hospital-Acquired Condition (HAC) Reduction Program. It found that among hospitals participating in the HAC Reduction Program, hospitals that were penalized more frequently had more quality accreditations, and had better performance on other process and outcome measure.
AHRQ-funded; HS000078.
Citation: Rajaram R, Chung JW, Kinnier CV .
Hospital characteristics associated with penalties in the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program.
JAMA 2015 Jul 28;314(4):375-83. doi: 10.1001/jama.2015.8609..
Keywords: Hospitals, Healthcare-Associated Infections (HAIs), Patient Safety, Provider Performance
Safdar N, Perencevich E
Crossing the quality chasm for Clostridium difficile infection prevention.
The author comments on a new population-based cohort study (Daneman, et al.) in the same journal issue on the association of hospital prevention processes and patient risk factors with the risk of Clostridium difficile infection. She concludes that the findings of the study are important and should serve as a wake-up call for institutions to participate actively in assessing and evaluating implementation of and adherence to CDI prevention practices.
AHRQ-funded; HS023791.
Citation: Safdar N, Perencevich E .
Crossing the quality chasm for Clostridium difficile infection prevention.
BMJ Qual Saf 2015 Jul;24(7):409-11. doi: 10.1136/bmjqs-2015-004344..
Keywords: Clostridium difficile Infections, Risk, Healthcare-Associated Infections (HAIs), Prevention
Mody L, Meddings J, Edson BS
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
The authors describe a new initiative based on lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent catheter-associated urinary tract infections in over 950 acute care hospitals. This initiative will now be implemented in nearly 500 nursing homes through a project funded by AHRQ. It will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship.
AHRQ-funded; 2902010000251; HS019979; HS019767.
Citation: Mody L, Meddings J, Edson BS .
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
Clin Infect Dis 2015 Jul 1;61(1):86-94. doi: 10.1093/cid/civ236..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Inpatient Care