National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Antibiotics (7)
- Antimicrobial Stewardship (1)
- Care Management (3)
- Catheter-Associated Urinary Tract Infection (CAUTI) (10)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Community-Acquired Infections (2)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Decision Making (1)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Emergency Department (1)
- Evidence-Based Practice (4)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (9)
- Healthcare Utilization (1)
- Health Literacy (1)
- Hospitals (2)
- Imaging (1)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (4)
- Long-Term Care (5)
- Medicare (1)
- Medication (3)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Newborns/Infants (1)
- Nursing (1)
- Nursing Homes (4)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (9)
- Practice Patterns (1)
- Prevention (6)
- Provider: Nurse (1)
- Quality Measures (1)
- (-) Urinary Tract Infection (UTI) (19)
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 19 of 19 Research Studies DisplayedAnesi JA, Lautenbach E, Nachamkin I
Poor clinical outcomes associated with community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae.
In this retrospective cohort study, the investigators sought to determine the clinical outcomes associated with community-onset ESC-resistant (ESC-R) EB urinary tract infections (UTIs) in a US health system. The authors found that community-onset UTI due to an ESC-R EB organism was significantly associated with clinical failure, which may be due in part to inappropriate initial antibiotic therapy. They indicate that further studies are needed to determine which patients in the community are at high risk for drug-resistant infection to help inform prompt diagnosis and appropriate antibiotic prescribing for ESC-R EB.
AHRQ-funded; HS020002.
Citation: Anesi JA, Lautenbach E, Nachamkin I .
Poor clinical outcomes associated with community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1431-35. doi: 10.1017/ice.2018.254..
Keywords: Antibiotics, Community-Acquired Infections, Medication, Outcomes, Patient Safety, Urinary Tract Infection (UTI)
Varda BK, Finkelstein JB, Wang HH
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
This study examined whether the routine use of continuous antibiotic prophylaxis (CAP) before initial postnatal imaging is effective to prevent urinary tract infection (UTI) in infants with a history of antenatal urinary tract dilation (AUTD). A single-institution, retrospective cohort study of infants with a history of AUTD was conducted. A random sample of 500 infants was selected with six excluded for other congenital anomalies. Of the 494 remaining, 157 (32%) received CAP. There was no difference found in UTI incidence among those treated with CAP and those who were not.
AHRQ-funded; HS000063.
Citation: Varda BK, Finkelstein JB, Wang HH .
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
J Pediatr Urol 2018 Dec;14(6):539.e1-39.e6. doi: 10.1016/j.jpurol.2018.04.022..
Keywords: Antibiotics, Antimicrobial Stewardship, Urinary Tract Infection (UTI), Newborns/Infants, Imaging, Medication, Prevention
Bardossy AC, Williams T, Jones K
Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: the tale of two teaching hospitals.
This study compared 2 teaching hospitals’ intervention programs for preventing catheter-associated urinary tract infections (CAUTI). The comparisons were done in their adult intensive care units.
AHRQ-funded; 290201000025I; 29032001T.
Citation: Bardossy AC, Williams T, Jones K .
Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: the tale of two teaching hospitals.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1494-96. doi: 10.1017/ice.2018.251..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Patient Safety, Urinary Tract Infection (UTI)
Bradley SM, Schweon SJ, Mody L
Identifying safe practices for use of the urinary leg bag drainage system in the postacute and long-term care setting: an integrative review.
In the postacute and long-term care setting, the practice of changing the indwelling urinary catheter large sterile drainage bag to a small-size leg drainage bag is intended to maintain a person's mobility, dignity, and comfort. There is scant evidence that assesses the impact of intermittent use of a leg bag on frequency of urinary tract infection since this breaks the closed urinary drainage system. The investigators identified the existence of low-level evidence that leg bags pose no evident, disproportionate risk of infection compared with maintaining a closed system.
AHRQ-funded; 290201000025I.
Citation: Bradley SM, Schweon SJ, Mody L .
Identifying safe practices for use of the urinary leg bag drainage system in the postacute and long-term care setting: an integrative review.
Am J Infect Control 2018 Sep;46(9):973-79. doi: 10.1016/j.ajic.2018.03.029..
Keywords: Care Management, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Long-Term Care, Patient Safety, Urinary Tract Infection (UTI)
Durkin MJ, Keller M, Butler AM
An assessment of inappropriate antibiotic use and guideline adherence for uncomplicated urinary tract infections.
In 2011, The Infectious Diseases Society of America released a clinical practice guideline (CPG) that recommended short-course antibiotic therapy and avoidance of fluoroquinolones for uncomplicated urinary tract infections (UTIs). This study assessed whether the CPG had an impact on national antibiotic prescribing practices. The study found that CPG was not associated with a clinically meaningful change in national antibiotic prescribing practices for UTIs.
AHRQ-funded; HS019455.
Citation: Durkin MJ, Keller M, Butler AM .
An assessment of inappropriate antibiotic use and guideline adherence for uncomplicated urinary tract infections.
Open Forum Infect Dis 2018 Sep;5(9):ofy198. doi: 10.1093/ofid/ofy198..
Keywords: Antibiotics, Decision Making, Guidelines, Practice Patterns, Urinary Tract Infection (UTI)
Krein SL, Greene MT, King B
Assessing a national collaborative program to prevent catheter-associated urinary tract infection in a Veterans Health Administration nursing home cohort.
Collaborative programs have helped reduce catheter-associated urinary tract infection (CAUTI) rates in community-based nursing homes. This study assessed whether collaborative participation produced similar benefits among Veterans Health Administration (VHA) nursing homes. The researchers found that no changes in CAUTI rates, catheter use, or urine culture orders were found during the program period. One potential reason was the relatively low baseline CAUTI rate, as compared with a cohort of community-based nursing homes.
AHRQ-funded; 290201000025I.
Citation: Krein SL, Greene MT, King B .
Assessing a national collaborative program to prevent catheter-associated urinary tract infection in a Veterans Health Administration nursing home cohort.
Infect Control Hosp Epidemiol 2018 Jul;39(7):820-25. doi: 10.1017/ice.2018.99..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Long-Term Care, Nursing Homes, Patient Safety, Prevention, Urinary Tract Infection (UTI)
Smith SN, Greene MT, Mody L
Evaluation of the association between Nursing Home Survey on Patient Safety culture (NHSOPS) measures and catheter-associated urinary tract infections: results of a national collaborative.
The investigators examined the association between nursing home safety culture, measured with the Nursing Home Survey on Patient Safety Culture (NHSOPS), and catheter-associated urinary tract infection rates (CAUTI) using data from a recent national collaborative for preventing healthcare-associated infections in nursing homes. They found that this large national collaborative of nursing homes saw declining CAUTI rates as well as improvements in several NHSOPS domains. However, no association was found between initial or over-time NHSOPS scores and CAUTI rates.
AHRQ-funded; 290201000025I.
Citation: Smith SN, Greene MT, Mody L .
Evaluation of the association between Nursing Home Survey on Patient Safety culture (NHSOPS) measures and catheter-associated urinary tract infections: results of a national collaborative.
BMJ Qual Saf 2018 Jun;27(6):464-73. doi: 10.1136/bmjqs-2017-006610.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Long-Term Care, Nursing Homes, Patient Safety, Quality Measures, Urinary Tract Infection (UTI)
Patel PK, Gupta A, Vaughn VM
Review of strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs.
This systematic review was conducted back in October 2015 within PubMed and Cochrane databases on interventions to reduce central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI). The interventions were categorized by stages applicable to both CAUTI and CLABSI prevention. Stage 0: avoid catheter if possible; Stage 1: ensure aseptic placement; Stage 2: maintain awareness and proper care of catheters in place, and Stage 3: promptly remove unnecessary catheters. They also looked for effective components that the 5 stages were most successful with. The review is designed for hospitalists to use to formulate quality improvement interventions for infection reduction.
AHRQ-funded; HS018334.
Citation: Patel PK, Gupta A, Vaughn VM .
Review of strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs.
J Hosp Med 2018 Feb;13(2):105-16. doi: 10.12788/jhm.2856..
Keywords: Care Management, Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Infectious Diseases, Intensive Care Unit (ICU), Patient Safety, Urinary Tract Infection (UTI)
Mody L, Greene MT, Meddings J
AHRQ Author: Burwen DR, Battles J
A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents.
The researchers developed, implemented, and evaluated an intervention to reduce catheter-associated urinary tract infection (UTI). They found that in a large-scale, national implementation project involving community-based nursing homes, combined technical and socioadaptive catheter-associated UTI prevention interventions successfully reduced the incidence of catheter-associated UTIs.
AHRQ-authored; AHRQ-funded; 290201000025I; HS019767; HS024385; HS018334.
Citation: Mody L, Greene MT, Meddings J .
A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents.
JAMA Intern Med 2017 Aug;177(8):1154-62. doi: 10.1001/jamainternmed.2017.1689.
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Keywords: Antibiotics, Catheter-Associated Urinary Tract Infection (CAUTI), Elderly, Long-Term Care, Nursing Homes, Prevention, Urinary Tract Infection (UTI)
Crnich CJ, Jump RL, Nace DA
Improving management of urinary tract infections in older adults: a paradigm shift or therapeutic nihilism?
The authors address the various arguments and solutions advanced in a commentary, published in the Journal of the American Geriatrics Society, which addresses over diagnosis and overtreatment of UTI in older adults and offer several alternative solutions for this challenging clinical problem.
AHRQ-funded; HS022465.
Citation: Crnich CJ, Jump RL, Nace DA .
Improving management of urinary tract infections in older adults: a paradigm shift or therapeutic nihilism?
J Am Geriatr Soc 2017 Aug;65(8):1661-63. doi: 10.1111/jgs.14961..
Keywords: Elderly, Care Management, Urinary Tract Infection (UTI)
Metersky ML, Eldridge N, Wang Y
AHRQ Author: Eldridge N
National trends in the frequency of bladder catheterization and physician-diagnosed catheter-associated urinary tract infections: results from the Medicare Patient Safety Monitoring System.
The researchers assessed bladder catheterization frequency (percentage of patients catheterized) and risk-adjusted catheter-associated urinary tract infection (CAUTI frequency (percentage of catheterized patients developing CAUTI) from 2009-2014. They found statistically significant declines in observed bladder catheterization frequency and adjusted CAUTI frequency in some patient populations between 2009 and 2014.
AHRQ-authored; AHRQ-funded; 290201200003C; HS019767; HS024385; HS018334.
Citation: Metersky ML, Eldridge N, Wang Y .
National trends in the frequency of bladder catheterization and physician-diagnosed catheter-associated urinary tract infections: results from the Medicare Patient Safety Monitoring System.
Am J Infect Control 2017 Aug;45(8):901-04. doi: 10.1016/j.ajic.2017.03.008.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Adverse Events, Medicare
Meddings J, Saint S, Krein SL
Systematic review of interventions to reduce urinary tract infection in nursing home residents.
This paper is a systematic literature review of strategies to reduce urinary tract infections (UTIs) in nursing home residents. It concludes that several practices, often implemented in bundles, such as improving hand hygiene, reducing and improving catheter use, managing incontinence without catheters, and enhanced barrier precautions, appear to reduce UTI or catheter-associated UTI in nursing home residents.
AHRQ-funded; HS019767; HS018334; 290201000025I.
Citation: Meddings J, Saint S, Krein SL .
Systematic review of interventions to reduce urinary tract infection in nursing home residents.
J Hosp Med 2017 May;12(5):356-68. doi: 10.12788/jhm.2724.
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Keywords: Antibiotics, Catheter-Associated Urinary Tract Infection (CAUTI), Elderly, Evidence-Based Practice, Long-Term Care, Nursing Homes, Patient Safety, Prevention, Urinary Tract Infection (UTI)
Furuno JP, Noble BN, Bearden DT
Feasibility of retrospective pharmacovigilance studies in hospice care: a case study of antibiotics for the treatment of urinary tract infections.
In this letter to the editor, the authors assert that pharmacovigilance may be useful to improve the evidence base for medication use in hospice care and an efficient alternative to expensive and logistically complicated clinical trials. They discuss the feasibility of retrospective pharmacovigilance studies in hospice care and provide a case study of antibiotics for the treatment of urinary tract infections.
AHRQ-funded; HS023366.
Citation: Furuno JP, Noble BN, Bearden DT .
Feasibility of retrospective pharmacovigilance studies in hospice care: a case study of antibiotics for the treatment of urinary tract infections.
J Palliat Med 2017 Apr;20(4):316-17. doi: 10.1089/jpm.2016.0531..
Keywords: Antibiotics, Evidence-Based Practice, Healthcare Utilization, Medication, Palliative Care, Urinary Tract Infection (UTI)
Anesi JA, Lautenbach E, Nachamkin I
Clinical and molecular characterization of community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae.
The objective of this paper was to evaluate risk factors for and molecular characteristics of community-onset extended-spectrum cephalosporin-resistant (ESC-R) Enterobacteriaceae (EB) urinary tract infections (UTIs) in a US health system. The investigators found that use of trimethoprim-sulfamethoxazole, older age, diabetes, and presentation to the emergency department were associated with community-onset ESC-R EB UTI, with a high prevalence of CTX-M among their community isolates.
AHRQ-funded; HS020002.
Citation: Anesi JA, Lautenbach E, Nachamkin I .
Clinical and molecular characterization of community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae.
Infect Control Hosp Epidemiol 2016 Dec;37(12):1433-39. doi: 10.1017/ice.2016.225.
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Keywords: Antibiotics, Community-Acquired Infections, Patient Safety, Urinary Tract Infection (UTI)
Saint S, Greene MT, Krein SL
AHRQ Author: Battles J
A program to prevent catheter-associated urinary tract infection in acute care.
The national Comprehensive Unit-based Safety Program, funded by AHRQ, aimed to reduce catheter-associated UTI in intensive care units (ICUs) and non-ICUs. The main program features were dissemination of information to sponsor organizations and hospitals, data collection, and guidance on key technical and socioadaptive factors in the prevention of catheter-associated UTI. Among the findings: in an adjusted analysis, catheter-associated UTI rates decreased from 2.40 to 2.05 infections per 1000 catheter-days.
AHRQ-authored; AHRQ-funded; 290201000025I; 29032001T.
Citation: Saint S, Greene MT, Krein SL .
A program to prevent catheter-associated urinary tract infection in acute care.
N Engl J Med 2016 Jun 2;374(22):2111-9. doi: 10.1056/NEJMoa1504906.
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Keywords: Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI)
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)
Masnick M, Morgan DJ, Sorkin JD
Lack of patient understanding of hospital-acquired infection data published on the Centers for Medicare and Medicaid Services Hospital Compare Website.
This study assessed the interpretability of hospital-acquired infection (HAI) data as presented on the Centers for Medicare and Medicaid Services Hospital Compare website among patients who might benefit from access to these data. It concluded that current public HAI data presentation methods may be inadequate. When presented with numeric HAI data, study participants incorrectly compared hospitals on the basis of HAI data in more than 40% of the responses.
AHRQ-funded; HS018111.
Citation: Masnick M, Morgan DJ, Sorkin JD .
Lack of patient understanding of hospital-acquired infection data published on the Centers for Medicare and Medicaid Services Hospital Compare Website.
Infect Control Hosp Epidemiol 2016 Feb;37(2):182-7. doi: 10.1017/ice.2015.260.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Education: Patient and Caregiver, Health Literacy, Healthcare-Associated Infections (HAIs), Hospitals, Urinary Tract Infection (UTI)
Huang SS, Septimus E, Hayden MK
Effect of body surface decolonisation on bacteriuria and candiduria in intensive care units: an analysis of a cluster-randomised trial.
The researchers aimed to assess the effect of decolonization on bacteriuria and candiduria in patients admitted to ICUs. They concluded that universal decolonization of patients in the ICU with once a day chlorhexidine baths and short-course nasal mupirocin could be a potential preventive strategy in male patients because it significantly decreases candiduria and any bacteriuria, but not for women.
AHRQ-funded; 290201000008I; 29032007T.
Citation: Huang SS, Septimus E, Hayden MK .
Effect of body surface decolonisation on bacteriuria and candiduria in intensive care units: an analysis of a cluster-randomised trial.
Lancet Infect Dis 2016 Jan;16(1):70-9. doi: 10.1016/s1473-3099(15)00238-8.
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Keywords: Intensive Care Unit (ICU), Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention
Manojlovich M, Saint S, Meddings J
Indwelling urinary catheter insertion practices in the emergency department: an observational study.
The researchers sought (1) to determine how frequently major breaks in aseptic insertion technique occur, and (2) to identify the number of patients who developed bacteriuria after catheter placement in the ED. They found that major breaks in aseptic insertion technique occurred in 48 of 81 insertion attempts. Of the 7 patients with bacteriuria after insertion, 5 had experienced a major break in technique.
AHRQ-funded; HS019767; 290201000025I; 29032001T.
Citation: Manojlovich M, Saint S, Meddings J .
Indwelling urinary catheter insertion practices in the emergency department: an observational study.
Infect Control Hosp Epidemiol 2016 Jan;37(1):117-9. doi: 10.1017/ice.2015.238.
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Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Emergency Department, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI)