National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (10)
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- Cancer (2)
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- Catheter-Associated Urinary Tract Infection (CAUTI) (14)
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- Quality Indicators (QIs) (1)
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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 25 of 133 Research Studies DisplayedJones KM, Krein SL, Mantey J
Characterizing infection prevention programs and urinary tract infection prevention practices in nursing homes: a mixed-methods study.
This study assessed nursing home (NH) infection prevention and control (IPC) resources and practices related to catheter and non-catheter-associated urinary tract infection (CAUTI and UTI). This mixed-methods study was conducted from April 2018 through November 2019 using quantitative surveys and semistructured qualitative interviews. Surveys were completed by 51 NH infection preventionists (IPs), and interviews were conducted with 13 participants from 7 NHs. The participating IPs had limited experience and/or additional roles, and in 36.7% of NHs, IPs had no specific IPC training, with a high turnover rate often mentioned during interviews. Most NHs were aware of their CAUTI and UTI rates and reported using prevention practices, such as hydration (85.7%) or nurse-initiated catheter discontinuation (65.3%). Interviewees expressed concerns about overuse of urine testing and antibiotics. Transfer sheets were used by 84% to communicate about infection, but the information received was described as suboptimal.
AHRQ-funded; HS25451.
Citation: Jones KM, Krein SL, Mantey J .
Characterizing infection prevention programs and urinary tract infection prevention practices in nursing homes: a mixed-methods study.
Infect Control Hosp Epidemiol 2024 Jan; 45(1):40-47. doi: 10.1017/ice.2023.127..
Keywords: Urinary Tract Infection (UTI), Nursing Homes, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Prevention
Liu S, Matvekas A, Naimi T
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
This study’s objective was to use algorithms that repurpose radiologic data into body composition (morphomics) to aid in informing dosing decisions for the antibiotic cefazolin for patients undergoing colorectal surgery who have obesity. This prospective study measured cefazolin plasma, fat, and colon tissue concentrations in these patients to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in 21 morbidly obese patients (body mass index ≥35 kg/m2 with one or more co-morbid conditions). Morphomics and pharmacokinetic data were available in 58 patients with a median weight of 95.9 kg and and 55 years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 for the PopPK model and 0.060 for the PBPK model. Covariates of cefazolin exposure were identified as the estimated creatinine clearance (eCL(cr) ) and body depth at the third lumbar vertebra (body depth_L3). The authors concluded that kidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. They advised that data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
AHRQ-funded; HS027183.
Citation: Liu S, Matvekas A, Naimi T .
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Pharmacotherapy 2024 Jan; 44(1):77-86. doi: 10.1002/phar.2878..
Keywords: Surgery, Antibiotics, Medication, Prevention, Obesity, Healthcare-Associated Infections (HAIs)
Oladapo-Shittu O, Hannum SM, Salinas AB
The need to expand the infection prevention workforce in home infusion therapy.
This study looked at the prevalence of formal surveillance and infection prevention training for home infusion staff. The authors interviewed home infusion staff who perform surveillance activities about barriers to and facilitators for central line-associated bloodstream infection (CLABSI) surveillance and identified barriers to training in CLABSI surveillance. Their findings showed a lack of formal surveillance training which can be addressed by by adapting existing training resources to the home infusion setting.
AHRQ-funded; HS027819.
Citation: Oladapo-Shittu O, Hannum SM, Salinas AB .
The need to expand the infection prevention workforce in home infusion therapy.
Am J Infect Control 2023 May; 51(5):594-96. doi: 10.1016/j.ajic.2022.11.008.AHRQ-funded; HS027819..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Home Healthcare, Central Line-Associated Bloodstream Infections (CLABSI)
Morgan DJ, Dubberke ER, Hink T
The impact of universal glove and gown use on Clostridioides difficile acquisition: a cluster-randomized trial.
This article described a secondary analysis of a cluster-randomized trial in medical and surgical intensive care units (ICUs) in 20 US hospitals to assess whether universal gown and glove use decreases Clostridioides difficile infection. ICUs were randomized to standard practice for glove and gown use versus all healthcare workers required to wear gloves and gowns for all patient contact or when entering a patient room. The results showed no significant difference in the rate of toxigenic C. difficile with universal gown and glove use.
AHRQ-funded; HS025456.
Citation: Morgan DJ, Dubberke ER, Hink T .
The impact of universal glove and gown use on Clostridioides difficile acquisition: a cluster-randomized trial.
Clin Infect Dis 2023 Feb 8; 76(3):e1202-e07. doi: 10.1093/cid/ciac519..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Prevention
Gregory ME, MacEwan SR, Sova LN
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
The objective of this study was to investigate the role of interprofessional teamwork in the prevention of health care-associated infections (HAIs), focusing on central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) prevention. The authors interviewed participating physicians, nurses, and other staff from 18 hospitals about interprofessional collaboration, and proposed an Input-Mediator-Output-Input (IMOI) model as well as strategies to support teamwork for the prevention of HAIs.
AHRQ-funded; HS024958.
Citation: Gregory ME, MacEwan SR, Sova LN .
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
Med Care Res Rev 2023 Feb;80(1):30-42. doi: 10.1177/10775587221103973..
Keywords: Teams, Prevention, Healthcare-Associated Infections (HAIs)
McNeil JC, Sommer LM, Vallejo JG
Going back in time: Increasing penicillin susceptibility among methicillin-susceptible staphylococcus aureus osteoarticular infections in children.
Researchers investigated the prevalence of penicillin susceptibility (PSSA) among pediatric methicillin susceptible S. aureus (MSSA) acute hematogenous osteoarticular infection (OAI) isolates; the isolates were obtained through surveillance studies at Texas Children's and St. Louis Children's Hospitals. Overall, PSSA isolates were found to be associated with a similar clinical presentation as penicillin-resistant isolates. The researchers concluded that potential for use of penicillin treatment in PSSA OAI merits further study.
AHRQ-funded; HS026896'HS021736' HS024269.
Citation: McNeil JC, Sommer LM, Vallejo JG .
Going back in time: Increasing penicillin susceptibility among methicillin-susceptible staphylococcus aureus osteoarticular infections in children.
Antimicrob Agents Chemother 2023 Jan 24; 67(1):e0119622. doi: 10.1128/aac.01196-22..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication, Prevention
Goto M, Hasegawa S, Balkenende EC
Effectiveness of ultraviolet-c disinfection on hospital-onset gram-negative rod bloodstream infection: a nationwide stepped-wedge time-series analysis.
This study evaluated the effectiveness of enhanced terminal room cleaning with ultraviolet C (UV-C) disinfection in reducing gram-negative rod (GNR) infections. The authors used information regarding UV-C use and the timing of implementation through a survey of all Veterans Health Administration (VHA) hospitals providing inpatient acute care from January 2010 and December 2018. Among 128 Veterans Health Administration hospitals, 120 provided complete survey responses with 40 reporting implementations of UV-C systems. UV-C use was associated with a 19% lower incident of hospital-onset (HO) GNR bloodstream infection (BSI).
AHRQ-funded; HS027472.
Citation: Goto M, Hasegawa S, Balkenende EC .
Effectiveness of ultraviolet-c disinfection on hospital-onset gram-negative rod bloodstream infection: a nationwide stepped-wedge time-series analysis.
Clin Infect Dis 2023 Jan 13; 76(2):291-98. doi: 10.1093/cid/ciac776..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Prevention, Sepsis
Crnich CJ
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
This paper provides an overview of nursing home (NH) infection and control, reviews the 2016 CMS changes to federal regulations, and proposes recommendations to sustain improvements. COVID-19 put further pressure on nursing homes who were already strained by rising numbers of infections from C. difficile and multidrug-resistant organisms. The author puts out a call for reimagining infection prevention and control using the Systems Engineering Initiative for Patient Safety framework. Additional recommendations are made to enhance NH infection prevention and control programs in the areas of people, tasks, tools, organization, built environment, and external environment.
AHRQ-funded; HS022465.
Citation: Crnich CJ .
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
J Am Med Dir Assoc 2022 Dec;23(12):1909-15. doi: 10.1016/j.jamda.2022.10.022..
Keywords: Elderly, COVID-19, Public Health, Infectious Diseases, Nursing Homes, Healthcare-Associated Infections (HAIs), Prevention
Krauss DM, Molefe A, Hung L
AHRQ Author: Henderson S, Miller M
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
Warren DK, Peacock KM, Nickel KB
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
The authors investigated factors associated with post-discharge prophylactic antibiotic use after mastectomy with and without immediate reconstruction and the impact on surgical-site infection (SSI). They found that anti-methicillin-sensitive Staphylococcus aureus antibiotics were associated with decreased risk of SSI for patients who had mastectomy only and those who had mastectomy with immediate reconstruction. They concluded that the high numbers needed to treat suggest that potential benefits of post-discharge antibiotics should be weighed against potential harms associated with antibiotic overuse.
AHRQ-funded; HS019455.
Citation: Warren DK, Peacock KM, Nickel KB .
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
Infect Control Hosp Epidemiol 2022 Oct;43(10):1382-88. doi: 10.1017/ice.2021.400..
Keywords: Antibiotics, Cancer: Breast Cancer, Cancer, Medication, Surgery, Healthcare-Associated Infections (HAIs), Prevention, Women, Practice Patterns
Morey DA, Rayo MF, Li M
From reactive to proactive safety: joint activity monitoring for infection prevention.
The authors explored Joint Activity Monitoring (JAM) as one key component of a proactive safety program within infection prevention. This paper described their strategies and challenges in developing this capability and discussed the implications for supporting a successful proactive safety implementation.
AHRQ-funded; HS027200.
Citation: Morey DA, Rayo MF, Li M .
From reactive to proactive safety: joint activity monitoring for infection prevention.
Proc Int Symp Hum Factors Ergon Healthc 2022 Sep; 11(1):48-52. doi: 10.1177/2327857922111009..
Keywords: Prevention, Healthcare-Associated Infections (HAIs), Patient Safety
MacEwan SR, Beal EW, Gaughan AA
Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections.
The purpose of this study was to contribute to evidence of standardized approaches to educate patients about how they can prevent infections. The researchers explored the perspectives of hospital leaders and staff across 18 hospitals about patient education for device-related healthcare-associated infections (HAIs) including catheter-associated urinary tract infections (CAUTIs) and central-line-associated bloodstream infections (CLABSIs). A total of 471 interviews were conducted with key informants and analyzed to identify themes within the topic of preventing infection through patient education. The study found that the key informants identified CAUTI and CLABSI infection-prevention-specific patient education topics including: the necessity of hand hygiene, the importance of maintenance care, the risks of indwelling urinary catheters and central lines, and having the support to voice concerns. The study concluded that hospital leaders and staff identified patient education topics and ways to deliver the information that were important in the prevention of CAUTIs and CLABSIs, and can provide guidance on how patient education can be improved.
AHRQ-funded; HS024958.
Citation: MacEwan SR, Beal EW, Gaughan AA .
Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections.
Infect Control Hosp Epidemiol 2022 Sep;43(9):1129-34. doi: 10.1017/ice.2021.271..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Education: Patient and Caregiver, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI)
Huang J, Park GW, Jones RM
Efficacy of EPA-registered disinfectants against two human norovirus surrogates and Clostridioides difficile endospores.
This study’s goal was to determine the efficacy of a panel of nine EPA-registered disinfectants against two human norovirus (HuNoV) surrogates (feline calicivirus [FCV] and Tulane virus [TuV]) and Clostridioides difficile endospores. These products, five of which contained H2O2 (hydrogen peroxide) as the active ingredient, were tested against infectious FCV, TuV, and C. difficile endospores using two ASTM methods, a suspension and carrier test. Products containing hydrogen peroxide were the most efficacious. Of the five products containing hydrogen peroxide, no strong correlation was observed between disinfection efficacy and hydrogen peroxide concentration. Addition of 0.025% ferrous sulphate to 1% hydrogen peroxide solution improved efficacy against FCV, TuV and C. difficile.
AHRQ-funded; HS025987.
Citation: Huang J, Park GW, Jones RM .
Efficacy of EPA-registered disinfectants against two human norovirus surrogates and Clostridioides difficile endospores.
J Appl Microbiol 2022 Jun;132(6):4289-99. doi: 10.1111/jam.15524..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Prevention, Patient Safety
McAlearney AS, MacEwan SR, Gregory ME
Identifying management practices for promoting infection prevention: perspectives on strategic communication.
The purpose of this study was to better understand the topics and communication strategies used by hospital administrative and clinical leaders to facilitate healthcare-associated infection prevention. Between 2017 and 2019 the researchers interviewed 188 administrative and clinical leaders in 18 U.S. Hospitals and interviewed them about management practices used to promote the prevention of HAI, with a focus on strategic communications. The study found that information sharing regarding infection prevention focused on two main topics: facilitators of success and barriers to success. The researchers also reported that storytelling using examples of real events was useful. The study concluded that the findings provide useful information about how the strategic communication of HAI information can contribute to improvement and advance hospitals’ infection prevention plans and efforts.
AHRQ-funded; HS024958.
Citation: McAlearney AS, MacEwan SR, Gregory ME .
Identifying management practices for promoting infection prevention: perspectives on strategic communication.
Am J Infect Control 2022 Jun;50(6):593-97. doi: 10.1016/j.ajic.2021.11.025..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Prevention, Communication
Cannon JL, Park GW, Anderson B
Hygienic monitoring in long-term care facilities using ATP, crAssphage, and human noroviruses to direct environmental surface cleaning.
Norovirus and C. difficile can be transmitted by contaminated environmental surfaces and are associated with diarrheal illnesses and deaths in long-term care (LTC) facilities. Hygienic monitoring tools such as adenosine triphosphate (ATP) bioluminescence and indicators of fecal contamination can help to identify LTC facility surfaces with cleaning deficiencies. The researchers swabbed and tested high-touch surfaces in 11 LTC facilities for contamination by norovirus, a fecal indicator virus, crAssphage, and ATP. The study found that greater than 90% of surfaces tested positive for crAssphage or failed in their ATP scores. Norovirus contamination was not detected. Handrails, equipment controls, and patient beds were 4 times more likely than other surfaces or locations to have high levels of crAssphage. Patient bed handrails and tables and chairs in patient lounges had high levels of both ATP and crAssphage.
AHRQ-funded; HS025987.
Citation: Cannon JL, Park GW, Anderson B .
Hygienic monitoring in long-term care facilities using ATP, crAssphage, and human noroviruses to direct environmental surface cleaning.
Am J Infect Control 2022 Mar; 50(3):289-94. doi: 10.1016/j.ajic.2021.11.014..
Keywords: Nursing Homes, Long-Term Care, Prevention, Healthcare-Associated Infections (HAIs), Clostridium difficile Infections
Racila AM, O'Shea AMJ, Nair R
Using nasal povidone-iodine to prevent bloodstream infections and transmission of Staphylococcus aureus among haemodialysis
This article describes a planned study; the objective is to determine the clinical efficacy and effectiveness of a novel intervention using nasal povidone-iodine to prevent bloodstream infections among patients in hemodialysis units. Findings will be presented at international meetings, and the study team will publish findings in peer-reviewed journals, making each accepted peer-reviewed manuscript publicly available.
AHRQ-funded; HS026724.
Citation: Racila AM, O'Shea AMJ, Nair R .
Using nasal povidone-iodine to prevent bloodstream infections and transmission of Staphylococcus aureus among haemodialysis
BMJ Open 2021 Dec 3;11(12):e048830. doi: 10.1136/bmjopen-2021-048830..
Keywords: Healthcare-Associated Infections (HAIs), Kidney Disease and Health, Prevention
Arntson E, Dimick JB, Nuliyalu U
Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.
This study evaluated changes in Hospital-Acquired Conditions (HACs) and 30-day mortality after the announcement of the Centers for Medicare and Medicare Services’ Hospital-Acquired Condition Reduction Program (HACRP) in August 2013. The authors evaluated models to test for changes in HACs and 30-day mortality before and after the Affordable Care Act (ACA), and after the HACRP. Fee-for-service Medicare claims from 2009 to 2015 were used. The HAC rate declined after the ACA was passed and declined further after the HACRP announcement. However, 30-day mortality rates were unchanged.
AHRQ-funded; HS026244.
Citation: Arntson E, Dimick JB, Nuliyalu U .
Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.
Ann Surg 2021 Oct 1;274(4):e301-e07. doi: 10.1097/sla.0000000000003641..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Mortality, Medicare, Payment, Prevention, Patient Safety
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
Brajcic BC, Ko CY, Liu JB
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
This paper describes the protocol for an upcoming multicenter randomized surgical trial to evaluate choice of prophylactic antibiotics for pancreaticoduodenectomy. The rationale and methodology of the trial evaluating piperacillin-tazobactam compared to cefoxitin for surgical site infection prevention is described. The study will utilize a clinical registry for data collection.
AHRQ-funded; HS000078.
Citation: Brajcic BC, Ko CY, Liu JB .
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
J Surg Oncol 2021 May;123(6):1387-94. doi: 10.1002/jso.26402..
Keywords: Cancer, Antibiotics, Medication, Prevention, Surgery, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Evidence-Based Practice
McAlearney AS, Gaughan AA, DePuccio MJ
Management practices for leaders to promote infection prevention: lessons from a qualitative study.
This study looked at the management practices around prevention of catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSI) that hospital leaders can take to promote healthcare associated infection (HAI) prevention efforts. Interviews were conducted with 420 managers and frontline staff in 18 hospitals across the United States. The three management practices characterized as important facilitators of HAI prevention were 1) engagement of executive leadership; 2) information sharing; and 3) manager coaching.
AHRQ-funded; HS024958.
Citation: McAlearney AS, Gaughan AA, DePuccio MJ .
Management practices for leaders to promote infection prevention: lessons from a qualitative study.
Am J Infect Control 2021 May;49(5):536-41. doi: 10.1016/j.ajic.2020.09.001..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Prevention, Communication
McDonald MV, Brickner C, Russell D
Observation of hand hygiene practices in home health care.
The purpose of this observational study was to describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits. The investigators concluded that hand hygiene adherence in HHC was suboptimal, with rates mirroring those reported in hospital and outpatient settings.
AHRQ-funded; HS024723.
Citation: McDonald MV, Brickner C, Russell D .
Observation of hand hygiene practices in home health care.
J Am Med Dir Assoc 2021 May;22(5):1029-34. doi: 10.1016/j.jamda.2020.07.031..
Keywords: Home Healthcare, Nursing, Provider: Nurse, Provider, Prevention, Healthcare-Associated Infections (HAIs), Guidelines
Milstone AM, Rosenberg C, Yenokyan G
Alcohol-impregnated caps and ambulatory central-line-associated bloodstream infections (CLABSIs): a randomized clinical trial.
The purpose of this study was to evaluate the effect of 70% isopropyl alcohol-impregnated central venous catheter caps on ambulatory central-line-associated bloodstream infections (CLABSIs) in pediatric hematology-oncology patients. Findings showed that isopropyl alcohol-impregnated central-line caps did not lead to a statistically significant reduction in CLABSI rates in ambulatory hematology-oncology patients. In the per-protocol analysis, there was a statistically significant decrease in positive blood cultures.
AHRQ-funded; HS022870.
Citation: Milstone AM, Rosenberg C, Yenokyan G .
Alcohol-impregnated caps and ambulatory central-line-associated bloodstream infections (CLABSIs): a randomized clinical trial.
Infect Control Hosp Epidemiol 2021 Apr;42(4):431-39. doi: 10.1017/ice.2020.467..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Sepsis, Children/Adolescents, Prevention
Dowding D, Russell D, McDonald MV
"A catalyst for action": factors for implementing clinical risk prediction models of infection in home care settings.
This study looked at how a clinical risk prediction model for identifying patients at risk of infection is perceived by home care nurses. It was a qualitative study using semi-structured interviews with 50 home care nurses. The interviews were audio-taped and transcribed with data evaluation using thematic analysis. Findings indicated that the nurses would find a clinical risk prediction model useful, as long as it provided both context around the reasons why a patient was deemed to be high risk and provided some guidance for action.
AHRQ-funded; HS024723.
Citation: Dowding D, Russell D, McDonald MV .
"A catalyst for action": factors for implementing clinical risk prediction models of infection in home care settings.
J Am Med Inform Assoc 2021 Feb 15;28(2):334-41. doi: 10.1093/jamia/ocaa267..
Keywords: Home Healthcare, Nursing, Risk, Healthcare-Associated Infections (HAIs), Prevention, Provider: Nurse, Provider
Harris AD, Morgan DJ, Pineles L
Acquisition of antibiotic-resistant gram-negative bacteria in the Benefits of Universal Glove and Gown (BUGG) cluster randomized trial.
This study is a secondary analysis of a randomized trial in 20 hospital intensive units called Benefits of Universal Glove and Gown (BUGG) to see if intervention decreases the acquisition of antibiotic-resistant gram-negative bacteria. The primary outcome included 40,492 admission and discharge perianal swabs from 20,246 individual patient admissions. A non-statistically significant decrease in acquisition of antibiotic-resistant gram-negative bacteria was associated with universal glove and gown use.
AHRQ-funded; HS024045.
Citation: Harris AD, Morgan DJ, Pineles L .
Acquisition of antibiotic-resistant gram-negative bacteria in the Benefits of Universal Glove and Gown (BUGG) cluster randomized trial.
Clin Infect Dis 2021 Feb 1;72(3):431-37. doi: 10.1093/cid/ciaa071..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Patient Safety
Lee BY, Bartsch SM, Lin MY
How long-term acute care hospitals can play an important role in controlling carbapenem-resistant Enterobacteriaceae in a region: a simulation modeling study.
Researchers investigated how implementing control measures in long-term acute care hospitals (LTACHs) can impact carbapenem-resistant Enterobacteriaceae (CRE) spread regionwide. They used their own Chicago metropolitan region agent-based model to simulate CRE spread and control. They found that a prevention bundle in only LTACHs decreased prevalence and averted new carriers, infections, and deaths over 3 years compared with no CRE control measures. When LTACHs and intensive care units intervened, prevalence decreased further. They concluded that LTACHs may be more important than other acute care settings for controlling CRE, and regional efforts to control drug-resistant organisms should start with LTACHs as a centerpiece.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Lin MY .
How long-term acute care hospitals can play an important role in controlling carbapenem-resistant Enterobacteriaceae in a region: a simulation modeling study.
Am J Epidemiol 2021 Feb 1;190(3):448-58. doi: 10.1093/aje/kwaa247..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Hospitals, Patient Safety, Implementation