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
26 to 50 of 158 Research Studies DisplayedMack DS, Baek J, Tjia J
Geographic variation of statin use among US nursing home residents with life-limiting illness.
The authors described regional variation in statin use among residents with life-limiting illness. Statin usage was determined by examination of Medicare Part D claims. Findings suggested extensive geographic variation in US statin prescribing across hospital referral regions, especially for those aged 76 years or older. This variation may reflect clinical uncertainty given the largely absent guidelines for statin use in nursing home residents.
AHRQ-funded; HS026840.
Citation: Mack DS, Baek J, Tjia J .
Geographic variation of statin use among US nursing home residents with life-limiting illness.
Med Care 2021 May;59(5):425-36. doi: 10.1097/mlr.0000000000001505..
Keywords: Elderly, Nursing Homes, Long-Term Care, Medicare, Practice Patterns
Mack DS, Hume AL, Tjia J
National trends in statin use among the United States nursing home population (2011-2016).
AHRQ-funded; HS026840.
Citation: Mack DS, Hume AL, Tjia J .
National trends in statin use among the United States nursing home population (2011-2016).
Drugs Aging 2021 May;38(5):427-39. doi: 10.1007/s40266-021-00844-8..
Keywords: Elderly, Nursing Homes, Long-Term Care, Blood Thinners, Medication
Hua CL, Cornell PY, Zimmerman S
Trends in serious mental illness in US assisted living compared to nursing homes and the community: 2007-2017.
This study examined trends in the prevalence of serious mental illness (SMI) in assisted living (AL) communities in the United States over time and in relationship to characteristics such as dual eligibility and health conditions. Using Medicare data, findings showed that the prevalence of SMI in AL increased by 54% from 2007 to 2017. Residents with SMI were more likely to be dually eligible for Medicare and Medicaid than residents without SMI. Approximately 10% of AL communities had over half of the sample's AL residents with SMI.
AHRQ-funded; HS000011.
Citation: Hua CL, Cornell PY, Zimmerman S .
Trends in serious mental illness in US assisted living compared to nursing homes and the community: 2007-2017.
Am J Geriatr Psychiatry 2021 May;29(5):434-44. doi: 10.1016/j.jagp.2020.09.011..
Keywords: Elderly, Behavioral Health, Nursing Homes, Long-Term Care, Medicare
Reistetter TA, Eschbach K K, Prochaska J
Understanding variation in postacute care: developing rehabilitation service areas through geographic mapping.
This study’s goal was to demonstrate a method for developing rehabilitation service areas for post-acute care. A secondary analysis of 2013-2014 Medicare records for older patients in Texas (n = 469,172) was conducted. The analysis included admission records for inpatient rehabilitation facilities, skilled nursing facilities, and long-term care hospitals. The authors used Ward’s algorithm to cluster patient ZIP code tabulation areas based on which facilities patients were admitted to for rehabilitation. They set the number of rehabilitation clusters to 22 to allow for comparison to the 22 hospital referral regions. Interclass Correlation Coefficient (ICC) and variance in the number of rehabilitation beds across areas were the methods used to evaluate rehabilitation service areas. The service areas had a higher ICC and variance in beds than the hospital referral regions.
AHRQ-funded; HS024711.
Citation: Reistetter TA, Eschbach K K, Prochaska J .
Understanding variation in postacute care: developing rehabilitation service areas through geographic mapping.
Am J Phys Med Rehabil 2021 May;100(5):465-72. doi: 10.1097/phm.0000000000001577..
Keywords: Elderly, Rehabilitation, Medicare, Nursing Homes, Long-Term Care, Home Healthcare, Access to Care
Enyioha C, Khairat S, Kistler CE
Adoption of electronic health records by practices of nursing home providers and Wi-Fi availability in nursing homes.
This study evaluated the rate of electronic health record (EHR) adoption by nursing homes (NHs) and nursing home providers and Wi-Fi availability in nursing homes by geographical region. The authors conducted a cross-sectional survey on a convenience sample of NH primary care providers (PCPs) serving 867 NHs recruited from the Medefield Primary Care research panel. They also sought to evaluate the proportion of NHs with Wi-Fi access. The states were categorized into four geographical locations: Midwest, Northeast, South, and West. Participants included a total of 515 physicians, 209 nurse practitioners, and 143 physician assistants. Mean age of participants was 49 years, 56% were male, and 76% white. The mean number of days per week participants worked in a NH was 1.8 and number of hours per week 32.3. Overall, 89.4% reported EHR adoption in their practice, and 73.2% reported Wi-Fi presence in their primary NH. The three most EHRs were EpicCare Ambulatory (24.0%), Vitera (20.4%), and eClinicalWorks (14.4%) Wi-Fi access was highest in the Northeast (78.1%) and lowest in the West (63.9%). Rates of EHR adoption was also highest in the Northeast (94.5%). These differences may help explain continued deficiencies in care coordination between NH and other sites of clinical care.
AHRQ-funded; HS024519.
Citation: Enyioha C, Khairat S, Kistler CE .
Adoption of electronic health records by practices of nursing home providers and Wi-Fi availability in nursing homes.
J Am Med Dir Assoc 2021 Feb;22(2):475-76. doi: 10.1016/j.jamda.2020.09.028..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing Homes, Long-Term Care
Alexander GL, Powell KR, Deroche CB
An evaluation of telehealth expansion in U.S. nursing homes.
This study contains the results of a national survey about telehealth use reported in a random sample of US nursing homes. The sample includes 664 nursing homes that completed surveys about information technology maturity from January 2019 to August 4, 2020. Differences in nursing home telehealth use was examined prior to and after telehealth expansion. A cumulative telehealth score was calculated using survey data from 6 questions about the expansion of telehealth use (score range 0-42). Larger metropolitan nursing homes had greater telehealth use. Ownership type had little effect. Nursing home telehealth use postexpansion used telehealth applications for resident evaluation 11.24 times more than pre-expansion. A wide range of telehealth use was reported, with approximately 16% having no telehealth use and 5% having the maximum amount of telehealth use. Mean telehealth use scores reported by the majority of these nursing homes were on the lower end of the range. However, increasing use will most likely continue due to the current pandemic.
AHRQ-funded; HS022497.
Citation: Alexander GL, Powell KR, Deroche CB .
An evaluation of telehealth expansion in U.S. nursing homes.
J Am Med Inform Assoc 2021 Feb 15;28(2):342-48. doi: 10.1093/jamia/ocaa253..
Keywords: Nursing Homes, Long-Term Care, Telehealth, Health Information Technology (HIT)
Orth J, Li Y, Simning A
End-of-life care among nursing home residents with dementia varies by nursing home and market characteristics.
This study’s objectives were to examine variations in end-of-life (EOL) care/outcomes among decedents with Alzheimer's disease/related dementias (ADRD) and to identify associations with nursing home (NH)/market characteristics. Findings showed that decedents with ADRD in NHs that were nonprofit, had Alzheimer's units, higher licensed nurse staffing, and in more competitive markets, had better EOL care/outcomes. Recommendations included modifications to state Medicaid NH payments to promote better EOL care/outcomes and future research to understand NH care practices associated with presence of Alzheimer's units in order to identify mechanisms possibly promoting higher-quality EOL care.
AHRQ-funded; HS024923.
Citation: Orth J, Li Y, Simning A .
End-of-life care among nursing home residents with dementia varies by nursing home and market characteristics.
J Am Med Dir Assoc 2021 Feb;22(2):320-28.e4. doi: 10.1016/j.jamda.2020.06.021..
Keywords: Elderly, Palliative Care, Dementia, Nursing Homes, Long-Term Care
Hanlon JT, Perera S, Schweon S
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
This study evaluated the impact of an educational quality improvement initiative on the appropriateness of antibiotic prescribing restricted to uncomplicated cystitis in older noncatheterized nursing home residents. This 1-year case-control study used 25 participating nursing homes that were randomized to the intervention or usual care group by strata that included state, urban/rural status, bed size, and geographic separation. A total of 75 cases of cystitis were found in the intervention groups and 92 in the control groups. The intervention group had a nonsignificant 21% reduction in the risk of antibiotic prescribing. There was a favorable comparison in appropriateness of duration. However, the intervention group had more problems with drug-drug interactions than the control group (8% vs 1%). There were also more problems with dosage in the intervention group. Both groups had similar rates of problems with choice or effectiveness (44% vs 45%). The most common antibiotic class that was prescribed inappropriately was quinolones.
AHRQ-funded; R18 HS023779.
Citation: Hanlon JT, Perera S, Schweon S .
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
J Am Med Dir Assoc 2021 Jan;22(1):173-77. doi: 10.1016/j.jamda.2020.07.040..
Keywords: Elderly, Nursing Homes, Long-Term Care, Antibiotics, Medication, Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Decision Making
Beeber AS, Kistler CE, Zimmerman S
Nurse decision-making for suspected urinary tract infections in nursing homes: potential targets to reduce antibiotic overuse.
This study’s goal was to determine what information is most important to registered nurses (RNs) decisions to call clinicians about suspected urinary tract infections (UTIs) in nursing home residents. An online survey was conducted with a convenience sample of 881 RNs recruited from a health care research panel. Clinical scenarios from 10 categories of resident characteristics were used: UTI risk, resident type, functional status, mental status, lower urinary tract status, body temperature, physical exam, urinalysis, antibiotic request, and goals of care. Participants were randomized into 2 deliberation conditions: self-paced (n=437) and forced deliberation (n=444). Painful or difficult urinary, obvious blood in urine and temperature at 101.5° had the highest odds of a RN calling a clinician by the forced-deliberation group. For the self-paced group, painful or difficult urination had the highest odds.
AHRQ-funded; HS024519.
Citation: Beeber AS, Kistler CE, Zimmerman S .
Nurse decision-making for suspected urinary tract infections in nursing homes: potential targets to reduce antibiotic overuse.
J Am Med Dir Assoc 2021 Jan;22(1):156-63. doi: 10.1016/j.jamda.2020.06.053..
Keywords: Urinary Tract Infection (UTI), Antibiotics, Antimicrobial Stewardship, Medication, Nursing Homes, Long-Term Care, Decision Making, Diagnostic Safety and Quality
Montoya A, Jenq G, Mills JP
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
In this study, the authors described, among short-term and long-term residents at three nursing homes (NHs) in Michigan, the outbreak identification process, universal testing, point prevalence of COVID-19, and subsequent containment efforts, outcomes, and challenges. They found that proactive and coordinated steps between NH medical directors and administrators, referral hospitals including their laboratories, and local public health officials were necessary to respond rapidly to an outbreak and to limit the transmission of COVID-19. They suggested that this coordinated public health approach may save lives, minimize the burden to the healthcare system, and reduce healthcare costs.
AHRQ-funded; HS025451.
Citation: Montoya A, Jenq G, Mills JP .
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
J Am Geriatr Soc 2021 Jan;69(1):30-36. doi: 10.1111/jgs.16869..
Keywords: Hospitals, Nursing Homes, Long-Term Care, Public Health, COVID-19, Elderly, Infectious Diseases
Kim JJ, Johnson JK, Stucke EM
Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves.
Transmission of Staphylococcus aureus (S. aureus) to health care workers (HCWs) on gowns and gloves has been an issue in nursing homes. This study evaluated the effect of the burden in 13 community-based nursing homes in Maryland and Michigan. Residents were cultured for S. aureus at the perianal skin and the anterior nares areas. A total of 403 residents were enrolled, with 169 colonized with methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA). Transmission to HCW gowns and gloves was greater from those colonized with greater quantities of S. aureus on the perianal skin. These findings inform future infection control practices for both MRSA and MSSA in nursing homes.
AHRQ-funded; HS019979; HS025451.
Citation: Kim JJ, Johnson JK, Stucke EM .
Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves.
Infect Control Hosp Epidemiol 2020 Dec;41(12):1396-401. doi: 10.1017/ice.2020.336..
Keywords: Elderly, Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs), Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention
McKinnell JA, Miller LG, Singh RD
High prevalence of multidrug-resistant organism colonization in 28 nursing homes: an "iceberg effect."
The objective of this study was to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), extended-spectrum beta-lactamase producing organisms (ESBLs), and carbapenem-resistant Enterobacteriaceae (CRE) among residents and in the environment of nursing homes (NHs). The investigators concluded that in more than half of the NHs, more than 50% of residents were colonized with MDROs of clinical and public health significance, most commonly MRSA and ESBL. Additionally, the vast majority of resident rooms and common areas were MDRO contaminated.
AHRQ-funded; HS024286.
Citation: McKinnell JA, Miller LG, Singh RD .
High prevalence of multidrug-resistant organism colonization in 28 nursing homes: an "iceberg effect."
J Am Med Dir Assoc 2020 Dec;21(12):1937-43.e2. doi: 10.1016/j.jamda.2020.04.007..
Keywords: Nursing Homes, Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs)
Konetzka RT, Jung DH, Gorges RJ
Outcomes of Medicaid home- and community-based long-term services relative to nursing home care among dual eligibles.
This study measured the outcomes of dual-eligible recipients of Medicaid home- and community-based long-term services (HCBS) compared to nursing home residents. The authors used the 2005 and 2012 Medicaid Analytic eXtract (MAX) database, a national compilation of Medicaid claims which merges Medicare claims to identify hospital admissions. A cohort of 1,312,498 older adults dually enrolled in Medicaid and Medicare and using long-term care was tracked. HCBS users were found to have 10 percent points higher annual rates of hospitalization than their nursing home counterparts when selection bias is addressed. The differences persisted across races, dementia status, and intensity of HCBS spending.
AHRQ-funded; HS000084.
Citation: Konetzka RT, Jung DH, Gorges RJ .
Outcomes of Medicaid home- and community-based long-term services relative to nursing home care among dual eligibles.
Health Serv Res 2020 Dec;55(6):973-82. doi: 10.1111/1475-6773.13573..
Keywords: Elderly, Long-Term Care, Nursing Homes, Medicaid, Medicare, Outcomes
Mack DS, Baek J, Tjia J
Statin discontinuation and life-limiting illness in non-skilled stay nursing homes at admission.
Researchers estimated 30-day statin discontinuation among newly admitted nursing home residents overall and within categories of life-limiting illness. Participants were Medicare fee-for-service beneficiaries age 65 or older who were undergoing statin pharmacotherapy before admission to Medicare- and Medicaid-certified nursing home facilities. The researchers found that statin use continued in a large proportion of Medicare beneficiaries after admission to a nursing home. They recommended additional deprescribing research.
AHRQ-funded; HS026840.
Citation: Mack DS, Baek J, Tjia J .
Statin discontinuation and life-limiting illness in non-skilled stay nursing homes at admission.
J Am Geriatr Soc 2020 Dec;68(12):2787-96. doi: 10.1111/jgs.16777.
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Keywords: Elderly, Nursing Homes, Long-Term Care, Medication
Makam AN, Nguyen OK, Miller ME
Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer.
This study compared the effectiveness of long-term acute care hospital (LTACH) use versus skilled nursing facility (SNF) transfer after hospitalization. Medicare claims linked to electronic health record (EHR) data from six Texas hospitals between 2009 and 2010 were used to conduct a retrospective cohort study of hospitalized patients transferred to either an LTACH or SNF and followed for one year. Out of 3505 patients, 18% were transferred to an LTACH and overall were younger, less likely to be female, and white, but sicker than transfers to an SNF. Patients transferred to an LTACH were less likely to survive (59 vs. 65%) or recover (62.5 vs 66%). Adjusting for demographic and clinical confounders found in Medicare claims and EHR data, transfer location was not significantly associated with differences in mortality but was associated with greater Medicare spending.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Miller ME .
Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer.
BMC Health Serv Res 2020 Nov 11;20(1):1032. doi: 10.1186/s12913-020-05847-6..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Long-Term Care, Elderly, Medicare, Transitions of Care, Nursing Homes, Hospitals
Zimmerman S, Wretman CJ, Ward K
Fidelity and sustainability of Mouth Care Without a Battle and lessons for other innovations in care.
This project examined the fidelity and sustainability of Mouth Care Without a Battle (MCWB), an evidence-based program conducted in a two-year cluster randomized trial in 14 nursing homes. The investigators found that results that triangulated two sources of data indicated that fidelity decreased after the first year; results provided guidance to promote fidelity and sustainability of this and other new care practices in nursing homes, including ongoing education, coaching, evaluation, feedback, and sufficient resources.
AHRQ-funded; HS022298.
Citation: Zimmerman S, Wretman CJ, Ward K .
Fidelity and sustainability of Mouth Care Without a Battle and lessons for other innovations in care.
Geriatr Nurs 2020 Nov-Dec;41(6):878-84. doi: 10.1016/j.gerinurse.2020.06.002..
Keywords: Elderly, Nursing Homes, Long-Term Care, Evidence-Based Practice
Mangrum R, Stewart MD, Gifford DR
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
The goal of this study was to create a uniform definition of omission of care in US nursing homes. Lack of a uniform definition has made efforts to prevent them challenging. Subject matter experts and a broad range of nursing home stakeholders were brought together in iterative rounds of engagement to identify key concepts and aspects of omissions of care and develop a consensus-based definition. The concise definition decided on was: “Omissions of care in nursing homes encompass situations when care–either clinical or nonclinical–is not provided for a resident and results in additional monitoring or intervention or increases the risk of an undesirable or adverse physical, emotional, or psychosocial outcome for the resident."
AHRQ-funded; 233201500014I.
Citation: Mangrum R, Stewart MD, Gifford DR .
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
J Am Med Dir Assoc 2020 Nov;21(11):1587-91.e2. doi: 10.1016/j.jamda.2020.08.016..
Keywords: Elderly, Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care, Medical Errors, Adverse Events, Patient Safety, Risk, Patient-Centered Outcomes Research
Orth J, Li Y, Simning A
Severe behavioral health manifestations in nursing homes: associations with service availability?
The objective of this study was to examine associations between availability of behavioral health (BH) services and the presence of severe depression, suicidal ideation (SI), and severe aggressive behaviors (ABs) among nursing home (NH) residents. 2017 survey data on BH service availability was obtained from 1,051 NHs and the Minimum Data Set (MDS) to identify long-term stay residents in these facilities (n = 101,238). Odds of severe depression were 21% higher when NHs reported inadequate BH staff education as well as 13% higher for SI and 10% higher for severe ABs among residents in facilities reporting inadequate facility infrastructure. Facility-level factors such as staffing, training, and turnover were also statistically significant associations with these severe BH manifestations.
AHRQ-funded; HS024923.
Citation: Orth J, Li Y, Simning A .
Severe behavioral health manifestations in nursing homes: associations with service availability?
J Am Geriatr Soc 2020 Nov;68(11):2643-49. doi: 10.1111/jgs.16772..
Keywords: Elderly, Nursing Homes, Long-Term Care, Depression, Behavioral Health, Access to Care
Alexander GL, Madsen R, Deroche CB
Ternary trends in nursing home information technology and quality measures in the United States.
This survey investigated whether improvements in nursing home information technology (NH IT) increases quality measures. Nursing home administrators were surveyed from 2014 to 2017. Nine dimensions/domains and total IT sophistication were measured. A total of 815 Year 1 surveys were completed. It was found that for every 10 units increase in administrative activity of IT use, a decrease of 1.3% occurred in the percentage of low-risk long-stay residents with bowel or bladder incontinence.
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen R, Deroche CB .
Ternary trends in nursing home information technology and quality measures in the United States.
J Appl Gerontol 2020 Oct;39(10):1134-43. doi: 10.1177/0733464819862928..
Keywords: Nursing Homes, Health Information Technology (HIT), Quality Measures, Quality Improvement, Long-Term Care, Quality of Care
White EM, Kosar CM, Feifer RA
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
The objective of this study was to identify county and facility factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks in skilled nursing facilities (SNFs). The investigators concluded that larger SNFs and SNFs in areas of high SARS-CoV-2 prevalence were at high risk for outbreaks and must have access to universal testing to detect cases, implement mitigation strategies, and prevent further potentially avoidable cases and related complications.
AHRQ-funded; HS000011.
Citation: White EM, Kosar CM, Feifer RA .
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
J Am Geriatr Soc 2020 Oct;68(10):2167-73. doi: 10.1111/jgs.16752..
Keywords: COVID-19, Elderly, Nursing Homes, Long-Term Care, Public Health, Infectious Diseases
Ramly E, Tong M, Bondar S
Workflow barriers and strategies to reduce antibiotic overuse in nursing homes.
Antibiotic overuse is a significant problem in nursing homes (NHs). Strategies to improve antibiotic prescribing practices in NHs are a critical need. In this study, the investigators analyzed antibiotic prescribing workflows to identify strategies for improving antibiotic prescribing in NHs. They found that such strategies included structured information tools, nurse and prescriber education, and organizational improvement.
AHRQ-funded; HS022465.
Citation: Ramly E, Tong M, Bondar S .
Workflow barriers and strategies to reduce antibiotic overuse in nursing homes.
J Am Geriatr Soc 2020 Oct;68(10):2222-31. doi: 10.1111/jgs.16632..
Keywords: Workflow, Antibiotics, Medication, Nursing Homes, Long-Term Care, Elderly, Antimicrobial Stewardship, Practice Patterns
Temkin-Greener H, Cen X, Li Y
Nursing home staff turnover and perceived patient safety culture: results from a national survey.
In this study, the investigators examined the association between turnover of registered nurses (RNs) and certified nurse assistants (CNAs) and perceived patient safety culture (PSC) in nursing homes (NHs). The investigators suggest that the effect of turnover on PSC depends on who leaves and to a lesser extent on the organizational characteristics. In NHs, improvements in PSC may depend on the ability to retain a well-trained and skilled nursing staff.
AHRQ-funded; HS024923.
Citation: Temkin-Greener H, Cen X, Li Y .
Nursing home staff turnover and perceived patient safety culture: results from a national survey.
Gerontologist 2020 Sep 15;60(7):1303-11. doi: 10.1093/geront/gnaa015..
Keywords: Nursing Homes, Long-Term Care, Surveys on Patient Safety Culture, Patient Safety, Provider: Nurse, Provider
Li Y, Temkin-Greener H, Shan G
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
This study looked at the relationship between higher registered nurse (RN) staffing, quality ratings, the concentration of Medicaid residents or racial/ethnic minorities; and the number of COVID-19 confirmed cases and deaths at nursing homes. All Connecticut nursing homes (n = 215) were included in the study. As of April 16, 2020, the average number of confirmed cases was 8 per nursing home (zero in 107 facilities) and the number of confirmed deaths was 1.7 per nursing (zero in 131 facilities). In nursing homes with at least one death, every 20-minute increase in RN staffing significantly predicted 26% fewer COVID-19 deaths and was associated with 22% fewer confirmed cases. Facilities with a high concentration of Medicaid residents or racial/ethnic minority residents had 16% and 15% more confirmed cases.
AHRQ-funded; HS024923; HS026893.
Citation: Li Y, Temkin-Greener H, Shan G .
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
J Am Geriatr Soc 2020 Sep;68(9):1899-906. doi: 10.1111/jgs.16689..
Keywords: Elderly, COVID-19, Nursing Homes, Long-Term Care, Mortality, Racial and Ethnic Minorities
Wretman CJ, Zimmerman S, Ward K
Measuring self-efficacy and attitudes for providing mouth care in nursing homes.
Mouth care is increasingly recognized as an important component of care in nursing homes (NHs) yet is known to be deficient. To promote quality improvement and inform research efforts, it is necessary to have valid measures of staff self-efficacy and attitudes to provide mouth care. The purpose of this study was to measure self-efficacy and attitudes for providing mouth care in nursing homes.
AHRQ-funded; HS022298.
Citation: Wretman CJ, Zimmerman S, Ward K .
Measuring self-efficacy and attitudes for providing mouth care in nursing homes.
J Am Med Dir Assoc 2020 Sep;21(9):1316-21. doi: 10.1016/j.jamda.2020.02.007..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dental and Oral Health
Abrahamson K, Hass Z, Arling G
Shall I stay or shall I go? The choice to remain in the nursing home among residents with high potential for discharge.
This study examines why private-pay nursing home (NH) residents who expressed a desire for discharge and had relatively low-care needs chose to remain in the NH. The Minnesota Return to Community Initiative (RTCI) is a program that assists those residents to return to the community. Those who remained were more likely to beolder, more cognitively impaired, unmarried, had behavior problems, or diagnosed with dementia. At a 90-day assessment, residents who remained in the facility had a small decline in cognitive status, their continence improved, and they become more independent in activities of daily living (ADLs). Seventy-four percent of those remaining reported a perception of health barriers to discharge.
AHRQ-funded; HS020224.
Citation: Abrahamson K, Hass Z, Arling G .
Shall I stay or shall I go? The choice to remain in the nursing home among residents with high potential for discharge.
J Appl Gerontol 2020 Aug;39(8):863-70. doi: 10.1177/0733464818807818..
Keywords: Elderly, Nursing Homes, Long-Term Care, Transitions of Care, Decision Making