National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (10)
- Cardiovascular Conditions (2)
- Care Management (2)
- Children/Adolescents (9)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- COVID-19 (1)
- Critical Care (2)
- Electronic Health Records (EHRs) (1)
- Healthcare-Associated Infections (HAIs) (2)
- Heart Disease and Health (2)
- Hospitalization (1)
- Infectious Diseases (1)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (6)
- Long-Term Care (1)
- Medication (1)
- Nutrition (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (2)
- (-) Patient Safety (19)
- Practice Patterns (1)
- Provider: Health Personnel (1)
- Quality Improvement (2)
- Registries (1)
- (-) Respiratory Conditions (19)
- Risk (3)
- Sleep Problems (1)
- Surgery (2)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedMcGrath SP, McGovern KM, Perreard IM
Inpatient respiratory arrest associated with sedative and analgesic medications: impact of continuous monitoring on patient mortality and severe morbidity.
Inpatient respiratory arrest associated with sedative and analgesic medications: impact of continuous monitoring on patient mortality and severe morbidity.
The purpose of this study was to investigate the impact of surveillance monitoring on mortality and severe morbidity associated with administration of sedative/analgesic medications in the general care setting. A review of available rescue event and patient safety data from a tertiary care hospital in a rural setting was conducted. Findings showed that, for a 10-year period, the rescue system with continuous surveillance monitoring had a profound effect on prevention of death due to sedative/analgesic administration in the general care setting.
The purpose of this study was to investigate the impact of surveillance monitoring on mortality and severe morbidity associated with administration of sedative/analgesic medications in the general care setting. A review of available rescue event and patient safety data from a tertiary care hospital in a rural setting was conducted. Findings showed that, for a 10-year period, the rescue system with continuous surveillance monitoring had a profound effect on prevention of death due to sedative/analgesic administration in the general care setting.
AHRQ-funded; HS024403.
Citation: McGrath SP, McGovern KM, Perreard IM .
Inpatient respiratory arrest associated with sedative and analgesic medications: impact of continuous monitoring on patient mortality and severe morbidity.
J Patient Saf 2021 Dec 1;17(8):557-61. doi: 10.1097/pts.0000000000000696..
Keywords: Respiratory Conditions, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Soares WE, Schoenfeld EM, Visintainer P
Safety assessment of a noninvasive respiratory protocol for adults with COVID-19.
As evidence emerged supporting noninvasive strategies for coronavirus disease 2019 (COVID-19)-related respiratory distress, the investigators implemented a noninvasive COVID-19 respiratory protocol (NCRP) that encouraged high-flow nasal cannula (HFNC) and self-proning across our healthcare system. To assess safety, the investigators conducted a retrospective chart review evaluating mortality and other patient safety outcomes after implementation of the NCRP protocol (April 3, 2020, to April 15, 2020) for adult patients hospitalized with COVID-19, compared with preimplementation outcomes (March 15, 2020, to April 2, 2020).
AHRQ-funded; HS025701.
Citation: Soares WE, Schoenfeld EM, Visintainer P .
Safety assessment of a noninvasive respiratory protocol for adults with COVID-19.
J Hosp Med 2020 Dec;15(12):734-38. doi: 10.12788/jhm.3548..
Keywords: Patient Safety, COVID-19, Respiratory Conditions, Inpatient Care, Infectious Diseases
Mathis MR, Duggal NM, Likosky DS
Intraoperative mechanical ventilation and postoperative pulmonary complications after cardiac surgery.
In this study, the authors hypothesized that a bundled intraoperative protective ventilation strategy was independently associated with decreased odds of pulmonary complications after cardiac surgery. They identified an intraoperative lung-protective ventilation bundle as independently associated with pulmonary complications after cardiac surgery. Their findings offer insight into components of protective ventilation associated with adverse outcomes and may serve as targets for future prospective interventional studies investigating the impact of specific protective ventilation strategies on postoperative outcomes after cardiac surgery.
AHRQ-funded; HS022535.
Citation: Mathis MR, Duggal NM, Likosky DS .
Intraoperative mechanical ventilation and postoperative pulmonary complications after cardiac surgery.
Anesthesiology 2019 Nov;131(5):1046-62. doi: 10.1097/aln.0000000000002909..
Keywords: Adverse Events, Cardiovascular Conditions, Patient Safety, Respiratory Conditions, Surgery
Sanders R, Edwards L, Nishisaki A
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
This editorial discusses a research study on outcomes of performing pediatric trachael intubations (TIs) and how the results can be applied to performing intubations on critically ill children in the United Kingdom outside of specialized centers. One of the authors is from a U.S. site that submits its airway management data to the National Emergency Airway Registry for Children (NEAR4KIDS). The results from the registry were compared to the results from the study. A total of 1,051 patients out of 1,237 eligible patients were analyzed. The results came from 47 nonspecialized local hospitals in the North Thames and East Anglia region of the UK. Adverse TI-associated events (TIAEs) occurred in 22.7% of the patients, which is higher than those in PICUs and cardiac ICUs. The majority of intubations were performed by the anesthesiologist in the team. The results were similar to those in the NEAR4KIDS registry. There were more complications with children with a higher grade of airway difficulties and comorbidities. The authors believe that pediatric airway management for acutely ill children would benefit from new strategies. They recommend a system change using Plan, Do, Study, Act (PDSA) cycles.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Sanders R, Edwards L, Nishisaki A .
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
Pediatr Crit Care Med 2019 Jun;20(6):572-73. doi: 10.1097/pcc.0000000000001946..
Keywords: Adverse Events, Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Outcomes, Patient Safety, Registries, Respiratory Conditions
Mokhateb-Rafii T, Bakar A, Gangadharan S
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
The objective of this study was to determine a level of oxygen desaturation associated with increased risk of tracheal intubation events in children in a pediatric or cardiac ICU with cyanotic and noncyanotic heart disease. Oxygen desaturation was measured by a fall in pulse oximetry from baseline after pre-oxygenation. The primary outcome was occurrence of hemodynamic tracheal intubation associated events defined as cardiac arrest, hypotension, or dysrhythmia. Results indicate that oxygen desaturation by 30% or more is associated with increased odds for adverse hemodynamic events, after adjusting for confounders. Oxygen desaturation was observed more often in children with cyanotic than those with noncyanotic heart disease, but hemodynamic tracheal intubation associated event rates were similar.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Mokhateb-Rafii T, Bakar A, Gangadharan S .
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
Pediatr Crit Care Med 2019 Jan;20(1):19-26. doi: 10.1097/pcc.0000000000001766..
Keywords: Adverse Events, Cardiovascular Conditions, Children/Adolescents, Heart Disease and Health, Respiratory Conditions, Intensive Care Unit (ICU), Patient Safety, Risk
Lee JH, Nuthall G, Ikeyama T
Tracheal intubation practice and safety across international PICUs: a report from national emergency airway registry for children.
Researchers hypothesized that there would be differences in the process of care and adverse outcomes for tracheal intubation across pediatric ICUs (PICUs) in six different geographical regions: Germany, Japan, Singapore, India, New Zealand, and North America. Adverse tracheal intubation-associated events and desaturation occurrences in PICUS in these regions were evaluated, and the international PICUs compared with those in North America. The proportion of tracheal intubations for endotracheal tube change was greater in international PICUs, and the median age for international tracheal intubations was younger when compared with North America PICUs. Occurrences of adverse tracheal intubation-associated events were slightly lower for international than for North American PICUs, except for Germany and Japan, which were slightly higher.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Lee JH, Nuthall G, Ikeyama T .
Tracheal intubation practice and safety across international PICUs: a report from national emergency airway registry for children.
Pediatr Crit Care Med 2019 Jan;20(1):1-8. doi: 10.1097/pcc.0000000000001782..
Keywords: Adverse Events, Care Management, Children/Adolescents, Intensive Care Unit (ICU), Respiratory Conditions, Outcomes, Patient Safety
Burgermaster M, Murray M, Saiman L
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
This study investigated the outcomes of children and a subsample of infants in pediatric long-term care facilities are need enteral nutrition (EN). Those patients who need EN had a higher risk of acute pediatric infection (ARI) and a lower odds of discharge than those who did not. Infants had a particular higher risk of comorbidities and infections when they were fed using percutaneous feeding tubes.
AHRQ-funded; HS021470.
Citation: Burgermaster M, Murray M, Saiman L .
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
Nutr Clin Pract 2018 Dec;33(6):865-71. doi: 10.1002/ncp.10017..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Nutrition, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions, Long-Term Care
Taenzer AH, Perreard IM, MacKenzie T
Characteristics of desaturation and respiratory rate in postoperative patients breathing room air versus supplemental oxygen: are they different?
Routine monitoring of postoperative patients with pulse oximetry-based surveillance monitoring has been shown to reduce adverse events. However, there is some concern that pulse oximetry is limited in its ability to detect deterioration quickly enough to allow for intervention in patients receiving supplemental oxygen. To address such concerns, this study expands on the current limited knowledge of differences in desaturation and respiratory rate characteristics between patients breathing room air and those receiving supplemental oxygen.
AHRQ-funded; HS024403.
Citation: Taenzer AH, Perreard IM, MacKenzie T .
Characteristics of desaturation and respiratory rate in postoperative patients breathing room air versus supplemental oxygen: are they different?
Anesth Analg 2018 Mar;126(3):826-32. doi: 10.1213/ane.0000000000002765..
Keywords: Adverse Events, Patient Safety, Respiratory Conditions
Li S, Hsieh TC, Rehder KJ
Frequency of desaturation and association with hemodynamic adverse events during tracheal intubations in PICUs.
In this retrospective cohort study, the investigators aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association with adverse hemodynamic tracheal intubation-associated events. They found that moderate and severe desaturation were reported among 19% and 13% of all tracheal intubation encounters; Moderate and severe desaturations were independently associated with the occurrence of adverse hemodynamic events.
AHRQ-funded; HS024511.
Citation: Li S, Hsieh TC, Rehder KJ .
Frequency of desaturation and association with hemodynamic adverse events during tracheal intubations in PICUs.
Pediatr Crit Care Med 2018 Jan;19(1):e41-e50. doi: 10.1097/pcc.0000000000001384..
Keywords: Adverse Events, Children/Adolescents, Patient Safety, Children/Adolescents, Respiratory Conditions
Badawy J, Nguyen OK, Clark C
Is everyone really breathing 20 times a minute? Assessing epidemiology and variation in recorded respiratory rate in hospitalised adults.
The researchers sought to assess the potential accuracy of respiratory rate (RR) by analyzing the distribution and variation as a proxy, since RR should be normally distributed if recorded accurately. The observed patterns suggest that RR is inaccurately recorded, even among those with cardiopulmonary compromise, and represents a 'spot' estimate with values of 18 and 20 breaths per minute representing 'normal.’
AHRQ-funded; HS022418.
Citation: Badawy J, Nguyen OK, Clark C .
Is everyone really breathing 20 times a minute? Assessing epidemiology and variation in recorded respiratory rate in hospitalised adults.
BMJ Qual Saf 2017 Oct;26(10):832-36. doi: 10.1136/bmjqs-2017-006671.
.
.
Keywords: Hospitalization, Inpatient Care, Patient Safety, Quality Improvement, Respiratory Conditions
Finn Davis K, Napolitano N, Li S
Promoters and barriers to implementation of tracheal intubation airway safety bundle: a mixed-method analysis.
This study describes promoters and barriers to implementation of an airway safety quality improvement bundle from the perspective of interdisciplinary frontline clinicians and ICU quality improvement leaders. Both early and late adopters identified similar promoter and barrier themes. Early adopter sites customized the quality improvement bundle and had an interdisciplinary quality improvement team approach.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Finn Davis K, Napolitano N, Li S .
Promoters and barriers to implementation of tracheal intubation airway safety bundle: a mixed-method analysis.
Pediatr Crit Care Med 2017 Oct;18(10):965-72. doi: 10.1097/pcc.0000000000001251.
.
.
Keywords: Critical Care, Intensive Care Unit (ICU), Patient Safety, Quality Improvement, Respiratory Conditions
Grunwell JR, Kamat PP, Miksa M
Trend and outcomes of video laryngoscope use across PICUs.
The use of video laryngoscopy for tracheal intubation is now common for adult ICUs, but has not been quantified in pediatric ICUs (PICUs). A retrospective review was conducted of PICUs across the US and four other countries. There was a wide variability of use of video laryngoscopy across PICUs. There has been a significant increase in the use of video laryngoscopy versus direct laryngoscopy from 2011 to 2015, which has resulted in a decrease in adverse outcomes.
AHRQ-funded; HS021583; HS022464.
Citation: Grunwell JR, Kamat PP, Miksa M .
Trend and outcomes of video laryngoscope use across PICUs.
Pediatr Crit Care Med 2017 Aug;18(8):741-49. doi: 10.1097/pcc.0000000000001175..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Patient Safety, Practice Patterns, Respiratory Conditions
Metersky ML, Klompas M, Eldridge N
Changes in rates of ventilator-associated pneumonia-reply.
In response to a critical letter, the authors comment that the discordance between ventilator-associated pneumonia (VAP) rates from the Medicare Patient Safety Monitoring System (MPSMS) vs the National Healthcare Safety Network (NHSN)is likely related to differences in data sources, as discussed in their report, including conscious or unconscious bias in VAP rates reported to the NHSN. It is unlikely to be related to differences in denominators or competing risks.
AHRQ-authored.
Citation: Metersky ML, Klompas M, Eldridge N .
Changes in rates of ventilator-associated pneumonia-reply.
JAMA 2017 Apr 18;317(15):1581-82. doi: 10.1001/jama.2017.2431.
.
.
Keywords: Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Patient Safety, Respiratory Conditions
Parker MM, Nuthall G, Brown C, 3rd
Relationship between adverse tracheal intubation associated events and PICU outcomes.
The aim of this study is to evaluate the association between immediate events such as tracheal intubation associated events or desaturation and ICU outcomes: length of stay, duration of mechanical ventilation, and mortality. It found that adverse tracheal intubation associated events and desaturations are common and associated with longer mechanical ventilation in critically ill children. Severe tracheal intubation associated events are associated with higher ICU mortality.
AHRQ-funded; HS021583; HS022464.
Citation: Parker MM, Nuthall G, Brown C, 3rd .
Relationship between adverse tracheal intubation associated events and PICU outcomes.
Pediatr Crit Care Med 2017 Apr;18(4):310-18. doi: 10.1097/pcc.0000000000001074.
.
.
Keywords: Adverse Events, Children/Adolescents, Respiratory Conditions, Patient Safety, Children/Adolescents
Press A, Khan S, McCullagh L
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
The authors developed a new and innovative usability process named 'sensitivity and specificity trigger analysis' (SSTA) as part of a larger project around a pulmonary embolism decision support tool. They explored a unique methodology, SSTA, used to limit inaccurate triggering of a clinical decision support tool prior to integration into the electronic health record. They concluded that their methodology can be applied to other studies aiming to decrease triggering rates and increase adoption rates of previously validated clinical decision support system tools.
AHRQ-funded; HS022061.
Citation: Press A, Khan S, McCullagh L .
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
Evid Based Med 2016 Dec;21(6):203-07. doi: 10.1136/ebmed-2016-110440.
.
.
Keywords: Clinical Decision Support (CDS), Respiratory Conditions, Electronic Health Records (EHRs), Provider: Health Personnel, Patient Safety
Lee JH, Turner DA, Kamat P
The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study.
The objective of this study is to determine the association between number of tracheal intubation (TI) attempts and severe desaturation (SpO2 < 70 percent) and adverse TI associated events (TIAEs). It found that the number of TI attempts was associated with desaturations and increased occurrence of TIAEs in critically ill children with acute respiratory failure.
AHRQ-funded; HS021583; HS022464.
Citation: Lee JH, Turner DA, Kamat P .
The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study.
BMC Pediatr 2016 Apr 29;16:58. doi: 10.1186/s12887-016-0593-y.
.
.
Keywords: Adverse Events, Children/Adolescents, Respiratory Conditions, Patient Safety, Children/Adolescents
Downes KJ, Patil NR, Rao MB
Risk factors for acute kidney injury during aminoglycoside therapy in patients with cystic fibrosis.
The aim of this study was to identify factors associated with acute kidney injury (AKI) during intravenous aminoglycoside (AG) courses in this population. It identified receipt of an AG within 90 days prior to admission, longer duration of AG therapy, low serum albumin, and receipt of trimethoprim/ sulfamethoxazole as independent risk factors for developing AKI.
AHRQ-funded; HS021114.
Citation: Downes KJ, Patil NR, Rao MB .
Risk factors for acute kidney injury during aminoglycoside therapy in patients with cystic fibrosis.
Pediatr Nephrol 2015 Oct;30(10):1879-88. doi: 10.1007/s00467-015-3097-3..
Keywords: Adverse Events, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions
Abdelsattar ZM, Hendren S, Wong SL
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
The purpose of this study was to determine whether preoperatively untreated obstructive sleep apnea (OSA) affects postoperative outcomes. It found that compared with treated OSA, untreated OSA was independently associated with more cardiopulmonary complications (risk-adjusted rates 6.7 percent versus 4.0 percent; particularly unplanned reintubations and myocardial infarction.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
The impact of untreated obstructive sleep apnea on cardiopulmonary complications in general and vascular surgery: a cohort study.
Sleep 2015 Aug;38(8):1205-10. doi: 10.5665/sleep.4892..
Keywords: Sleep Problems, Surgery, Patient Safety, Risk, Heart Disease and Health, Respiratory Conditions, Chronic Conditions
Nykiel-Bailey SM, McAllister JD, Schrock CR
Difficult airway consultation service for children: steps to implement and preliminary results.
The article demonstrates how to implement a consultative service focusing on difficult airway (DAW) identification, management and education. The initial 3-month experience confirmed that a majority of pediatric DAW events are associated with congenital or acquired abnormalities. Through appropriate consultation and leadership, the Difficult Airway Service was able to physically and electronically identify pediatric patients with a DAW and provide management.
AHRQ-funded; HS022265.
Citation: Nykiel-Bailey SM, McAllister JD, Schrock CR .
Difficult airway consultation service for children: steps to implement and preliminary results.
Paediatr Anaesth 2015 Apr;25(4):363-71. doi: 10.1111/pan.12625..
Keywords: Care Management, Children/Adolescents, Respiratory Conditions, Patient Safety, Risk