Unit-level time trends and seasonality in the rate of hospital-acquired pressure ulcers in US acute care hospitals

2013 ◽  
Vol 36 (2) ◽  
pp. 171-180 ◽  
Author(s):  
Jianghua He ◽  
Vincent S. Staggs ◽  
Sandra Bergquist-Beringer ◽  
Nancy Dunton
Keyword(s):  
Acute Care ◽  
Time Trends ◽  
Pressure Ulcers ◽  
Acute Care Hospitals ◽  
Unit Level ◽  
Hospital Acquired

Pressure Ulcers and Prevention Among Acute Care Hospitals in the United States

2013 ◽  
Vol 39 (9) ◽  
pp. 404-414 ◽  
Author(s):  
Sandra Bergquist-Beringer ◽  
Lei Dong ◽  
Jianghua He ◽  
Nancy Dunton
Keyword(s):  
United States ◽  
Acute Care ◽  
Pressure Ulcers ◽  
Acute Care Hospitals ◽  
The United States

scholarly journals Predictive validity of the INTEGRARE scale in identifying the risk of hospital-acquired pressure ulcers in acute care hospital settings

2022 ◽  
Author(s):  
Ana María Porcel-Gálvez ◽  
Regina Allande-Cussó ◽  
Elena Fernández-García ◽  
Alonso Naharro-Álvarez ◽  
Sergio Barrientos-Trigo
Keyword(s):  
Acute Care ◽  
Predictive Validity ◽  
Pressure Ulcers ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Hospital Acquired

scholarly journals Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study

BMJ ◽  
2019 ◽  
pp. l4109 ◽  
Author(s):  
Roshun Sankaran ◽  
Devraj Sukul ◽  
Ushapoorna Nuliyalu ◽  
Baris Gulseren ◽  
Tedi A Engler ◽  
...  
Keyword(s):  
Acute Care ◽  
Retrospective Cohort ◽  
Acute Care Hospitals ◽  
The United States ◽  
Fiscal Year ◽  
Percentage Points ◽  
Hospital Acquired Conditions ◽  
The Us ◽  
Reduction Program ◽  
Hospital Acquired

Abstract Objective To evaluate the association between hospital penalization in the US Hospital Acquired Condition Reduction Program (HACRP) and subsequent changes in clinical outcomes. Design Regression discontinuity design applied to a retrospective cohort from inpatient Medicare claims. Setting 3238 acute care hospitals in the United States. Participants Medicare fee-for-service beneficiaries discharged from acute care hospitals between 23 July 2014 and 30 November 2016 and eligible for at least one targeted hospital acquired condition (n=15 470 334). Intervention Hospital receipt of a penalty in the first year of the HACRP. Main outcome measures Episode level count of targeted hospital acquired conditions per 1000 episodes, 30 day readmissions, and 30 day mortality. Results Of 724 hospitals penalized under the HACRP in fiscal year 2015, 708 were represented in the study. Mean counts of hospital acquired conditions were 2.72 per 1000 episodes for penalized hospitals and 2.06 per 1000 episodes for non-penalized hospitals; 30 day readmissions were 14.4% and 14.0%, respectively, and 30 day mortality was 9.0% for both hospital groups. Penalized hospitals were more likely to be large, teaching institutions, and have a greater share of patients with low socioeconomic status than non-penalized hospitals. HACRP penalties were associated with a non-significant change of −0.16 hospital acquired conditions per 1000 episodes (95% confidence interval −0.53 to 0.20), −0.36 percentage points in 30 day readmission (−1.06 to 0.33), and −0.04 percentage points in 30 day mortality (−0.59 to 0.52). No clear patterns of clinical improvement were observed across hospital characteristics. Conclusions Penalization was not associated with significant changes in rates of hospital acquired conditions, 30 day readmission, or 30 day mortality, and does not appear to drive meaningful clinical improvements. By disproportionately penalizing hospitals caring for more disadvantaged patients, the HACRP could exacerbate inequities in care.

Has Improved Hand Hygiene Compliance Reduced the Risk of Hospital-Acquired Infections among Hospitalized Patients in Ontario? Analysis of Publicly Reported Patient Safety Data from 2008 to 2011

2013 ◽  
Vol 34 (6) ◽  
pp. 605-610 ◽  
Author(s):  
Giulio DiDiodato
Keyword(s):  
Patient Safety ◽  
Hand Hygiene ◽  
Acute Care ◽  
Poisson Regression ◽  
Hand Hygiene Compliance ◽  
Acute Care Hospitals ◽  
Ordinary Least Squares ◽  
Hospital Acquired Infections ◽  
Hygiene Compliance ◽  
Hospital Acquired

Design.Prospective, observational, ecological, time series, cross-sectional study examining the association between hand hygiene compliance (HHC) rates and the incidence of hospital-acquired infections.Setting.Acute care hospitals (N = 166) located in the province of Ontario, Canada.Methods.All data were extracted from the Ontario patient safety indicator database (http://www.hqontario.ca/public-reporting/patient-safety). Complete data were available for 166 acute care hospitals from October 1, 2008, to December 31, 2011. The rates of Clostridium difficile infection (CDI) are reported monthly, methicillin-resistant Staphylococcus aureus (MRSA) bacteremia quarterly, and HHC rates yearly. Trends and associations for each indicator were evaluated by ordinary least squares regression (HHC), zero-inflated Poisson regression (MRSA bacteremia), or Poisson regression (CDI). Dependent variables included in the regression analyses were extracted from the same database and included year, healthcare region, and type of hospital (teaching or small or large community).Results.Compared to those in 2008, reported HHC rates improved every year both before and after environment/patient contact (range, 10.6%–25.3%). Compared to those in 2008, there was no corresponding change in the rates of MRSA bacteremia; however, the rates of CDI decreased in 2009 but were not statistically significantly decreased from baseline in either 2010 or 2011. No consistent association was demonstrated between changes in the rates of HHC and these two healthcare-associated infections (HAIs).Conclusions.Despite significant improvements in reported rates of HHC among healthcare personnel in Ontario's hospitals, we could not demonstrate a positive ecological impact on rates of these two HAIs.

Hospital-acquired infections in Belgian acute-care hospitals: an estimation of their global impact on mortality, length of stay and healthcare costs

2011 ◽  
Vol 140 (1) ◽  
pp. 126-136 ◽  
Author(s):  
F. VRIJENS ◽  
F. HULSTAERT ◽  
S. DEVRIESE ◽  
S. VAN DE SANDE
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Excess Mortality ◽  
National Level ◽  
Acute Care Hospitals ◽  
Public Healthcare ◽  
Hospital Acquired Infections ◽  
Number Of Patients ◽  
Hospital Acquired ◽  
The Impact

SUMMARYAssessing the overall burden of disease which can be attributed to hospital-acquired infections (HAIs) remains a challenge. A matched cohort study was performed to estimate excess mortality, length of stay and costs attributable to HAIs in Belgian acute-care hospitals, using six matching factors (hospital, diagnosis-related group, age, ward, Charlson score, estimated length of stay prior to infection). Information was combined from different sources on the epidemiology and burden of HAIs to estimate the impact at national level. The total number of patients affected by a HAI each year was 125 000 (per 10·9 million inhabitants). The excess mortality was 2·8% and excess length of stay was 7·3 days, corresponding to a public healthcare cost of €290 million. A large burden was observed outside the intensive-care unit setting (87% of patients infected and extra costs, 73% of excess deaths).

scholarly journals Nursing Specialty Certification and Patient Outcomes: What We Know in Acute Care Hospitals and Future Directions

2017 ◽  
Vol 22 (3) ◽  
pp. 137-142 ◽  
Author(s):  
Diane K. Boyle
Keyword(s):  
Conceptual Model ◽  
Acute Care ◽  
Patient Outcomes ◽  
Work Organization ◽  
Acute Care Hospitals ◽  
National Database ◽  
Failure To Rescue ◽  
Total Patient ◽  
Specialty Certification ◽  
Hospital Acquired

Abstract Purpose: To discuss the current research evidence about the relationship of nursing specialty certification and patient outcomes in acute care hospitals, interpret research findings within Needleman's Expanded Conceptual Model for Credentialing Research, provide future direction for research using Needleman's model, and discuss how Needleman's model applies to vascular access certification. Review of Literature: Studies have found relationships between higher rates of nursing specialty certification and lower rates of total patient falls, pressure injuries, selected hospital-acquired infections, failure to rescue, and death. Inconsistent or contradictory evidence exists for the association of specialty certified nurses and lower total patient fall rates, selected hospital-acquired infection rates, and hospital-acquired pressure injuries. In addition, many of the significant associations supporting a relationship between specialty certified nurses and better patient outcomes are weak and may not be clinically meaningful. Many completed studies were not guided by a conceptual framework or model. Conclusions: Needleman's Expanded Conceptual Model for Credentialing Research provides a mechanism for driving theory-based research about the association of specialty certification and patient outcomes by providing specific intervening variables: invisible architecture, work organization, and performance. Specific aspects of the model can be studied using large datasets such as the National Database of Nursing Quality Indicators.

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