National Healthcare Quality and Disparities Report
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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
76 to 100 of 113 Research Studies DisplayedBoltey E, Yakusheva O, Costa DK
5 nursing strategies to prevent ventilator-associated pneumonia.
This article reviews the top five evidence-based nursing practices for reducing ventilator-associated pneumonia (VAP) risk in critically ill adults.
AHRQ-funded; HS024552.
Citation: Boltey E, Yakusheva O, Costa DK .
5 nursing strategies to prevent ventilator-associated pneumonia.
Am Nurse Today 2017 Jun;12(6):42-43..
Keywords: Critical Care, Healthcare-Associated Infections (HAIs), Nursing, Prevention, Pneumonia
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID, Guofen Y .
A national comparison of rural/urban pressure ulcer and fall rates.
Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health
Bhattacharjee P, Churpek MM, Snyder A
Detecting sepsis: are two opinions better than one?
Researchers conducted a study to characterize the agreement between different providers' suspicion of infection and the correlation with patient outcomes using prospective data from a general medicine ward. They concluded that provider disagreement regarding suspected infection is common, with RNs suspecting infection more often, suggesting that a collaborative model for sepsis detection may improve timing and accuracy.
AHRQ-funded; HS000078.
Citation: Bhattacharjee P, Churpek MM, Snyder A .
Detecting sepsis: are two opinions better than one?
J Hosp Med 2017 Apr;12(4):256-58. doi: 10.12788/jhm.2721.
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Keywords: Diagnostic Safety and Quality, Nursing, Risk, Sepsis
Dunn Lopez K, Gephart SM, Raszewski R
Integrative review of clinical decision support for registered nurses in acute care settings.
To report on the state of the science of clinical decision support (CDS) for hospital bedside nurses, the researchers performed an integrative review of qualitative and quantitative peer-reviewed original research studies. They concluded that clinical support systems targeting bedside nurses have positive effects on outcomes and hold promise for improving care quality.
AHRQ-funded; HS022908.
Citation: Dunn Lopez K, Gephart SM, Raszewski R .
Integrative review of clinical decision support for registered nurses in acute care settings.
J Am Med Inform Assoc 2017 Mar 1;24(2):441-50. doi: 10.1093/jamia/ocw084.
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Keywords: Critical Care, Clinical Decision Support (CDS), Health Information Technology (HIT), Nursing, Patient Safety
Asan O, Flynn KE, Azam L
Nurses’ perceptions of a novel health information technology: a qualitative study in the pediatric intensive care unit.
The purpose of this study was to evaluate the use of a novel health information technology (HIT), a large customizable interactive monitor (LCIM), implemented in a pediatric intensive care unit (PICU). The study collected and analyzed data from 55 PICU nurses in seven focus groups. Six major themes emerged including familiarity and use routines, positive perceptions with the LCIM, negative perceptions with the LCIM, privacy, training, and suggestions for improvement.
AHRQ-funded; HS023626.
Citation: Asan O, Flynn KE, Azam L .
Nurses’ perceptions of a novel health information technology: a qualitative study in the pediatric intensive care unit.
Int J Hum Comput Interact 2017;33(4):258-64. doi: 10.1080/10447318.2017.1279828.
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Keywords: Health Information Technology (HIT), Intensive Care Unit (ICU), Patient and Family Engagement, Children/Adolescents, Nursing
Kolko RP, Kass AE, Hayes JF
Provider training to screen and initiate evidence-based pediatric obesity treatment in routine practice settings: a randomized pilot trial.
This randomized pilot trial evaluated two training modalities for first-line, evidence-based pediatric obesity services (screening and goal setting) among nursing students. Both live interactive training and Web-facilitated self-study training were acceptable, with higher ratings for live training and participants with previous experience. Knowledge and skill improved from pretraining to post-training and follow-up in both conditions.
AHRQ-funded; HS000078.
Citation: Kolko RP, Kass AE, Hayes JF .
Provider training to screen and initiate evidence-based pediatric obesity treatment in routine practice settings: a randomized pilot trial.
J Pediatr Health Care 2017 Jan - Feb;31(1):16-28. doi: 10.1016/j.pedhc.2016.01.001.
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Keywords: Children/Adolescents, Evidence-Based Practice, Nursing, Obesity, Training
de Cordova PB
Staffing and nurse-perceived quality of care.
This article comments on a study by Cho and colleagues, the purpose of which was to explore the associations between nurse staffing and overtime with nurse-perceived patient safety and care left undone. Cho and colleagues found that as patients per nurse and nurse work hours increase, so does the perception of reduced patient safety. The author argues that the study reinforces the view that educating nurses, administrators and policymakers about the importance of nurse staffing on quality care should continue.
AHRQ-funded; HS024339.
Citation: de Cordova PB .
Staffing and nurse-perceived quality of care.
Evid Based Nurs 2017 Jan;20(1):19. doi: 10.1136/eb-2016-102478.
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Keywords: Quality of Care, Provider, Nursing, Workforce
Bakken S, Reame N
http://www.ingentaconnect.com/content/springer/arnr/2016/00000034/00000001/art00013
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
The purposes of this chapter are to (a) briefly summarize the current drivers for the use of big data in research; (b) describe the promise of big data and associated data science methods for advancing symptom management research; and (c) explicate the potential perils of big data and data science from the perspective of the ethical principles of autonomy, beneficence, and justice.
AHRQ-funded; HS022961
Citation: Bakken S, Reame N .
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
Annu Rev Nurs Res 2016;34:247-60. doi: 10.1891/0739-6686.34.247..
Keywords: Data, Disparities, Nursing, Patient-Centered Outcomes Research
Martsolf GR, Gibson TB, Benevent R
AHRQ Author: Jiang HJ, Stocks C
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
The researchers studied the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. After controlling for unobserved hospital characteristics, they found that the positive influences of increased nurse staffing levels and skill mix were relatively small in size and limited to a few measures of patients' inpatient experience.
AHRQ-authored.
Citation: Martsolf GR, Gibson TB, Benevent R .
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
Health Serv Res 2016 Dec;51(6):2221-41. doi: 10.1111/1475-6773.12462.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Nursing, Patient Experience, Patient Experience, Healthcare Cost and Utilization Project (HCUP)
Harrod M, Montoya A, Mody L
Challenges for nurses caring for individuals with peripherally inserted central catheters in skilled nursing facilities.
The researchers sought to understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. They noted differences between resident self-reported PICC concerns (quality of life) and those described by frontline nurses.
AHRQ-funded; HS019979; HS022835.
Citation: Harrod M, Montoya A, Mody L .
Challenges for nurses caring for individuals with peripherally inserted central catheters in skilled nursing facilities.
J Am Geriatr Soc 2016 Oct;64(10):2059-64. doi: 10.1111/jgs.14341.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Nursing, Quality of Life, Transitions of Care
Grundy Q
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
The author analyzed the ways that committee members constructed and evaluated a case for a product's value, concluding that purchasing committees need unique support that emphasizes local contexts and expertise, while maintaining rigor and minimizing bias. Grundy proposed a guiding framework to support this decision-making.
AHRQ-funded; HS022383.
Citation: Grundy Q .
"Whether something cool is good enough": the role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.
Soc Sci Med 2016 Sep;165:82-91. doi: 10.1016/j.socscimed.2016.07.042.
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Keywords: Decision Making, Healthcare Costs, Hospitals, Nursing
Connor JA, Larson C, Baird J
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
The authors aimed to identify and develop standardized measures representative of pediatric nursing care of the cardiovascular patient for benchmarking within freestanding children's hospitals. The Consortium of Congenital Cardiac Care-Measurement of Nursing Practice members developed quality measures within working groups and then individually critiqued all drafted measures. The process resulted in 10 measures eligible for testing. The Consortium will continue with implementation and testing of each measure, supporting the development of benchmarks and the evaluation of the association of the measures with patient outcomes.
AHRQ-funded; HS000063.
Citation: Connor JA, Larson C, Baird J .
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
J Pediatr Nurs 2016 Sep-Oct;31(5):471-7. doi: 10.1016/j.pedn.2016.04.010.
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Keywords: Children/Adolescents, Cardiovascular Conditions, Nursing, Quality Measures, Hospitals
Poghosyan L, Liu J
Nurse practitioner autonomy and relationships with leadership affect teamwork in primary care practices: a cross-sectional survey.
The authors investigated whether nurse practitioner (NP) autonomy within primary care practices and the relationships they have with leadership affect teamwork between NPs and physicians. They concluded that NP autonomy and favorable relationships with leadership improve teamwork, and they recommended that policy and organizational change focus on promoting NP autonomy and improving the relationship between NPs and leadership to improve teamwork and consequently improve patient care and outcomes.
AHRQ-funded; HS020999.
Citation: Poghosyan L, Liu J .
Nurse practitioner autonomy and relationships with leadership affect teamwork in primary care practices: a cross-sectional survey.
J Gen Intern Med 2016 Jul;31(7):771-7. doi: 10.1007/s11606-016-3652-z.
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Keywords: Nursing, Organizational Change, Primary Care, Teams
Silber JH, Rosenbaum PR, McHugh MD
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
This study tested whether hospitals with better nursing work environments displayed better value than those with worse nursing. It found that hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients.
AHRQ-funded; HS018338.
Citation: Silber JH, Rosenbaum PR, McHugh MD .
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
JAMA Surg 2016 Jun;151(6):527-36. doi: 10.1001/jamasurg.2015.4908.
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Keywords: Healthcare Costs, Quality of Care, Nursing, Workforce
Navarra AM, Schlau R, Murray M
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
The researchers designed and tested the Nursing-Kids Intensity of Care Survey (N-KICS) tool and describe intensity of nursing care for children with complex medical conditions. Their psychometric evaluation confirmed an acceptable standard for reliability and validity and feasibility. Intensity scores were highest for nursing care related to infection control, medication administration, nutrition, diaper changes, hygiene, neurological and respiratory support, and standing program.
AHRQ-funded; HS021470.
Citation: Navarra AM, Schlau R, Murray M .
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
J Pediatr Nurs 2016 May-Jun;31(3):299-310. doi: 10.1016/j.pedn.2015.11.012.
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Keywords: Children/Adolescents, Chronic Conditions, Disabilities, Long-Term Care, Nursing, Vulnerable Populations
Baird J, Rehm RS, Hinds PS
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
The objective of this analysis was to explore the delivery of continuity of nursing care in the pediatric intensive care unit (PICU), from the perspective of both parents and nurses. Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child's care regimen.
AHRQ-funded; HS000063.
Citation: Baird J, Rehm RS, Hinds PS .
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
Nurs Res 2016 Mar-Apr;65(2):142-50. doi: 10.1097/nnr.0000000000000135.
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Keywords: Care Management, Children/Adolescents, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU), Nursing
Schondelmeyer AC, Brady PW, Landrigan CP
Alarm fatigue: clearing the air.
The authors discuss an article in the same issue of the Journal of Hospital Medicine by Paine and colleagues that sets out to review the small but growing body of literature addressing physiologic monitor alarms and interventions that have tried to address alarm fatigue. They conclude that the review demonstrates that the great majority of alarms do not help clinicians and likely contribute to alarm fatigue.
AHRQ-funded; HS023827.
Citation: Schondelmeyer AC, Brady PW, Landrigan CP .
Alarm fatigue: clearing the air.
J Hosp Med 2016 Feb;11(2):153-4. doi: 10.1002/jhm.2521.
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Keywords: Patient Safety, Nursing, Adverse Events, Hospitals
Abraham J, Kannampallil T, Brenner C
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
This paper describes Sequential Conversational Analysis (SCA) - a mixed-method approach integrating qualitative conversational analysis with quantitative sequential pattern analysis. This approach allows characterization of the nature of nurse handoff communication, highlighting the relationships underlying verbal content. The authors also discuss how SCA can help in understanding the dynamics of communication in other settings.
AHRQ-funded; HS017586.
Citation: Abraham J, Kannampallil T, Brenner C .
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
J Biomed Inform 2016 Feb;59:76-88. doi: 10.1016/j.jbi.2015.11.009.
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Keywords: Communication, Quality of Care, Intensive Care Unit (ICU), Nursing, Workflow
Jones K, Sibai J, Battjes R
How and when nurses collect urine cultures on catheterized patients: a survey of 5 hospitals.
Obtaining a specimen for urine culture is a key element in evaluating for catheter-associated urinary tract infections (CAUTIs). Nurses at 5 hospitals completed a survey regarding their knowledge, training, and practices of appropriate reasons for obtaining urine cultures. The researchers concluded that important opportunities exist for nurses to optimize the decisions to obtain urine cultures and the process for obtaining them.
AHRQ-funded; 290201000025I; 29032001T.
Citation: Jones K, Sibai J, Battjes R .
How and when nurses collect urine cultures on catheterized patients: a survey of 5 hospitals.
Am J Infect Control 2016 Feb;44(2):173-6. doi: 10.1016/j.ajic.2015.09.003.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Hospitals, Nursing, Provider: Nurse, Urinary Tract Infection (UTI)
Ricciardi R, Moy E, Wilson NJ
AHRQ Author: Ricciardi R and Moy E
Finding the true north: lessons from the National Healthcare Quality and Disparities Report.
The authors delineate important features and findings of the 2014 report. For example, it shows that one measure of patient safety improved quickly. The rate of central line–associated bloodstream infection per 1000 medical and surgical discharges (age 18+ years or obstetric admissions) improved at an annual rate of change of more than 10 percent. This success reflects the direct impact that nurses can have in making care safer for their patients.
AHRQ authors Ricciardi and Moy
Citation: Ricciardi R, Moy E, Wilson NJ .
Finding the true north: lessons from the National Healthcare Quality and Disparities Report.
J Nurs Care Qual 2016 Jan-Mar;31(1):9-12. doi: 10.1097/ncq.0000000000000164..
Keywords: Quality of Care, Disparities, Patient Safety, Nursing, Central Line-Associated Bloodstream Infections (CLABSI)
Gephart S, Carrington JM, Finley B
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
The purpose of this article is to present the state of the science on nurses' experiences with unintended consequences of electronic health records (EHRs). Findings demonstrate that nurses experience changes to workflow, must continually adapt to meet patient's needs in the context of imperfect EHR systems, and have difficulty accessing the information they need to make patient care decisions. Implications for nurse administrators include the need for continual engagement with nurses along the continuum of EHR design, as well as the need to encourage nurses to speak up and acknowledge workflow changes that threaten patient safety or do not support work efficiency.
AHRQ-funded; HS021074.
Citation: Gephart S, Carrington JM, Finley B .
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
Nurs Adm Q 2015 Oct-Dec;39(4):345-56. doi: 10.1097/naq.0000000000000119.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Electronic Health Records (EHRs), Nursing, Workflow
Gephart SM
Fostering best practice: strategies for writing evidence-based practice briefs.
In this editorial, the author provides instructions to make the task of writing a brief manageable for even the newest of authors. From asking a compelling clinical question to telling the story of a critical appraisal of evidence to making recommendations, the overall goal of writing such a brief is to support best practice care in the neonatal intensive care unit.
AHRQ-funded; HS022908.
Citation: Gephart SM .
Fostering best practice: strategies for writing evidence-based practice briefs.
Adv Neonatal Care 2015 Oct;15(5):299-306. doi: 10.1097/anc.0000000000000222.
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Keywords: Evidence-Based Practice, Nursing, Research Methodologies, Neonatal Intensive Care Unit (NICU)
Price LE, Shea K, Gephart S
The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice.
This article described the developments in research associated with the VHA's transition into the world of Big Data analytics through Corporate Data Warehouse (CDW) utilization. The authors found that the most commonly-occurring research topics are pharmacy/medications, systems issues, and weight management/obesity. They concluded that, despite the potential benefit of data mining techniques to improve patient care and services, the CDW and alternative analytical approaches are underutilized by researchers and clinicians.
AHRQ-funded; HS022908.
Citation: Price LE, Shea K, Gephart S .
The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice.
Nurs Adm Q 2015 Oct-Dec;39(4):311-8. doi: 10.1097/naq.0000000000000118.
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Keywords: Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Ricciardi R
AHRQ Author: Ricciardi R
I'm in an NP state of mind: a tribute to Dr. Henry K. Silver on the 50th anniversary of the nurse practitioner profession.
The author gives a personal tribute to Dr. Henry K Silver who co-founded the nurse practitioner role with Dr. Loretta Ford and founded the Child Health Associate/Physician Assistant program at the University of Colorado.
AHRQ-authored.
Citation: Ricciardi R .
I'm in an NP state of mind: a tribute to Dr. Henry K. Silver on the 50th anniversary of the nurse practitioner profession.
J Pediatr Health Care 2015 Sep-Oct;29(5):397-9. doi: 10.1016/j.pedhc.2015.06.009..
Keywords: Nursing, Children/Adolescents, Provider: Health Personnel
Stifter J, Yao Y, Lodhi MK
Nurse continuity and hospital-acquired pressure ulcers: A comparative analysis using an electronic health record "big data" set.
The aim of this study was to examine the association of nurse continuity with the prevention of hospital-acquired pressure ulcers (HAPU). It found that patient characteristics including nutrition, mobility, and perfusion were associated with HAPUs, but nurse continuity was not.
AHRQ-funded; HS023072.
Citation: Stifter J, Yao Y, Lodhi MK .
Nurse continuity and hospital-acquired pressure ulcers: A comparative analysis using an electronic health record "big data" set.
Nurs Res 2015 Sep-Oct;64(5):361-71. doi: 10.1097/nnr.0000000000000112..
Keywords: Patient Safety, Pressure Ulcers, Nursing