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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Antibiotics (4)
- Antimicrobial Stewardship (2)
- Cancer (1)
- (-) Clostridium difficile Infections (18)
- Community-Acquired Infections (1)
- Comparative Effectiveness (1)
- Data (1)
- Decision Making (1)
- Education: Continuing Medical Education (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (14)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Hospital Discharge (1)
- Hospital Readmissions (1)
- Hospitals (3)
- Infectious Diseases (3)
- Inpatient Care (2)
- Medicare (1)
- Medication (2)
- Medication: Safety (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Nursing Homes (1)
- Patient Safety (7)
- Policy (1)
- Prevention (8)
- Provider (1)
- Risk (4)
- Surgery (1)
- Treatments (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 18 of 18 Research Studies DisplayedD'Agata EMC, Tran D, Bautista J
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
In this study, the authors developed a decision analytic model of antimicrobial use on the clinical and economic consequences of implementing a nationwide antimicrobial stewardship program in outpatient dialysis facilities. The authors found that the model suggested that implementation of antimicrobial stewardship programs in outpatient dialysis facilities would result in substantial reductions in infections caused by multidrug-resistant organisms and C. difficile, infection-related deaths, and costs.
AHRQ-funded; R18 HS021666.
Citation: D'Agata EMC, Tran D, Bautista J .
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
Clin J Am Soc Nephrol 2018 Sep 7;13(9):1389-97. doi: 10.2215/cjn.12521117..
Keywords: Antimicrobial Stewardship, Decision Making, Antibiotics, Medication, Healthcare Costs, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs)
Anderson DJ, Moehring RW, Weber DJ
Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover
In this study, the investigators aimed to assess the effectiveness of four disinfection strategies on hospital-wide incidence of multidrug-resistant organisms and Clostridium difficile in the Benefits of Enhanced Terminal Room (BETR) Disinfection study. The investigators found that enhanced terminal room disinfection with ultraviolet (UV) in a targeted subset of high-risk rooms led to a decrease in hospital-wide incidence of C difficile and vancomycin-resistant enterococci.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Moehring RW, Weber DJ .
Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover
Lancet Infect Dis 2018 Aug;18(8):845-53. doi: 10.1016/s1473-3099(18)30278-0..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Infectious Diseases, Inpatient Care, Patient Safety, Prevention
Harris AD, Sbarra AN, Leekha S
Electronically available comorbid conditions for risk prediction of healthcare-associated Clostridium difficile infection.
This study analyzed whether electronically available comorbid conditions are risk factors for Centers for Disease Control and Prevention (CDC)-defined, hospital-onset Clostridium difficile infection (CDI) after controlling for antibiotic and gastric acid suppression therapy use. It concluded that comorbid conditions are important risk factors for CDI.
AHRQ-funded; HS022291.
Citation: Harris AD, Sbarra AN, Leekha S .
Electronically available comorbid conditions for risk prediction of healthcare-associated Clostridium difficile infection.
Infect Control Hosp Epidemiol 2018 Mar;39(3):297-301. doi: 10.1017/ice.2018.10.
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Keywords: Clostridium difficile Infections, Electronic Health Records (EHRs), Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Psoinos CM, Collins CE, Ayturk MD
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
C. difficile (CDI) has surpassed methicillin-resistant staph aureus as the most common nosocomial infection with recurrence reaching 30% and the elderly being disproportionately affected. The authors hypothesized that post-discharge antibiotic therapy for continued CDI treatment reduces readmissions. The study concluded that patients discharged with single-drug therapy for CDI had lower readmission rates compared to patients discharged on no ongoing CDI treatment suggesting that short-term monotherapy may be beneficial in inducing eradication and preventing relapse.
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AHRQ-funded; HS022694
Citation: Psoinos CM, Collins CE, Ayturk MD .
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
World J Surg 2018 Jan;42(1):246-53. doi: 10.1007/s00268-017-4139-8..
Keywords: Antibiotics, Clostridium difficile Infections, Elderly, Hospital Discharge, Hospital Readmissions
Seibert G, Ewers T, Barker AK
What do visitors know and how do they feel about contact precautions?
This study surveyed visitors of Clostridium difficile infection (CDI) patients to understand their compliance, knowledge, and perceptions of contact precautions. Nursing staff were the fundamental source for information on personal protective equipment (PPE) for visitors, but the researchers discovered variation in staff communication regarding the need for PPE use. Although most visitors knew where to find required personal protective equipment, less than half were fully compliant with gown and gloves.
AHRQ-funded; HS024039.
Citation: Seibert G, Ewers T, Barker AK .
What do visitors know and how do they feel about contact precautions?
Am J Infect Control 2018 Jan;46(1):115-17. doi: 10.1016/j.ajic.2017.05.011..
Keywords: Clostridium difficile Infections, Guidelines, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention
Jump RLP, Gaur S, Katz MJ
Template for an antibiotic stewardship policy for post-acute and long-term care settings.
To support compliance with Centers for Medicare and Medicaid services (CMS) requirements and aid facilities in establishing a stewardship program, the Infection Advisory Committee at the American Medical Directors Association -The Society for Post-Acute and Long-Term Care Medicine, has developed an antibiotic stewardship policy template tailored to the long-term care setting. This paper describes that policy template.
AHRQ-funded; HS022465; HS023779.
Citation: Jump RLP, Gaur S, Katz MJ .
Template for an antibiotic stewardship policy for post-acute and long-term care settings.
J Am Med Dir Assoc 2017 Nov;18(11):913-20. doi: 10.1016/j.jamda.2017.07.018..
Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Policy, Prevention
Roghmann MC, Andronescu LR, Stucke EM
Clostridium difficile colonization of nursing home residents.
This letter to the editor notes that Clostridum difficile is a leading cause of infectious diarrhea in nursing homes and asserts that evidence-based infection control guidelines are needed to reduce transmission of C. difficile in these settings.
AHRQ-funded; HS019979.
Citation: Roghmann MC, Andronescu LR, Stucke EM .
Clostridium difficile colonization of nursing home residents.
Infect Control Hosp Epidemiol 2017 Oct;38(10):1267-68. doi: 10.1017/ice.2017.172..
Keywords: Clostridium difficile Infections, Evidence-Based Practice, Guidelines, Nursing Homes
Barker AK, Zellmer C, Tischendorf J
On the hands of patients with Clostridium difficile: a study of spore prevalence and the effect of hand hygiene on C difficile removal.
This study assessed the prevalence of Clostridium difficile spores in 48 observations of infected inpatients after randomly assigning them to hand hygiene with either alcohol-based handrub or soap and water.
AHRQ-funded; HS023791.
Citation: Barker AK, Zellmer C, Tischendorf J .
On the hands of patients with Clostridium difficile: a study of spore prevalence and the effect of hand hygiene on C difficile removal.
Am J Infect Control 2017 Oct;45(10):1154-56. doi: 10.1016/j.ajic.2017.03.005..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Ferrada P, Callcut R, Zielinski MD
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
The objective of this study was to compare loop ileostomy (LI) and total colectomy (TC) procedures in a multicentric approach to help the surgeon decide what procedure was best suited for the patient in need. In this study, the investigators found that LI carried less mortality than TC.
AHRQ-funded; HS024547.
Citation: Ferrada P, Callcut R, Zielinski MD .
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
J Trauma Acute Care Surg 2017 Jul;83(1):36-40. doi: 10.1097/ta.0000000000001498..
Keywords: Clostridium difficile Infections, Comparative Effectiveness, Infectious Diseases, Surgery, Treatments
Cannon CM, Musuuza JS, Barker AK
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
This study determined that the prevalence of colonization with toxigenic Clostridium difficile among patients with hematological malignancies and/or bone marrow transplant at admission to a 566-bed academic medical care center was 9.3 percent. Thirteen percent of colonized patients developed symptomatic disease during hospitalization. This population may benefit from targeted C. difficile infection control interventions.
AHRQ-funded; HS024039; HS023791.
Citation: Cannon CM, Musuuza JS, Barker AK .
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
Infect Control Hosp Epidemiol 2017 Jun;38(6):718-20. doi: 10.1017/ice.2017.48.
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Keywords: Cancer, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Seidelman J, Dicks KV, Durkin MJ
Using clinical scenarios to understand preventability of Clostridium difficile infections by inpatient antibiotic stewardship programs.
The authors of this research brief designed a 2-phase study (1) to define the types of clostridium difficile infections (CDI) that clinicians consider unlikely preventable by inpatient antibiotic stewardship programs and (2) to estimate the relative proportion of inpatient CDI cases at a tertiary-care hospital that belongs to this category of “nonpreventable” CDI.
AHRQ-funded; HS023866.
Citation: Seidelman J, Dicks KV, Durkin MJ .
Using clinical scenarios to understand preventability of Clostridium difficile infections by inpatient antibiotic stewardship programs.
Infect Control Hosp Epidemiol 2017 Jun;38(6):747-49. doi: 10.1017/ice.2017.32..
Keywords: Antibiotics, Antimicrobial Stewardship, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Inpatient Care
Anderson DJ, Rojas LF, Watson S
Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.
The rate of community-acquired Clostridium difficile infection (CA-CDI) is increasing. While receipt of antibiotics remains an important risk factor for CDI, studies related to acquisition of C. difficile outside of hospitals are lacking. This study found that proximity to a livestock farm (0.01), proximity to farming raw materials services (0.02), and proximity to a nursing home (0.04) were independently associated with increased rates of CA-CDI.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Rojas LF, Watson S .
Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.
PLoS One 2017 May 16;12(5):e0176285. doi: 10.1371/journal.pone.0176285.
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Keywords: Clostridium difficile Infections, Community-Acquired Infections, Risk, Patient Safety
Deshpande A, Cadnum JL, Fertelli D
Are hospital floors an underappreciated reservoir for transmission of health care-associated pathogens?
In a survey of 5 hospitals, the researchers found that floors in patient rooms were frequently contaminated with pathogens and high-touch objects such as blood pressure cuffs and call buttons were often in contact with the floor. Contact with objects on floors frequently resulted in transfer of pathogens to hands.
AHRQ-funded; HS020004.
Citation: Deshpande A, Cadnum JL, Fertelli D .
Are hospital floors an underappreciated reservoir for transmission of health care-associated pathogens?
Am J Infect Control 2017 Mar;45(3):336-38. doi: 10.1016/j.ajic.2016.11.005.
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Keywords: Hospitals, Healthcare-Associated Infections (HAIs), Clostridium difficile Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety
Anderson DJ, Chen LF, Weber DJ
Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study.
The researchers determined the effects of three enhanced strategies for terminal room disinfection (disinfection of a room between occupying patients) on acquisition and infection due to methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, C difficile, and multidrug-resistant Acinetobacter. They found that the incidence of target organisms among exposed patients was significantly lower after adding UV (quaternary ammonium disinfectant and disinfecting ultraviolet [UV-C]) light to standard cleaning strategies.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Chen LF, Weber DJ .
Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study.
Lancet 2017 Feb 25;389(10071):805-14. doi: 10.1016/s0140-6736(16)31588-4.
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Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety
Ruis AR, Shaffer DW, Shirley DK
Teaching health care workers to adopt a systems perspective for improved control and prevention of health care-associated infections.
The authors argue that procedural approaches alone, even with high levels of adherence, are often insufficient to solve the growing problem of health care-associated infections (HAIs); it is equally important that interventions address the more complex cognitive aspects of HAI control and prevention. Health care workers (HCWs) face many patient care situations for which standard procedures have not been and cannot be developed.
AHRQ-funded; HS023791.
Citation: Ruis AR, Shaffer DW, Shirley DK .
Teaching health care workers to adopt a systems perspective for improved control and prevention of health care-associated infections.
Am J Infect Control 2016 Nov;44(11):1360-64. doi: 10.1016/j.ajic.2016.04.211.
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Keywords: Clostridium difficile Infections, Education: Continuing Medical Education, Healthcare-Associated Infections (HAIs), Prevention, Provider
Olsen MA, Young-Xu Y, Stwalley D
The burden of Clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases.
The researchers used comparable methods with multiple administrative databases to compare the incidence of clostridium difficile infection (CDI) in older and younger persons in the United States. They found that the incidence of CDI was 10-fold lower and the proportion of community-onset CDI was much higher in the privately insured younger LabRx population compared to the elderly Medicare population.
AHRQ-funded; HS019455.
Citation: Olsen MA, Young-Xu Y, Stwalley D .
The burden of Clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases.
BMC Infect Dis 2016 Apr 22;16:177. doi: 10.1186/s12879-016-1501-7.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Data, Prevention
Croft L, Ladd J, Doll M
Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection.
To understand how often Clostridium difficile infection (CDI) is related to inappropriate medication use, the researchers evaluated appropriateness of antimicrobial therapy and gastric acid suppression preceding CDI acquired. Of all CDI episodes, 38.0 percent (27 of 71) were preceded by inappropriate gastric acid suppressant medications. For the 40 episodes in which gastric acid suppressant medications were used prior to CDI, 27 (67.5 percent) were inappropriately treated.
AHRQ-funded; HS018111.
Citation: Croft L, Ladd J, Doll M .
Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection.
Infect Control Hosp Epidemiol 2016 Apr;37(4):494-5. doi: 10.1017/ice.2016.2.
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Keywords: Adverse Drug Events (ADE), Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication: Safety, Medication
Dubberke ER, Olsen MA, Stwalley D
Identification of Medicare recipients at highest risk for Clostridium difficile infection in the US by population attributable risk analysis.
This study determined the population attributable risk percent (PAR%) for Clostridium difficile infection (CDI) in various subpopulations in the Medicare 5% random sample. It found that small and identifiable subpopulations that account for relatively large proportions of CDI cases in the elderly were identified. These data can be used to target specific subpopulations for CDI prevention interventions.
AHRQ-funded; HS019455.
Citation: Dubberke ER, Olsen MA, Stwalley D .
Identification of Medicare recipients at highest risk for Clostridium difficile infection in the US by population attributable risk analysis.
PLoS One 2016 Feb 9;11(2):e0146822. doi: 10.1371/journal.pone.0146822.
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Keywords: Medicare, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Risk