National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Antibiotics (2)
- Antimicrobial Stewardship (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- (-) Clostridium difficile Infections (6)
- Decision Making (1)
- Genetics (1)
- Healthcare-Associated Infections (HAIs) (5)
- Hospitals (3)
- Intensive Care Unit (ICU) (1)
- Medication (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
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- Quality of Care (2)
- Risk (1)
- Sepsis (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 6 of 6 Research Studies DisplayedAlrawashdeh M, Rhee C, Hsu H
Assessment of federal value-based incentive programs and in-hospital Clostridioides difficile infection rates.
The authors sought to examine the association between value-based incentive program (VBIP) implementation and health care facility-onset Clostridioides difficile infection (HO-CDI) rates. Their study evaluated HO-CDI rates among adults hospitalized at acute-care hospitals from January 2013 to March 2019. They found that, in this study, VBIP implementation was associated with improvements in HO-CDI rates, independent of CDI testing method. They recommended that future research focus on elucidating the specific processes that contributed to improvement in HO-CDI rates to inform the design of future VBIP interventions.
AHRQ-funded; HS018414; HS025008.
Citation: Alrawashdeh M, Rhee C, Hsu H .
Assessment of federal value-based incentive programs and in-hospital Clostridioides difficile infection rates.
JAMA Netw Open 2021 Oct;4(10):e2132114. doi: 10.1001/jamanetworkopen.2021.32114..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Quality of Care
Page B, Klompas M, Chan C
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
US hospitals are required by the Centers for Medicare and Medicaid Services to publicly report central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), Clostridioidesdiffficile, methicillin-resistant Staphylococcus aureus bacteremia, and selected surgical site infections for benchmarking and pay-for-performance programs. In this study the investigators retrospectively assessed the overlap between HO-ASEs and reportable HAIs among adults hospitalized between June 2015-June 2018 in 3 hospitals.
AHRQ-funded; HS025008.
Citation: Page B, Klompas M, Chan C .
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
Clin Infect Dis 2021 Sep 15;73(6):1013-19. doi: 10.1093/cid/ciab217..
Keywords: Sepsis, Healthcare-Associated Infections (HAIs), Hospitals, Clostridium difficile Infections, Catheter-Associated Urinary Tract Infection (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI)
Cabral SM, Goodman KE, Blanco N
Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.
This study’s objective was to determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Adult patients admitted to 3 hospitals in Maryland from 2016 to 2018 were included. Patients with comorbid conditions were assigned using the Elixhauser comorbidity index. Standardized infection rates (SIRs) were computed using current CDC risk adjustment methodology and included the addition of Elixhauser score and individual comorbidities. Hospital 1 had 314 (0.65%) of patients with a HO-CDI, Hospital 2 had 41 (0.47%) with a HO-CDI, and Hospital 3 had 75 (0.26%) with a HO-CDI. Elixhauser score in multivariable regression was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic user, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospitals 1 and 2. Including the Elixhauser score in the risk adjustment model was statistically significant.
AHRQ-funded; HS022291.
Citation: Cabral SM, Goodman KE, Blanco N .
Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.
Infect Control Hosp Epidemiol 2021 Aug;42(8):955-61. doi: 10.1017/ice.2020.1344..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Risk
Safdar N, Parmasad V, Brown R
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interventions are effective in CDI control, but there is little evidence regarding the most effective AS interventions. In this paper the investigators describe their multisite, stepped-wedge, cluster, effectiveness-implementation clinical trial.
AHRQ-funded; R01 HS026226.
Citation: Safdar N, Parmasad V, Brown R .
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
BMJ Open 2021 Jun 29;11(6):e046480. doi: 10.1136/bmjopen-2020-046480..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Antimicrobial Stewardship, Antibiotics, Medication, Prevention
Golob JL, Rao K
Signal versus noise: how to analyze the microbiome and make progress on antimicrobial resistance.
This paper’s objective is to: 1) review the current thought on risk from antibiotic-resistant organization (ARO) acquisition; 2) review the current understanding on the gut microbiome’s ability to resist colonization with AROs; 3) describe how experimental model systems can test these global initial, global insights to arrive at more granular, mechanistic ones; and 4) suggest a path forward to make further progress in the field. This review is informed from experiences and successes with understanding of the role of the microbiome in mediating risk of Clostridioides difficile infection.
AHRQ-funded; HS027431.
Citation: Golob JL, Rao K .
Signal versus noise: how to analyze the microbiome and make progress on antimicrobial resistance.
J Infect Dis 2021 Jun 16;223(Suppl 3):S214-S21. doi: 10.1093/infdis/jiab184..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Genetics
Tamma PD, Miller MA, Dullabh P
AHRQ Author: Miller MA
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
Regulatory agencies and professional organizations recommend antibiotic stewardship programs (ASPs) in US hospitals. The optimal approach to establish robust, sustainable ASPs across diverse hospitals is unknown. The purpose of this study was to assess whether the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use was associated with reductions in antibiotic use across US hospitals. The investigators concluded that AHRQ Safety Program appeared to enable diverse hospitals to establish ASPs and teach frontline clinicians to self-steward their antibiotic use.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Tamma PD, Miller MA, Dullabh P .
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
JAMA Netw Open 2021 Feb;4(2):e210235. doi: 10.1001/jamanetworkopen.2021.0235..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Decision Making, Clostridium difficile Infections, Patient Safety, Quality Improvement, Quality of Care, Hospitals