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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Behavioral Health (1)
- Brain Injury (1)
- Care Management (2)
- Children/Adolescents (3)
- Communication (1)
- (-) Critical Care (19)
- Decision Making (1)
- Diagnostic Safety and Quality (2)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
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- Healthcare Utilization (1)
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- (-) Intensive Care Unit (ICU) (19)
- Medical Errors (1)
- Medication (2)
- Mortality (1)
- Neurological Disorders (3)
- Nursing (1)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (3)
- Patient Safety (3)
- Practice Patterns (1)
- Prevention (1)
- Provider: Health Personnel (1)
- Provider Performance (1)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (2)
- Quality of Life (1)
- Respiratory Conditions (3)
- Teams (2)
- 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 19 of 19 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
Wysham NG, Hochman MJ, Wolf SP
Performance of consultative palliative care model in achieving quality metrics in the ICU.
The purpose of this paper was to assess adherence to proposed quality metrics of ICU-based palliative care by palliative care specialists. The authors found that palliative care consultations in an ICU setting are characterized by variable adherence to candidate ICU palliative care quality metrics. Although symptom management was the foremost reason for palliative care consultation, consultants infrequently documented symptom assessments. The consultants performed better in offering spiritual support and managing documented symptoms.
AHRQ-funded; HS023681.
Citation: Wysham NG, Hochman MJ, Wolf SP .
Performance of consultative palliative care model in achieving quality metrics in the ICU.
J Pain Symptom Manage 2016 Dec;52(6):873-77. doi: 10.1016/j.jpainsymman.2016.05.026.
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Keywords: Critical Care, Intensive Care Unit (ICU), Palliative Care, Quality of Care, Quality Measures
Sakata KK, Stephenson LS, Mulanax A
Professional and interprofessional differences in electronic health records use and recognition of safety issues in critically ill patients.
The authors conducted this study to determine how each professional group - physicians, nurses, and pharmacists - reviews electronic health records (EHR) data in preparation for rounds and their ability to identify patient safety issues. They found significant and non-overlapping differences in individual profession recognition of patient safety issues in the EHR which may be attributed to differences in EHR use.
AHRQ-funded; HS023793; HS021637.
Citation: Sakata KK, Stephenson LS, Mulanax A .
Professional and interprofessional differences in electronic health records use and recognition of safety issues in critically ill patients.
J Interprof Care 2016 Sep;30(5):636-42. doi: 10.1080/13561820.2016.1193479.
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Keywords: Critical Care, Electronic Health Records (EHRs), Provider: Health Personnel, Intensive Care Unit (ICU), Patient Safety
Costa DK, Dammeyer J, White M
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
The purpose of this study was to examine the reliability of an observational rating tool to assess team interactions about the awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle in one ICU. It provided pilot evidence of reliability of an observational rating tool to assess interprofessional team interactions about ABCDE.
AHRQ-funded; HS024552.
Citation: Costa DK, Dammeyer J, White M .
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
BMC Res Notes 2016 Aug 18;9:408. doi: 10.1186/s13104-016-2213-1.
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Keywords: Healthcare Delivery, Communication, Critical Care, Intensive Care Unit (ICU), Teams
Lyu PF, Hockenberry JM, Gaydos LM
Impact of a sequential intervention on albumin utilization in critical care.
The authors evaluated the effect of a sequential multifaceted intervention on decreasing albumin use in the intensive care unit. They found that a sequential intervention achieved significant reductions in albumin use and cost savings without changes in patient outcomes, supporting the combination of financial and nonfinancial strategies to align providers with evidence-based practices.
AHRQ-funded; HS000055.
Citation: Lyu PF, Hockenberry JM, Gaydos LM .
Impact of a sequential intervention on albumin utilization in critical care.
Crit Care Med 2016 Jul;44(7):1307-13. doi: 10.1097/ccm.0000000000001638.
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Keywords: Critical Care, Healthcare Utilization, Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Practice Patterns
Sjoding MW, Prescott HC, Wunsch H
Longitudinal changes in ICU admissions among elderly patients in the United States.
The researchers sought to describe the changing demographics, diagnoses, and outcomes of patients admitted to critical care units in the U.S. hospitals. They ound that patients with infectious diseases increased from 8.8 percent to 17.2 percent of admissions, and explicitly labeled sepsis moved from the 11th-ranked diagnosis in 1996 to the top-ranked primary discharge diagnosis in 2010.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Prescott HC, Wunsch H .
Longitudinal changes in ICU admissions among elderly patients in the United States.
Crit Care Med 2016 Jul;44(7):1353-60. doi: 10.1097/ccm.0000000000001664.
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Keywords: Elderly, Intensive Care Unit (ICU), Hospitalization, Diagnostic Safety and Quality, Critical Care
Baird J, Rehm RS, Hinds PS
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
The objective of this analysis was to explore the delivery of continuity of nursing care in the pediatric intensive care unit (PICU), from the perspective of both parents and nurses. Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child's care regimen.
AHRQ-funded; HS000063.
Citation: Baird J, Rehm RS, Hinds PS .
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
Nurs Res 2016 Mar-Apr;65(2):142-50. doi: 10.1097/nnr.0000000000000135.
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Keywords: Care Management, Children/Adolescents, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU), Nursing
Collinsworth AW, Priest EL, Campbell CR
A review of multifaceted care approaches for the prevention and mitigation of delirium in intensive care units.
The objective of this review was to examine the effectiveness, implementation, and costs of multifaceted care approaches, including care bundles, for the prevention and mitigation of delirium in patients hospitalized in intensive care units (ICUs). It concluded that although multifaceted care approaches may reduce delirium and improve patient outcomes, greater improvements may be achieved by deploying a comprehensive bundle of care practices.
AHRQ-funded; HS021459.
Citation: Collinsworth AW, Priest EL, Campbell CR .
A review of multifaceted care approaches for the prevention and mitigation of delirium in intensive care units.
J Intensive Care Med 2016 Feb;31(2):127-41. doi: 10.1177/0885066614553925.
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Keywords: Intensive Care Unit (ICU), Prevention, Evidence-Based Practice, Critical Care, Quality of Care
Hasvold J, Sjoding M, Pohl K
The role of human metapneumovirus in the critically ill adult patient.
The purpose of the study is to describe the role of human metapneumovirus (hMPV) infection in critical illness and acute respiratory distress syndrome (ARDS). It concluded that although most patients hospitalized with hMPV had chronic cardiac or pulmonary disease, hMPV can also be associated with serious respiratory illness and ARDS in adult patients without significant comorbidities or immunosuppression.
AHRQ-funded; HS020672.
Citation: Hasvold J, Sjoding M, Pohl K .
The role of human metapneumovirus in the critically ill adult patient.
J Crit Care 2016 Feb;31(1):233-7. doi: 10.1016/j.jcrc.2015.09.035.
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Keywords: Critical Care, Respiratory Conditions, Intensive Care Unit (ICU), Hospitalization
Nagendran M, Dimick JB, Gonzalez AA
Mortality among older adults before versus after hospital transition to intensivist staffing.
The researchers sought to determine whether hospitals can reduce their mortality by adopting an intensivist staffing model. Adoption of an intensivist staffing model was not associated with improved mortality in Medicare beneficiaries. These findings suggest that the lower mortality rates previously observed at hospitals with intensivist staffing may be attributable to other factors.
AHRQ-funded; HS023621; HS024403.
Citation: Nagendran M, Dimick JB, Gonzalez AA .
Mortality among older adults before versus after hospital transition to intensivist staffing.
Med Care 2016 Jan;54(1):67-73. doi: 10.1097/mlr.0000000000000446.
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Keywords: Mortality, Elderly, Intensive Care Unit (ICU), Hospitalization, Critical Care