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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 9 of 9 Research Studies Displayed
Wang J, Gong Y
Potential of decision support in preventing pressure ulcers in hospitals.
The development of hospital-acquired pressure ulcers signals low quality of care. To meet the challenges of consistently translating best practices into effective clinical practices and promote effective teamwork communication and interprofessional collaboration, the authors consider the failure of consistent care delivery as loss of information and reveal the opportunities of informatics methods to reinforce information delivery, evidenced by typical cases. They then explain and summarize information-related issues existing at the initial assessment upon hospital admission, routine treatments, and team communication.
Citation: Wang J, Gong Y . Potential of decision support in preventing pressure ulcers in hospitals. Stud Health Technol Inform 2017;241:15-20.
Keywords: Clinical Decision Support (CDS), Decision Making, Hospitals, Patient Safety, Pressure Ulcers, Prevention
Soban LM, Kim L, Yuan AH
Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.
The researchers describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high level.
Citation: Soban LM, Kim L, Yuan AH . Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey. J Nurs Manag 2017 Sep;25(6):457-67. doi: 10.1111/jonm.12416.
Keywords: Pressure Ulcers, Prevention, Hospitals, Patient Safety, Implementation, Organizational Change
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
Citation: Baernholdt M, Hinton ID, Guofen Y . A national comparison of rural/urban pressure ulcer and fall rates. Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health
Padula WV, Gibbons RD, Pronovost PJ
Using clinical data to predict high-cost performance coding issues associated with pressure ulcers: a multilevel cohort model.
Hospital-acquired pressure ulcers (HAPUs) have a mortality rate of 11.6 percent, are costly to treat, and result in Medicare reimbursement penalties. The study’s objective was to use electronic health records to predict pressure ulcers and to identify coding issues leading to penalties. Its analysis identified spinal cord injuries as high risk for HAPUs and as being often inappropriately coded without paralysis.
Citation: Padula WV, Gibbons RD, Pronovost PJ . Using clinical data to predict high-cost performance coding issues associated with pressure ulcers: a multilevel cohort model. J Am Med Inform Assoc 2017 Apr 1;24(e1):e95-e102. doi: 10.1093/jamia/ocw118.
Keywords: Electronic Health Records (EHRs), Healthcare Costs, Hospitals, Pressure Ulcers, Spinal Cord Injury
Brennan MB, Hess TM, Bartle B
Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes.
Diabetic foot ulcers are associated with an increased risk of death. This study evaluated whether ulcer severity at presentation predicts mortality. It concluded that initial diabetic foot ulcer severity is a more significant predictor of subsequent mortality than coronary artery disease, peripheral arterial disease, or stroke.
Citation: Brennan MB, Hess TM, Bartle B . Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes. J Diabetes Complications. 2017 Mar;31(3):556-561. doi: 10.1016/j.jdiacomp.2016.11.020..
Keywords: Diabetes, Mortality, Veterans, Chronic Conditions, Pressure Ulcers
Krishnan S, Karg PE, Boninger ML
Early detection of pressure ulcer development following traumatic spinal cord injury using inflammatory mediators.
The authors aimed to identify changes in concentrations of inflammatory mediators in plasma and urine after traumatic spinal cord injury and before the occurrence of a first pressure ulcer. They found that an increase in concentration of the chemokine interferon-γ-induced protein in plasma and a decrease in concentration of the cytokine interferon-α in urine were observed before occurrence of a first pressure ulcer compared with matched controls. They concluded that inflammatory mediators should be explored as possible biomarkers for identifying individuals at risk for pressure ulcer formation.
Citation: Krishnan S, Karg PE, Boninger ML . Early detection of pressure ulcer development following traumatic spinal cord injury using inflammatory mediators. Arch Phys Med Rehabil 2016 Oct;97(10):1656-62. doi: 10.1016/j.apmr.2016.01.003.
Keywords: Adverse Events, Pressure Ulcers, Spinal Cord Injury
Spector WD, Limcangco R, Owens PL
AHRQ Author: Spector WD, Limcangco R, Owens PL, Steiner CA
Marginal hospital cost of surgery-related hospital-acquired pressure ulcers.
The researchers estimated the hospital marginal cost of a hospital-acquired pressure ulcer (HAPU) for adults patients who were hospitalized for major surgeries, adjusted for patient characteristics, comorbidities, procedures, and hospital characteristics. They found that 3.5 percent of major surgical patients developed HAPUs and that the HAPUs added approximately $8,200 to the cost of a surgical stay after adjusting for comorbidities, patient characteristics, procedures, and hospital characteristics.
Citation: Spector WD, Limcangco R, Owens PL . Marginal hospital cost of surgery-related hospital-acquired pressure ulcers. Med Care 2016 Sep;54(9):845-51. doi: 10.1097/mlr.0000000000000558.
Keywords: Pressure Ulcers, Surgery, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Patient Safety
Padula WV, Gibbons RD, Valuck RJ
Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers?
The objective of this study was to evaluate the longitudinal impact of CMS policy and quality improvement adoption on hospital-acquired pressure ulcers (HAPU) rates. It concluded that HAPU rates were significantly lower after changes in CMS reimbursement. Reductions are associated with hospital-wide implementation of evidence-based practices for HAPU prevention.
Citation: Padula WV, Gibbons RD, Valuck RJ . Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers? Med Care 2016 May;54(5):512-8. doi: 10.1097/mlr.0000000000000516..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Pressure Ulcers, Quality Improvement
Creehan S, Cuddigan J, Gonzales D
The VCU pressure ulcer summit-developing centers of pressure ulcer prevention excellence: a framework for sustainability.
The purpose of this paper is to present a framework describing the proposed Magnet-designated Centers of Pressure Ulcer Prevention Excellence resulting from a national summit convened at the Virginia Commonwealth University Medical Center in March 2014. The authors discussed the structures, processes, and outcome measures necessary to become a proposed Center of Pressure Ulcer Prevention Excellence.
Citation: Creehan S, Cuddigan J, Gonzales D . The VCU pressure ulcer summit-developing centers of pressure ulcer prevention excellence: a framework for sustainability. J Wound Ostomy Continence Nurs 2016 Mar-Apr;43(2):121-8. doi: 10.1097/won.0000000000000203.
Keywords: Guidelines, Healthcare-Associated Infections (HAIs), Outcomes, Patient Safety, Pressure Ulcers