National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (5)
- Anxiety (1)
- Behavioral Health (1)
- Case Study (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Education: Patient and Caregiver (1)
- Elderly (11)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Evidence-Based Practice (1)
- (-) Falls (20)
- Health Information Technology (HIT) (2)
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- Injuries and Wounds (7)
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- Long-Term Care (1)
- Medicare (1)
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- Nursing (1)
- Nursing Homes (4)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (2)
- Patient Safety (7)
- Prevention (10)
- Provider (1)
- Public Reporting (1)
- Quality Indicators (QIs) (2)
- Quality Measures (2)
- Quality of Care (2)
- Risk (6)
- Rural Health (1)
- Teams (1)
- Tools & Toolkits (1)
- Training (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Urban Health (1)
- Young Adults (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 20 of 20 Research Studies DisplayedPatterson BW, Jacobsohn GC, Maru AP
Comparing strategies for identifying falls in older adult emergency department visits using EHR data.
This study compared seven different strategies for identifying falls in older adult emergency department (ED) visits using electronic health record (EHR) data. This retrospective cohort study used randomly selected data from 500 ED visits by patients 65 and older at an academic medical center from December 2016 to April 2017. The seven strategies tested were: Chief complaint (CC), ICD codes, Restrictive ICD codes, Broad ICD codes, Combined approaches, Natural language processing (NLP), and Manual abstraction (gold standard). When compared with manual chart review, NLP was found to be the most accurate fall identification strategy, followed by a combination of a restrictive ICD code-based definition with CC.
AHRQ-funded; HS024558.
Citation: Patterson BW, Jacobsohn GC, Maru AP .
Comparing strategies for identifying falls in older adult emergency department visits using EHR data.
J Am Geriatr Soc 2020 Dec;68(12):2965-67. doi: 10.1111/jgs.16831..
Keywords: Elderly, Falls, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT)
Dykes PC, Burns Z, Adelman J
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
The purpose of this study was to assess whether a fall-prevention tool kit that engages patients and families in the fall-prevention process throughout hospitalization is associated with reduced falls and injurious falls. Findings showed that, in this nonrandomized controlled trial, implementation of a fall-prevention tool kit was associated with a significant reduction in falls and related injuries. A patient-care team partnership appeared to be beneficial for prevention of falls and fall-related injuries.
AHRQ-funded; HS023535.
Citation: Dykes PC, Burns Z, Adelman J .
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
JAMA Netw Open 2020 Nov 2;3(11):e2025889. doi: 10.1001/jamanetworkopen.2020.25889..
Keywords: Falls, Injuries and Wounds, Prevention, Tools & Toolkits, Patient and Family Engagement, Patient-Centered Healthcare, Clinical Decision Support (CDS), Hospitalization, Hospitals
Burns Z, Khasnabish S, Hurley AC
Classification of injurious fall severity in hospitalized adults.
The purpose of this project was to refine the National Database of Nursing Quality Indicators Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries. Three subcategories were created: A - injuries that caused temporary functional impairment, major facial injury without internal injury, or disruption of a surgical wound; B - injuries that caused long-term functional impairment or had the potential risk of increased mortality; and C - injuries that had a well-established risk of mortality. These subcategories enhanced the National Database of Nursing Quality Indicators categorization. Using this project’s administration manual, trained personnel can classify injurious fall severity with excellent reliability.
AHRQ-funded; HS025128.
Citation: Burns Z, Khasnabish S, Hurley AC .
Classification of injurious fall severity in hospitalized adults.
J Gerontol A Biol Sci Med Sci 2020 Sep 25;75(10):e138-e44. doi: 10.1093/gerona/glaa004..
Keywords: Elderly, Falls, Injuries and Wounds, Nursing, Quality Measures, Quality Indicators (QIs), Quality of Care, Inpatient Care
Hoffman GJ, Tinetti ME, Ha J
Prehospital and posthospital fall injuries in older US adults.
Investigators estimated the risk of older adult fall injury within and across discrete periods during a 12-month care episode anchored by an acute hospitalization using national data from 2006 to 2014. Participants in this cohort study included Medicare fee-for-service beneficiaries aged 65 and older from the Health and Retirement Study. The investigators found that an episode-based assessment of fall injury illustrated substantial variability in period-specific risks over an extended period including an anchor hospitalization. Risk transitions between periods included sizable increases just before hospitalization that do not fully subside after hospital discharge. Financial incentives to coordinate hospital and posthospital care for patients at risk for fall injury are needed.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Tinetti ME, Ha J .
Prehospital and posthospital fall injuries in older US adults.
JAMA Netw Open 2020 Aug 3;3(8):e2013243. doi: 10.1001/jamanetworkopen.2020.13243..
Keywords: Elderly, Falls, Injuries and Wounds, Risk, Hospitalization, Medicare
Lurie JD, Zagaria AB, Ellis L
Surface perturbation training to prevent falls in older adults: a highly pragmatic, randomized controlled trial.
This study’s objective was to determine if adding a component of surface-perturbation training to usual gait/balance training was more effective than gait/balance training alone for reducing falls and fall-related injuries in high-risk older adults referred to physical therapy. This multi-center trial took place at 8 outpatient physical therapy clinics. The cohort included 506 patients aged 65 and older at high fall risk. The group was randomized between treatment with and without surface-perturbation treadmill training. The results were that the training did not significantly reduce risk of any fall but did significantly reduce chance of a fall-related injury after the first 3 months.
AHRQ-funded; HS018459.
Citation: Lurie JD, Zagaria AB, Ellis L .
Surface perturbation training to prevent falls in older adults: a highly pragmatic, randomized controlled trial.
Phys Ther 2020 Jul 19;100(7):1153-62. doi: 10.1093/ptj/pzaa023..
Keywords: Elderly, Falls, Prevention, Training
Bushnell GA, Gerhard T, Crystal S
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
This study examined whether benzodiazepine treatment increases fall and fracture risk in young persons as it has been shown to do in older adults. They examined whether children (6-17 years) and young adults (18-24) recently diagnosed with anxiety disorder had an increased fracture risk. A cohort of commercially insured children and young adults who had initiated use of benzodiazepine or SSRIs were followed for 3 months, or until fracture, treatment discontinuation or switching or disenrollment occurred. The cohort consisted of 120,715 children and 179,768 young adults. There was an increased fracture rate found in children, but not young adults.
AHRQ-funded; HS026001.
Citation: Bushnell GA, Gerhard T, Crystal S .
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
Pediatrics 2020 Jul;146(1):e20193478. doi: 10.1542/peds.2019-3478..
Keywords: Children/Adolescents, Young Adults, Medication, Falls, Injuries and Wounds, Risk, Anxiety, Behavioral Health
Sanghavi P, Pan S, Caudry D
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
The purpose of this study was to assess the accuracy of nursing home self-report of major injury falls on the Minimum Data Set (MDS). They linked inpatient claims for major injury falls with MDS assessments. The investigators concluded that the nursing home-reported data used for the Nursing Home Compare (NHC) falls measure may be highly inaccurate.
AHRQ-funded; HS026957.
Citation: Sanghavi P, Pan S, Caudry D .
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
Health Serv Res 2020 Apr;55(2):201-10. doi: 10.1111/1475-6773.13247..
Keywords: Falls, Nursing Homes, Quality Measures, Quality Indicators (QIs), Quality of Care, Elderly, Public Reporting, Injuries and Wounds
Christiansen TL, Lipsitz S, Scanlan M
Patient activation related to fall prevention: a multisite study.
The purpose of this study was to examine the impact of the Fall TIPS (Tailoring Interventions for Patient Safety) program on patient activation related to fall prevention. Researchers used the short form Patient Activation Measure (PAM-13) adapted for fall prevention. Their findings showed that patient activation improved from preintervention to postintervention at all three studied sites. Patients with access to the Fall TIPS program are more activated and engaged in their fall prevention plan. Recommendations include engaging patients in the fall prevention plan to increase their knowledge, skill, and confidence.
AHRQ-funded; HS023535.
Citation: Christiansen TL, Lipsitz S, Scanlan M .
Patient activation related to fall prevention: a multisite study.
Jt Comm J Qual Patient Saf 2020 Mar;46(3):129-35. doi: 10.1016/j.jcjq.2019.11.010..
Keywords: Falls, Prevention, Patient Safety, Patient and Family Engagement, Education: Patient and Caregiver
Khasnabish S, Burns Z, Couch M
Best practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program.
This case report applied principles from the data visualization literature and feedback from nurses to develop an effective report to display adherence with an evidence-based fall prevention program. The literature emphasized that the ideal display maximizes the information communicated, minimizes the cognitive efforts involved with interpretation, and selects the correct type of display. Lessons learned from this study can inform report development for clinicians in implementation science.
AHRQ-funded; HS025128.
Citation: Khasnabish S, Burns Z, Couch M .
Best practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program.
J Am Med Inform Assoc 2020 Feb;27(2):308-14. doi: 10.1093/jamia/ocz190..
Keywords: Falls, Prevention, Evidence-Based Practice
Kang H, Zhou S, Yao B
A prototype of knowledge-based patient safety event reporting and learning system.
In this study, a hierarchical list of contributing factors for patient falls, based on the key contributing factors defined by AHRQ Common Formats 2.0, was established by expert review and discussion. Using the list as an infrastructure, the investigators designed and developed a novel reporting system, where a strategy to identify contributing factors was intended to provide reporters knowledge support, in the form of similar cases and potential solutions.
AHRQ-funded; HS022895.
Citation: Kang H, Zhou S, Yao B .
A prototype of knowledge-based patient safety event reporting and learning system.
BMC Med Inform Decis Mak 2018 Dec 7;18(Suppl 5):110. doi: 10.1186/s12911-018-0688-5..
Keywords: Adverse Events, Patient Safety, Falls
Jayadevappa R, Chhatre S, Newman DK
Association between overactive bladder treatment and falls among older adults.
The purpose of this study was to analyze the risk of falls associated with overactive bladder (OAB) and the effects of OAB treatment on falls among older adult Medicare fee-for-service enrollees. Results showed that a diagnosis of OAB was associated with higher odds of falls compared to those without OAB and that treatment for OAB was associated with lower odds of falls compared to those untreated.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Newman DK .
Association between overactive bladder treatment and falls among older adults.
Neurourol Urodyn 2018 Nov;37(8):2688-94. doi: 10.1002/nau.23719..
Keywords: Falls, Elderly, Patient Safety
Noureldin M, Hass Z, Abrahamson K
Fall risk, supports and services, and falls following a nursing home discharge.
The purpose of this study was to examine whether the presence of supports and services have an impact on the relationship between fall-related risk factors and fall occurrence following a nursing-home discharge. The study sample was comprised of 1459 participants in the Minnesota Return to Community Initiative, who had been assisted in achieving a community discharge; 15 percent of participants fell within 30 days of nursing-home discharge. A structural equation model was used to determine relationship between emerging latent variables and falls. Results indicated that use of high-risk medications and fall concerns/history had a direct, positive effect on falling. Receiving supports/services did not have a direct effect on falls, but the authors note that it reduced the effect of high-risk medication use on falling.
AHRQ-funded; HS020224.
Citation: Noureldin M, Hass Z, Abrahamson K .
Fall risk, supports and services, and falls following a nursing home discharge.
Gerontologist 2018 Nov 3;58(6):1075-84. doi: 10.1093/geront/gnx133..
Keywords: Adverse Events, Elderly, Falls, Nursing Homes, Risk
Baernholdt M, Hinton ID
Fall rates in urban and rural nursing units: does location matter?
This paper discusses a study of fall rates in 65 rural hospitals with 222 nursing units and 560 urban hospitals with 4274 nursing units. The authors found that geographic region, unit type, and nurse staffing, education, experience, and outcomes were associated with fall rates.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID .
Fall rates in urban and rural nursing units: does location matter?
J Nurs Care Qual 2018 Oct/Dec;33(4):326-33. doi: 10.1097/ncq.0000000000000319..
Keywords: Falls, Patient Safety, Rural Health, Urban Health
Fan T, Erickson EA
AHRQ Author: Fan T
Interventions to prevent falls and fractures in community-dwelling older adults.
This case study addresses the U.S. Preventive Health Service Task Force recommendations and offers a scenario, questions, and answers related to interventions to prevent falls and fractures in community-dwelling older adults.
AHRQ-authored.
Citation: Fan T, Erickson EA .
Interventions to prevent falls and fractures in community-dwelling older adults.
Am Fam Physician 2018 Aug 15;98(4):253-55..
Keywords: Case Study, Elderly, Falls, Injuries and Wounds, Prevention, U.S. Preventive Services Task Force (USPSTF)
Elliott S, Leland NE
Occupational therapy fall prevention interventions for community-dwelling older adults: a systematic review.
The authors of this paper updated and broadened a 2008 systematic review examining the evidence for the effectiveness of fall prevention interventions in improving fall-related outcomes, occupational performance, quality of life, and health care facility readmissions for community-dwelling older adults. They assert that these findings can inform the delivery and integration of fall prevention interventions from acute care to community discharge.
AHRQ-funded; HS022907.
Citation: Elliott S, Leland NE .
Occupational therapy fall prevention interventions for community-dwelling older adults: a systematic review.
Am J Occup Ther 2018 Jul/Aug;72(4):7204190040p1-40p11. doi: 10.5014/ajot.2018.030494..
Keywords: Elderly, Falls, Patient-Centered Outcomes Research, Prevention
Reiter-Palmon R, Kennel V, Allen J
Good catch! Using interdisciplinary teams and team reflexivity to improve patient safety.
This article considers the role of reflexivity in team innovation implementation and its association with inpatient fall rates. The study it describes examined 16 small rural hospitals in which interdisciplinary teams intended to decrease fall risk were implemented, supported, and evaluated. Team reflexivity was assessed at the start and at the end of the 2-year intervention, and innovation implementation assessed at the end of the intervention. The hospitals reported objective fall event data and patient days throughout the project. Both the theoretical and practical applications of the results are discussed.
AHRQ-funded; HS021429; HS024630.
Citation: Reiter-Palmon R, Kennel V, Allen J .
Good catch! Using interdisciplinary teams and team reflexivity to improve patient safety.
Group & Organization Management 2018 Jun;43(3):414-39. doi: 10.1177/1059601118768163..
Keywords: Teams, Patient Safety, Falls, Prevention, Hospitals, Adverse Events
Dore DD, Zullo AR, Mor V
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
This study examined the rate of hip fracture in nursing home residents prescribed nonbenzodiazepine hypnotics. A sample of nursing home residents was used and linked to Medicare and Minimum Data Set (2007-2008) data. The rate of hip fracture was higher in residents aged 90 and above, and lower in residents 70 or below. There was no different by sex.
AHRQ-funded; HS022998.
Citation: Dore DD, Zullo AR, Mor V .
Age, sex, and dose effects of nonbenzodiazepine hypnotics on hip fracture in nursing home residents.
J Am Med Dir Assoc 2018 Apr;19(4):328-32.e2. doi: 10.1016/j.jamda.2017.09.015..
Keywords: Injuries and Wounds, Medication, Nursing Homes, Long-Term Care, Adverse Drug Events (ADE), Adverse Events, Falls, Risk, Patient Safety
Patterson BW, Repplinger MD, Pulia MS
Using the Hendrich II Inpatient Fall Risk Screen to predict outpatient falls after emergency department visits.
This study examined the utility of using the Hendrich II Inpatient Fall Risk Screen to predict outpatient falls in elderly patients after emergency department (ED) visits. Individuals aged 65 and older seen in the ED from January 2013 to September 30, 2015 participated in the study. The Hendrich II screen was found to correlate with outpatient falls, but it is likely it would have little utility as a stand-alone fall screen. When the screen was combined with other potential confounders or predictors, the screen performed much better.
AHRQ-funded; HS024558.
Citation: Patterson BW, Repplinger MD, Pulia MS .
Using the Hendrich II Inpatient Fall Risk Screen to predict outpatient falls after emergency department visits.
J Am Geriatr Soc 2018 Apr;66(4):760-65. doi: 10.1111/jgs.15299..
Keywords: Elderly, Falls, Risk, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Prevention, Patient Safety, Adverse Events
Thomas KS, Parikh RB, Zullo AR
Home-delivered meals and risk of self-reported falls: results from a randomized trial.
The purpose of this study was to evaluate whether home-delivered meals, and the frequency of delivery, reduces self-reported falls among homebound older adults. The study suggests that daily delivered meals may reduce the risk of falls. Additional work is needed to understand the effect of meals on falls, particularly among previous fallers, a high-risk subgroup.
AHRQ-funded; HS022998.
Citation: Thomas KS, Parikh RB, Zullo AR .
Home-delivered meals and risk of self-reported falls: results from a randomized trial.
J Appl Gerontol 2018 Jan;37(1):41-57. doi: 10.1177/0733464816675421..
Keywords: Elderly, Falls, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention
Cary MP, Hall RK, Anderson AL
Management team perceptions of risks and strategies for preventing falls among short-stay patients in nursing homes.
This study sought to understand and describe strategies reported by members of the nursing home management team used to prevent falls in short-stay nursing home patients. The authors propose interventions that might reduce falls for short-stay patients and could be tested in future research.
AHRQ-funded; HS022134.
Citation: Cary MP, Hall RK, Anderson AL .
Management team perceptions of risks and strategies for preventing falls among short-stay patients in nursing homes.
Health Care Manag 2018 Jan/Mar;37(1):76-85. doi: 10.1097/hcm.0000000000000192..
Keywords: Falls, Nursing Homes, Prevention, Provider, Risk