National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (3)
- Antibiotics (1)
- Cancer (1)
- Caregiving (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (2)
- Clinician-Patient Communication (1)
- Clostridium difficile Infections (2)
- Community-Acquired Infections (1)
- Decision Making (1)
- Depression (1)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Falls (4)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (6)
- Health Information Technology (HIT) (1)
- Hospitals (2)
- Injuries and Wounds (3)
- Inpatient Care (2)
- Long-Term Care (1)
- Medication (1)
- Organizational Change (1)
- Palliative Care (1)
- (-) Patient Safety (15)
- Prevention (2)
- (-) Risk (15)
- Skin Conditions (1)
- Surgery (4)
- Tools & Toolkits (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 15 of 15 Research Studies DisplayedGianfrancesco MA, Schmajuk G, Haserodt S
Hydroxychloroquine dosing in immune-mediated diseases: implications for patient safety.
Evidence suggests that hydroxychloroquine (HCQ) retinal toxicity is more common than previously thought. Adhering to careful weight-based dosing can significantly reduce the risk of this adverse event and is recommended in recent guidelines. The study authors used electronic health record data from a large health system to examine HCQ dosing over a 5-year period and identify risk factors associated with higher dosage of HCQ.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Schmajuk G, Haserodt S .
Hydroxychloroquine dosing in immune-mediated diseases: implications for patient safety.
Rheumatol Int 2017 Oct;37(10):1611-18. doi: 10.1007/s00296-017-3782-6..
Keywords: Adverse Drug Events (ADE), Patient Safety, Risk, Skin Conditions
Sittig DF, Singh H
Toward more proactive approaches to safety in the electronic health record era.
This article discusses a proactive approach to safety in the electronic health record era. It discusses an updated health IT Sentinel Event Alert, released in March 2015 by the Joint Commission which took a broad, sociotechnical approach in exploring the factors involved in the safe use of health IT.
AHRQ-funded; HS023602; HS022087.
Citation: Sittig DF, Singh H .
Toward more proactive approaches to safety in the electronic health record era.
Jt Comm J Qual Patient Saf 2017 Oct;43(10):540-47. doi: 10.1016/j.jcjq.2017.06.005..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Guidelines, Organizational Change, Risk
Jackson SS, Leekha S, Magder LS
Electronically available comorbidities should be used in surgical site infection risk adjustment.
A multicenter retrospective cohort study of patients undergoing surgical procedures at 28 US hospitals was performed. The authors developed a well-performing risk adjustment model for surgical site infections (SSI) using electronically available comorbidities. Healthcare-associated infections, such as SSIs, are used by the Centers for Medicare and Medicaid Services (CMS) as pay-for-performance metrics. The authors recommended that comorbidity-based risk adjustment should be strongly considered by the Centers for Disease Control and Prevention and CMS to adequately compare SSI rates across hospitals.
AHRQ-funded; HS022291.
Citation: Jackson SS, Leekha S, Magder LS .
Electronically available comorbidities should be used in surgical site infection risk adjustment.
Clin Infect Dis 2017 Sep 1;65(5):803-10. doi: 10.1093/cid/cix431..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Risk, Injuries and Wounds, Adverse Events
Saiman L, Maykowski P, Murray M
Incidence, risks, and types of infections in pediatric long-term care facilities.
The researchers described the types of infections diagnosed in residents of pediatric long-term care facilities, calculate infection rates, and identified risk factors for respiratory tract infections (RTIs). RTIs were the most common infections diagnosed, but modifiable risk factors for RTIs were not identified. Also included in the study were skin and soft-tissue infections; chronic comorbid conditions, including neurologic and respiratory disorders; and device use.
AHRQ-funded; HS021470.
Citation: Saiman L, Maykowski P, Murray M .
Incidence, risks, and types of infections in pediatric long-term care facilities.
JAMA Pediatr 2017 Sep;171(9):872-78. doi: 10.1001/jamapediatrics.2017.1482.
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Keywords: Healthcare-Associated Infections (HAIs), Long-Term Care, Patient Safety, Children/Adolescents, Risk
Olsen MA, Nickel KB, Fraser VJ
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
This study determined utilization, predictors, and outcomes of postdischarge prophylactic antibiotics after mastectomy with or without immediate breast reconstruction. The study conclude that prophylactic postdischarge antibiotics are commonly prescribed after mastectomy; immediate reconstruction is the strongest predictor. The authors recommended stewardship efforts in this population to limit continuation of prophylactic antibiotics after discharge are needed to limit antimicrobial resistance.
AHRQ-funded; HS019455.
Citation: Olsen MA, Nickel KB, Fraser VJ .
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1048-54. doi: 10.1017/ice.2017.128.
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Keywords: Antibiotics, Healthcare-Associated Infections (HAIs), Medication, Patient Safety, Surgery, Injuries and Wounds, Prevention, Adverse Events, Risk
Jackson SS, Leekha S, Magder LS
The effect of adding comorbidities to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology.
The authors of this study hypothesized that risk adjustment would be improved by including patient demographics and comorbidities from electronically available hospital discharge codes to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology. They concluded that their risk-adjustment model for CLABSI using electronically available comorbidities demonstrated better discrimination than did the CDC model.
AHRQ-funded; HS022291.
Citation: Jackson SS, Leekha S, Magder LS .
The effect of adding comorbidities to current Centers for Disease Control and Prevention central-line-associated bloodstream infection risk-adjustment methodology.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1019-24. doi: 10.1017/ice.2017.129..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Risk
Dykes PC, Duckworth M, Cunningham S
Pilot testing Fall TIPS (Tailoring Interventions for Patient Safety): a patient-centered fall prevention toolkit.
Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. The investigators examined strategies to integrate this evidence into clinical practice. They concluded that engaging hospital and clinical leadership is critical in translating evidence-based care into clinical practice. They address and detail barriers to adoption of the protocol to provide guidance for spread to other institutions.
AHRQ-funded; HS025128.
Citation: Dykes PC, Duckworth M, Cunningham S .
Pilot testing Fall TIPS (Tailoring Interventions for Patient Safety): a patient-centered fall prevention toolkit.
Jt Comm J Qual Patient Saf 2017 Aug;43(8):403-13. doi: 10.1016/j.jcjq.2017.05.002..
Keywords: Clinical Decision Support (CDS), Decision Making, Evidence-Based Practice, Falls, Hospitals, Injuries and Wounds, Inpatient Care, Patient Safety, Prevention, Risk, Tools & Toolkits
Galambos C, Rantz M, Back J
Older adults' perceptions of and preferences for a fall risk assessment system: exploring stages of acceptance model.
The study aim was to explore the perceptions and preferences of older adults and their family members about a fall risk assessment system. Using a qualitative approach, this study found that there was acceptance of the technology as participants adapted to it. Two themes were present across the five points in time-safety and usefulness. Five stages of acceptance emerged from the data from preinstallation to 2 years postinstallation.
AHRQ-funded; HS018477.
Citation: Galambos C, Rantz M, Back J .
Older adults' perceptions of and preferences for a fall risk assessment system: exploring stages of acceptance model.
Comput Inform Nurs 2017 Jul;35(7):331-37. doi: 10.1097/cin.0000000000000330.
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Keywords: Elderly, Falls, Risk, Patient Safety
Le P, Martinez KA, Pappas MA
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
To determine a threshold for prophylaxis based on risk of venous thromboembolism, the researchers constructed a decision model with a decision-tree following patients for 3 months after hospitalization, and a lifetime Markov model with 3-month cycles. They found that the prophylaxis threshold was relatively insensitive to low-molecular-weight heparin cost and bleeding risk, but very sensitive to patient age and life expectancy.
AHRQ-funded; HS022883.
Citation: Le P, Martinez KA, Pappas MA .
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
J Thromb Haemost 2017 Jun;15(6):1132-41. doi: 10.1111/jth.13687.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Inpatient Care, Patient Safety, Risk
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
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
Hoffman GJ, Hays RD, Wallace SP
Depressive symptomatology and fall risk among community-dwelling older adults.
The directionality of observed relationship between falls and depressive symptoms (DS) is in need of elaboration given that cross-sectional study designs can yield biased estimates of the DS-falls relationship. This study found that the DS-falls relationship was not significant when use of psychiatric medications, which was positively associated with falls, was included in the model.
AHRQ-funded; HS000046.
Citation: Hoffman GJ, Hays RD, Wallace SP .
Depressive symptomatology and fall risk among community-dwelling older adults.
Soc Sci Med 2017 Apr;178:206-13. doi: 10.1016/j.socscimed.2017.02.020.
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Keywords: Depression, Elderly, Falls, Patient Safety, Risk
Hoffman GJ, Hays RD, Wallace SP
Receipt of caregiving and fall risk in US community-dwelling older adults.
The researchers examined whether receipt of low (0-13 weekly hours) and high levels (>/=14 weekly hours) of informal care or any formal care is associated with lower risk of falls and fall-related injuries (FRI) among community-dwelling older adults. They found that among individuals with >/=3 activities of daily living, fall risks were reduced by 21 percent for those receiving high levels of informal care.
AHRQ-funded; HS000046.
Citation: Hoffman GJ, Hays RD, Wallace SP .
Receipt of caregiving and fall risk in US community-dwelling older adults.
Med Care 2017 Apr;55(4):371-78. doi: 10.1097/mlr.0000000000000677.
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Keywords: Caregiving, Elderly, Falls, Risk, Patient Safety
Harris AD, Pineles L, Anderson D
Which comorbid conditions should we be analyzing as risk factors for healthcare-associated infections?
This study sought to determine which comorbid conditions are considered causally related to central-line associated bloodstream infection (CLABSI) and surgical-site infection (SSI) based on expert consensus. Its results have produced a list of comorbid conditions that should be analyzed as risk factors for and further explored for risk adjustment of CLABSI and SSI.
AHRQ-funded; HS022291.
Citation: Harris AD, Pineles L, Anderson D .
Which comorbid conditions should we be analyzing as risk factors for healthcare-associated infections?
Infect Control Hosp Epidemiol 2017 Apr;38(4):449-54. doi: 10.1017/ice.2016.314.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Risk, Surgery
Nabozny MJ, Kruser JM, Steffens NM
Patient-reported limitations to surgical buy-in: a qualitative study of patients facing high-risk surgery.
The researchers characterized how patients buy-in to treatments beyond the operating room and what limits they would place on additional life-supporting treatments. Their recordings of patients' pre- and post-operative conversations with surgeons showed that patients expressed trust in their surgeon to make decisions about additional treatments if a serious complication occurred. However, patients expressed a preference for significant treatment limitations that were not discussed with their surgeon preoperatively.
AHRQ-funded; HS000078.
Citation: Nabozny MJ, Kruser JM, Steffens NM .
Patient-reported limitations to surgical buy-in: a qualitative study of patients facing high-risk surgery.
Ann Surg 2017 Jan;265(1):97-102. doi: 10.1097/sla.0000000000001645.
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Keywords: Surgery, Palliative Care, Risk, Clinician-Patient Communication, Patient Safety