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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 8 of 8 Research Studies Displayed
Davidson C, Loganathan S, Bishop L
AHRQ Author: Bergofsky L, Spector W
Scalability of an IT intervention to prevent pressure ulcers in nursing homes.
Researchers assessed the scalability of the On-Time Pressure Ulcer Prevention intervention strategy in nursing homes nationwide. They found that the overall decline in pressure ulcer rates for treatment relative to matched comparison homes was statistically insignificant.
AHRQ-authored; AHRQ-funded; 2332010500023I.
Citation: Davidson C, Loganathan S, Bishop L . Scalability of an IT intervention to prevent pressure ulcers in nursing homes. J Am Med Dir Assoc 2019 Jul;20(7):816-21.e2. doi: 10.1016/j.jamda.2019.02.008..
Keywords: Elderly, Health Information Technology (HIT), Nursing Homes, Patient-Centered Outcomes Research, Prevention, Pressure Ulcers
Santosa KB, Keller M, Olsen MA
Negative-pressure wound therapy in infants and children: a population-based study.
Although the safety and benefits of negative-pressure wound therapy (NPWT) have been clearly demonstrated in the adult population, studies evaluating the safety and describing the use of NPWT in the pediatric population have been limited. In this study, the investigators performed a literature review and analyzed the Truven Health Analytics MarketScan Commercial Claims Databases from 2006 to 2014 to identify infants and children treated with NPWT.
Citation: Santosa KB, Keller M, Olsen MA . Negative-pressure wound therapy in infants and children: a population-based study. J Surg Res 2019 Mar;235:560-68. doi: 10.1016/j.jss.2018.10.043..
Keywords: Children/Adolescents, Newborns/Infants, Pressure Ulcers, Injuries and Wounds, Care Management, Patient Safety
Padula WV, Pronovost PJ, Makic MBF
Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis.
The objective of this study was to analyze the cost-utility of repeated risk-assessments for pressure-injury prevention in all hospital patients or in high-risk groups. Hospitalized adults were classified by Braden Scale scores into five risk levels: very high risk, high risk, moderate risk, at-risk, and minimal risk. The costs of pressure-injury treatment and prevention, and quality-adjusted life years (QALYs) related to pressure injuries were weighted by transition probabilities to calculate the incremental cost-effectiveness ratio. The results of the study indicate that simulating prevention for all patients yielded greater QALYs at higher cost from societal and healthcare sector perspectives. Prevention for all patients was cost-effective in more than 99% of probabilistic simulations. The authors conclude that hospitals should invest in nursing compliance with international prevention guidelines.
Citation: Padula WV, Pronovost PJ, Makic MBF . Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis. BMJ Qual Saf 2019 Feb;28(2):132-41. doi: 10.1136/bmjqs-2017-007505..
Keywords: Healthcare Costs, Hospitals, Pressure Ulcers, Prevention, Value
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