Nonadherence With Guidelines Associated With Cardiac Surgery Infection

AHRQ Stats: COVID-19 Visits and Age-Related Disparities in 2020

In 2020, 3.8 percent of civilian, noninstitutionalized Americans had a COVID-19-related medical visit or prescribed medicine purchase. Adults between the ages of 18 and 64 were more likely to receive treatment for COVID-19 (over 4.5 percent) than children ages 5–17 (1.5 percent). (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #549, Healthcare Use and Expenditures for COVID-19, U.S. Civilian Noninstitutionalized Population, 2020.)

Today's Headlines:

• Nonadherence With Guidelines Associated With Cardiac Surgery Infection.
• New AHRQ Report Explores Optimizing Health and Function as We Age.
• Topic Brief Explores Use of Behavioral Health Apps in Primary Care and Integrated Care Settings.
• Highlights From AHRQ’s Patient Safety Network.
• Now Available: Inaugural Chartbook for Consumer Assessment of Healthcare Providers and Systems Home and Community-Based Services Survey Database.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature.

Nonadherence With Guidelines Associated With Cardiac Surgery Infection

Nonadherence to the Society of Thoracic Surgeons’ (STS) postoperative cardiac surgery guidelines is associated with adverse events, according to an AHRQ-funded study in the Journal of Thoracic and Cardiovascular Surgery. STS guidelines include timing of first dose of antibiotics, weight-adjusted dosing, redosing of antibiotics and choice of certain drugs. Researchers’ review of more than 2,800 records from 2016 to 2021 indicated that 38 percent of patients received care that did not follow at least one aspect of the guidelines. Failure to comply with the antibiotic timing and weight-adjusted dosing guidelines was associated with higher rates of postoperative infection, sepsis and mortality after cardiac surgery. Most providers comply with postoperative guidelines from The Joint Commission’s Surgical Care Improvement Project, but the STS guidelines have received less attention, the authors said. Access the abstract.

New AHRQ Report Explores Optimizing Health and Function as We Age

AHRQ’s new Optimizing Health and Function as We Age Roundtable Report (PDF, 1.7 MB) explores topics that range from opportunities for developing a person-centered care system and integrating the voices of older adults, caregivers and communities, to designing effective models of care for improving older adults’ health and well-being. The report summarizes an April 14 roundtable of approximately 40 multidisciplinary experts who discussed how AHRQ can impact the research, dissemination and implementation of evidence to improve the organization and delivery of healthcare with the goal of optimizing the health, functional status and well-being of the U.S. population as it ages.

Topic Brief Explores Use of Behavioral Health Apps in Primary Care and Integrated Care Settings

A new topic brief from AHRQ summarizes the evidence on finding, evaluating and selecting smartphone and Internet-based behavioral health apps to recommend or prescribe in primary care and integrated care settings. The resource is provided by AHRQ’s Academy for Integrating Behavioral Health and Primary Care, which promotes the integration of behavioral health into primary and ambulatory care settings with a focus on care for patients using substances and those with mental health conditions. The new brief provides basic definitions on behavioral health apps and the benefits and risks of recommending apps for patients. Access the brief.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Physician and nurse well-being and preferred interventions to address burnout in hospital practice: factors associated with turnover, outcomes, and patient safety.
• A national analysis of ED presentations for early pregnancy and complications: implications for post-Roe America.
• Medication reconciliation for patients after their discharge from intensive care unit to the hospital ward.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Now Available: Inaugural Chartbook for Consumer Assessment of Healthcare Providers and Systems Home and Community-Based Services Survey Database

Results from AHRQ’s new 2023 Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Home and Community-Based Services (HCBS) Survey Database are now available. The HCBS CAHPS Survey asks adult Medicaid beneficiaries about their recent experiences with their long-term services and support from state HCBS programs. The 2023 HCBS CAHPS Survey Database includes 4,731 survey responses voluntarily submitted by state Medicaid agencies and managed care plans for 17 HCBS programs. Select to access the results via the Chartbook (PDF, 1.7 MB) or infographic (402 KB).

New Research and Evidence From AHRQ

• Systematic review (draft open for comment): Respectful Maternity Care: Dissemination and Implementation of Perinatal Safety Culture to Improve Equitable Maternal Healthcare Delivery and Outcomes.

AHRQ in the Professional Literature

Respiratory culture organism isolation and test characteristics in children with tracheostomies with and without acute respiratory infection. Steuart R, Ale GB, Woolums A, et al. Pediatr Pulmonol 2023 May;58(5):1481-91. Epub 2023 Feb 15. Access the abstract on PubMed®.

Pharmacologic restraint use for children experiencing mental health crises in pediatric hospitals. Wolf RM, Hall M, Williams DJ, et al. J Hosp Med 2023 Feb;18(2):120-9. Epub 2022 Nov 22. Access the abstract on PubMed®.

The impact of surgical volume on hospital ranking using the standardized infection ratio. Ye S, Li D, Yu T, et al. Sci Rep 2023 May 10;13(1):7624. Access the abstract on PubMed®.

Deciding whether to take sacubitril/valsartan: how cardiologists and patients discuss out-of-pocket costs. Rao BR, Akrobetu DJ, Dickert NW, et al. J Am Heart Assoc 2023 Apr 4;12(7):e028278. Epub 2023 Mar 28. Access the abstract on PubMed®.

Health systems and telemedicine adoption for diabetes and hypertension care. Rodriguez HP, Ciemins EL, Rubio K, et al. Am J Manag Care 2023 Jan;29(1):42-9. Access the abstract

Urban-rural disparities in interfacility transfers for children during COVID-19. McDaniel CE, Leyenaar JK, Bryan MA, et al. J Rural Health 2023 Jun;39(3):611-6. Epub 2023 Jan 29. Access the abstract on PubMed®.

Data science and precision oncology nursing: creating an analytic ecosystem to support personalized supportive care across the trajectory of illness. Keim-Malpass J, Kausch SL. Semin Oncol Nurs 2023 Jun;39(3):151432. Epub 2023 May 5. Access the abstract on PubMed®.

Developing, pilot testing, and refining requirements for 3 EHR-integrated interventions to improve diagnostic safety in acute care: a user-centered approach. Garber A, Garabedian P, Wu L, et al. JAMIA Open 2023 Jul;6(2):ooad031. Epub 2023 May 10. Access the abstract on PubMed®.