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Research Studies is a compilation of published research articles funded by ´óÏóÊÓƵor authored by ´óÏóÊÓƵresearchers.

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26 to 50 of 51 Research Studies Displayed
Baker AW, Dicks KV, Durkin MJ
Epidemiology of surgical site infection in a community hospital network.
The researchers described the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens. They found that the prevalence of MRSA SSI decreased from 2008 to 2012. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence.
AHRQ-funded; HS023866.
Citation: Baker AW, Dicks KV, Durkin MJ . Epidemiology of surgical site infection in a community hospital network. Infect Control Hosp Epidemiol 2016 May;37(5):519-26. doi: 10.1017/ice.2016.13.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Injuries and Wounds, Adverse Events, Risk, Hospitals
Tischendorf J, de Avila RA, Safdar N
Risk of infection following colonization with carbapenem-resistant Enterobactericeae: a systematic review.
The authors examined the risk of developing infection among those colonized with carbapenem-resistant enterobacteriaceae (CRE). They found an overall 16.5% risk of infection with CRE, with the most common site of infection being the lung. They concluded that, given the high mortality rate observed with CRE infection and the difficulty in treating these infections, research to investigate and develop strategies to eliminate the colonization state are needed.
AHRQ-funded; HS023791; HS024039.
Citation: Tischendorf J, de Avila RA, Safdar N . Risk of infection following colonization with carbapenem-resistant Enterobactericeae: a systematic review. Am J Infect Control 2016 May;44(5):539-43. doi: 10.1016/j.ajic.2015.12.005.
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Keywords: Antibiotics, Healthcare-Associated Infections (HAIs), Patient Safety, Risk, Risk
Schulte DM, Duster M, Warrack S
Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients.
The primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. It found overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients.
AHRQ-funded; HS024039.
Citation: Schulte DM, Duster M, Warrack S . Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients. Subst Abuse Treat Prev Policy 2016 Apr 26;11:15. doi: 10.1186/s13011-016-0059-0.
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Keywords: Healthcare-Associated Infections (HAIs), Patient Experience, Patient Experience, Prevention, Tobacco Use
Olsen MA, Young-Xu Y, Stwalley D
The burden of Clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases.
The researchers used comparable methods with multiple administrative databases to compare the incidence of clostridium difficile infection (CDI) in older and younger persons in the United States. They found that the incidence of CDI was 10-fold lower and the proportion of community-onset CDI was much higher in the privately insured younger LabRx population compared to the elderly Medicare population.
AHRQ-funded; HS019455.
Citation: Olsen MA, Young-Xu Y, Stwalley D . The burden of Clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases. BMC Infect Dis 2016 Apr 22;16:177. doi: 10.1186/s12879-016-1501-7.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Data, Prevention
Popoola VO, Colantuoni E, Suwantarat N
Active surveillance cultures and decolonization to reduce staphylococcus aureus infections in the neonatal intensive care unit.
The researchers examined the impact of methicillin-susceptible S. aureus (MSSA) decolonization on the incidence of MSSA infection and to measure the prevalence of mupirocin resistance. They found that active surveillance cultures and decolonization may be effective in decreasing S. aureus infections in NICUs.
AHRQ-funded; HS022872.
Citation: Popoola VO, Colantuoni E, Suwantarat N . Active surveillance cultures and decolonization to reduce staphylococcus aureus infections in the neonatal intensive care unit. Infect Control Hosp Epidemiol 2016 Apr;37(4):381-7. doi: 10.1017/ice.2015.316..
Keywords: Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Newborns/Infants
Croft L, Ladd J, Doll M
Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection.
To understand how often Clostridium difficile infection (CDI) is related to inappropriate medication use, the researchers evaluated appropriateness of antimicrobial therapy and gastric acid suppression preceding CDI acquired. Of all CDI episodes, 38.0 percent (27 of 71) were preceded by inappropriate gastric acid suppressant medications. For the 40 episodes in which gastric acid suppressant medications were used prior to CDI, 27 (67.5 percent) were inappropriately treated.
AHRQ-funded; HS018111.
Citation: Croft L, Ladd J, Doll M . Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection. Infect Control Hosp Epidemiol 2016 Apr;37(4):494-5. doi: 10.1017/ice.2016.2.
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Keywords: Adverse Drug Events (ADE), Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication: Safety, Medication
Chopra V, Smith S, Swaminathan L
Variations in peripherally inserted central catheter use and outcomes in Michigan hospitals.
The researchers examined the use of peripherally inserted central catheters (PICCs) by conducting a prospective study at 10 hospitals through the Michigan Hospital Medicine Safety Consortium. Their multicenter study found substantial variation in PICC indications, patterns of use, and outcomes at the 10 Michigan hospitals included in the study.
AHRQ-funded; HS022835.
Citation: Chopra V, Smith S, Swaminathan L . Variations in peripherally inserted central catheter use and outcomes in Michigan hospitals. JAMA Intern Med 2016 Apr;176(4):548-51. doi: 10.1001/jamainternmed.2015.8402.
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Keywords: Patient Safety, Practice Patterns, Healthcare-Associated Infections (HAIs), Hospitals, Outcomes, Adverse Events
Fakih MG, Gould CV, Trautner BW
Beyond infection: device utilization ratio as a performance measure for urinary catheter harm.
As multiple definitions for measuring catheter-associated urinary tract infections exist, the authors advocate use of the device utilization ratio (DUR) as an additional performance measure for potential urinary catheter harm. The DUR is currently captured as part of National Healthcare Safety Network reporting, and the data are readily obtainable from electronic medical records. This method also provides a more direct reflection of improvement efforts focused on reducing inappropriate urinary catheter use.
AHRQ-funded; 290201000025I.
Citation: Fakih MG, Gould CV, Trautner BW . Beyond infection: device utilization ratio as a performance measure for urinary catheter harm. Infect Control Hosp Epidemiol 2016 Mar;37(3):327-33. doi: 10.1017/ice.2015.287.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Prevention, Patient-Centered Outcomes Research
Safdar N, Codispoti N, Purvis S
Patient perspectives on indwelling urinary catheter use in the hospital.
The researchers assessed patient perspectives of indwelling urinary catheters. They recommended implementing educational programs incorporating patient preferences for both health care workers and patients in order to increase the involvement of patients in decision-making regarding urinary catheters, which may lead to a decline in catheter-associated urinary tract infections.
AHRQ-funded; HS023791.
Citation: Safdar N, Codispoti N, Purvis S . Patient perspectives on indwelling urinary catheter use in the hospital. Am J Infect Control 2016 Mar;44(3):e23-4. doi: 10.1016/j.ajic.2015.10.011.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Education: Patient and Caregiver, Shared Decision Making, Healthcare-Associated Infections (HAIs), Patient Safety
Davis KK, Harris KG, Mahishi V
Perceptions of culture of safety in hemodialysis centers.
Staff members, physicians, nurse practitioners, and physician assistants from a sample of hemodialysis facilities completed a 10-item assessment with modified questions from the Hospital Survey on Patient Safety Culture, with an emphasis on safety culture related to vascular access infections. Overall, scores were high, indicating a positive patient safety culture.
AHRQ-funded; 2902010000251.
Citation: Davis KK, Harris KG, Mahishi V . Perceptions of culture of safety in hemodialysis centers. Nephrol Nurs J 2016 Mar-Apr;43(2):119-26, 82; quiz 27.
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Keywords: Surveys on Patient Safety Culture, Patient Safety, Dialysis, Kidney Disease and Health, Organizational Change, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Provider
Loyland B, Wilmont S, Hessels AJ
Staff knowledge, awareness, perceptions, and beliefs about infection prevention in pediatric long-term care facilities.
The aims of this study were to explore direct care providers' knowledge about infection prevention and hand hygiene, attitudes regarding their own and others' hand hygiene practices, and ideas and advice for improving infection prevention efforts. Findings suggested that one essential driver of staff behavior change is having expectations that are meaningful to staff, and many staff members stated that they wanted more in-person staff meetings with education and hands-on, practical advice. Also, workflow patterns and/or the physical environment need to be carefully evaluated to identify systems and methods to minimize cross-contamination.
AHRQ-funded; HS021470.
Citation: Loyland B, Wilmont S, Hessels AJ . Staff knowledge, awareness, perceptions, and beliefs about infection prevention in pediatric long-term care facilities. Nurs Res 2016 Mar-Apr;65(2):132-41. doi: 10.1097/nnr.0000000000000136.
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Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Children/Adolescents, Prevention
Lee BY, Bartsch SM, Wong KF
The potential trajectory of carbapenem-resistant enterobacteriaceae, an emerging threat to health-care facilities, and the impact of the Centers for Disease Control and Prevention Toolkit.
The researchers simulated the spread of Carbapenem-resistant Enterobacteriaceae (CRE), throughout Orange County health-care facilities under 3 scenarios. Their model suggests that without increased infection control approaches, CRE would become endemic in nearly all Orange County health-care facilities within 10 years. While implementing the interventions in the Centers for Disease Control and Prevention's CRE toolkit would not completely stop the spread of CRE, it would cut its spread substantially, by half.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Wong KF . The potential trajectory of carbapenem-resistant enterobacteriaceae, an emerging threat to health-care facilities, and the impact of the Centers for Disease Control and Prevention Toolkit. Am J Epidemiol 2016 Mar 1;183(5):471-9. doi: 10.1093/aje/kwv299.
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Keywords: Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Hospitalization, Public Health
Creehan S, Cuddigan J, Gonzales D
The VCU pressure ulcer summit-developing centers of pressure ulcer prevention excellence: a framework for sustainability.
The purpose of this paper is to present a framework describing the proposed Magnet-designated Centers of Pressure Ulcer Prevention Excellence resulting from a national summit convened at the Virginia Commonwealth University Medical Center in March 2014. The authors discussed the structures, processes, and outcome measures necessary to become a proposed Center of Pressure Ulcer Prevention Excellence.
AHRQ-funded; HS023710.
Citation: Creehan S, Cuddigan J, Gonzales D . The VCU pressure ulcer summit-developing centers of pressure ulcer prevention excellence: a framework for sustainability. J Wound Ostomy Continence Nurs 2016 Mar-Apr;43(2):121-8. doi: 10.1097/won.0000000000000203.
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Keywords: Guidelines, Healthcare-Associated Infections (HAIs), Outcomes, Patient Safety, Pressure Ulcers
Dubberke ER, Olsen MA, Stwalley D
Identification of Medicare recipients at highest risk for Clostridium difficile infection in the US by population attributable risk analysis.
This study determined the population attributable risk percent (PAR%) for Clostridium difficile infection (CDI) in various subpopulations in the Medicare 5% random sample. It found that small and identifiable subpopulations that account for relatively large proportions of CDI cases in the elderly were identified. These data can be used to target specific subpopulations for CDI prevention interventions.
AHRQ-funded; HS019455.
Citation: Dubberke ER, Olsen MA, Stwalley D . Identification of Medicare recipients at highest risk for Clostridium difficile infection in the US by population attributable risk analysis. PLoS One 2016 Feb 9;11(2):e0146822. doi: 10.1371/journal.pone.0146822.
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Keywords: Medicare, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Risk
Rock C, Thom KA, Harris AD
A multicenter longitudinal study of hospital-onset bacteremia: time for a new quality outcome measure?
This study evaluates hospital-onset bacteremia (HOB) as a healthcare-associated infection-related outcome measure by assessing the association between HOB and central-line-associated bloodstream infection (CLABSI) rates and comparing the power of each to discriminate quality among intensive care units (ICUs). The researchers found that change in HOB rate is strongly associated with change in CLABSI rate and has greater power to discriminate between ICU performances.
AHRQ-funded; HS022291.
Citation: Rock C, Thom KA, Harris AD . A multicenter longitudinal study of hospital-onset bacteremia: time for a new quality outcome measure? Infect Control Hosp Epidemiol 2016 Feb;37(2):143-8. doi: 10.1017/ice.2015.261.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Quality Measures, Quality Measures
Loyland B, Wilmont S, Cohen B
Hand-hygiene practices and observed barriers in pediatric long-term care facilities in the New York metropolitan area.
The authors described hand-hygiene practices in pediatric long-term care (pLTC) facilities and identified observed barriers to, and potential solutions for, improved infection prevention. They found that hand hygiene was performed for 40% of the 847 indications observed and recorded, and that adherence appeared to be influenced by individuals' knowledge, attitudes, beliefs and work setting. They concluded by offering suggestions for overcoming barriers or mitigating their effect and suggesting an adaptation of the '5 Moments for Hand Hygiene' to improve infection prevention in pLTC.
AHRQ-funded; HS021470.
Citation: Loyland B, Wilmont S, Cohen B . Hand-hygiene practices and observed barriers in pediatric long-term care facilities in the New York metropolitan area. Int J Qual Health Care 2016 Feb;28(1):74-80. doi: 10.1093/intqhc/mzv097.
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Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Children/Adolescents, Prevention
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)
Szymczak JE
Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety.
The author examined how clinicians talk about speaking up or not in the face of breaches in infection prevention technique. Mutual focus of attention, interactional path dependence, and the presence of an audience are reasons found that influence the decision to speak up in a clinical setting. This decision is dynamic, highly context-dependent, embedded in the interaction rituals that suffuse everyday work, and constrained by organizational dynamics.
AHRQ-funded; HS020760.
Citation: Szymczak JE . Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety. Sociol Health Illn 2016 Feb;38(2):325-39. doi: 10.1111/1467-9566.12371.
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Keywords: Communication, Provider: Health Personnel, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Alvarez E, Uslan DZ, Malloy T
It is time to revise our approach to registering antimicrobial agents for health care settings.
This paper discusses antimicrobial surfaces, such as copper alloy, for the prevention of healthcare-associated infections. The authors address the current process for registering antimicrobial products, flaws in the registration requirements, and the need for evidence-based approaches to reduce healthcare-associated infections.
AHRQ-funded; HS021188.
Citation: Alvarez E, Uslan DZ, Malloy T . It is time to revise our approach to registering antimicrobial agents for health care settings. Am J Infect Control 2016 Feb;44(2):228-32. doi: 10.1016/j.ajic.2015.09.015.
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Keywords: Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Prevention, Evidence-Based Practice, Registries
Masnick M, Morgan DJ, Sorkin JD
Lack of patient understanding of hospital-acquired infection data published on the Centers for Medicare and Medicaid Services Hospital Compare Website.
This study assessed the interpretability of hospital-acquired infection (HAI) data as presented on the Centers for Medicare and Medicaid Services Hospital Compare website among patients who might benefit from access to these data. It concluded that current public HAI data presentation methods may be inadequate. When presented with numeric HAI data, study participants incorrectly compared hospitals on the basis of HAI data in more than 40% of the responses.
AHRQ-funded; HS018111.
Citation: Masnick M, Morgan DJ, Sorkin JD . Lack of patient understanding of hospital-acquired infection data published on the Centers for Medicare and Medicaid Services Hospital Compare Website. Infect Control Hosp Epidemiol 2016 Feb;37(2):182-7. doi: 10.1017/ice.2015.260.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Education: Patient and Caregiver, Health Literacy, Healthcare-Associated Infections (HAIs), Hospitals, Urinary Tract Infection (UTI)
Cocoros NM, Kleinman K, Priebe GP
Ventilator-associated events in neonates and children--a new paradigm.
The objective of this study was to identify a pediatric ventilator-associated condition definition for use in neonates and children by exploring whether potential ventilator-associated condition definitions identify patients with worse outcomes. It found that pediatric patients with ventilator-associated conditions are at substantially higher risk for mortality and morbidity across ICUs, regardless of thresholds used.
AHRQ-funded; HS021636.
Citation: Cocoros NM, Kleinman K, Priebe GP . Ventilator-associated events in neonates and children--a new paradigm. Crit Care Med 2016 Jan;44(1):14-22. doi: 10.1097/ccm.0000000000001372.
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Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Newborns/Infants, Children/Adolescents
Yun H, Xie F, Delzell E
Comparative risk of hospitalized infection associated with biologic agents in rheumatoid arthritis patients enrolled in Medicare.
The aim of this study was to determine whether the associated risk of hospitalized infections differed between specific biologic agents used to treat rheumatoid arthritis (RA). It concluded that RA patients with prior exposure to a biologic agent, exposure to etanercept, infliximab, or rituximab was associated with a greater 1-year risk of hospitalized infection compared with the risk associated with exposure to abatacept.
AHRQ-funded; HS021694; HS018517.
Citation: Yun H, Xie F, Delzell E . Comparative risk of hospitalized infection associated with biologic agents in rheumatoid arthritis patients enrolled in Medicare. Arthritis Rheumatol 2016 Jan;68(1):56-66. doi: 10.1002/art.39399..
Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Arthritis, Hospitalization, Risk
Huang SS, Septimus E, Hayden MK
Effect of body surface decolonisation on bacteriuria and candiduria in intensive care units: an analysis of a cluster-randomised trial.
The researchers aimed to assess the effect of decolonization on bacteriuria and candiduria in patients admitted to ICUs. They concluded that universal decolonization of patients in the ICU with once a day chlorhexidine baths and short-course nasal mupirocin could be a potential preventive strategy in male patients because it significantly decreases candiduria and any bacteriuria, but not for women.
AHRQ-funded; 290201000008I; 29032007T.
Citation: Huang SS, Septimus E, Hayden MK . Effect of body surface decolonisation on bacteriuria and candiduria in intensive care units: an analysis of a cluster-randomised trial. Lancet Infect Dis 2016 Jan;16(1):70-9. doi: 10.1016/s1473-3099(15)00238-8.
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Keywords: Intensive Care Unit (ICU), Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention
Calderwood MS, Vaz LE, Tse Kawai A
Impact of hospital operating margin on central line-associated bloodstream infections following Medicare's hospital-acquired conditions payment policy.
In October 2008, Medicare ceased additional payment for hospital-acquired conditions not present on admission. The researchers evaluated the policy's differential impact in hospitals with high vs low operating margins. They concluded that Medicare's payment policy may have had an impact on reducing central line-associated bloodstream infections in hospitals with low operating margins.
AHRQ-funded; HS018414.
Citation: Calderwood MS, Vaz LE, Tse Kawai A . Impact of hospital operating margin on central line-associated bloodstream infections following Medicare's hospital-acquired conditions payment policy. Infect Control Hosp Epidemiol 2016 Jan;37(1):100-3. doi: 10.1017/ice.2015.250.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Medicare, Quality of Care, Payment, Sepsis
Manojlovich M, Saint S, Meddings J
Indwelling urinary catheter insertion practices in the emergency department: an observational study.
The researchers sought (1) to determine how frequently major breaks in aseptic insertion technique occur, and (2) to identify the number of patients who developed bacteriuria after catheter placement in the ED. They found that major breaks in aseptic insertion technique occurred in 48 of 81 insertion attempts. Of the 7 patients with bacteriuria after insertion, 5 had experienced a major break in technique.
AHRQ-funded; HS019767; 290201000025I; 29032001T.
Citation: Manojlovich M, Saint S, Meddings J . Indwelling urinary catheter insertion practices in the emergency department: an observational study. Infect Control Hosp Epidemiol 2016 Jan;37(1):117-9. doi: 10.1017/ice.2015.238.
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Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Emergency Department, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI)

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