New Nursing Home Resources Aimed at Preventing COVID-19

AHRQ Stats

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Today's Headlines:

• New Nursing Home Resources Aimed at Preventing COVID-19.
• Highlights From AHRQ’s Patient Safety Network.
• Physicians Express Reluctance To Recommend Discontinuing Medications That Increase Fall Risks.
• Community Characteristics Predict Opioid and Antibiotic Prescribing by Dentists.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature.

New Nursing Home Resources Aimed at Preventing COVID-19

Two new resources from AHRQ are part of the agency’s ongoing efforts to protect nursing home residents and staff from COVID-19. Both are intended to support the use of observational audits, which help facilities understand if staff members are fully complying with infection prevention practices:

• Competency Check vs. Observational Audit: Validate Nursing Home Staff Performance to Improve Infection Prevention Processes for COVID-19. This comparison tool helps skilled nursing facilities differentiate between competency validation for regulatory compliance and observational auditing for quality assurance performance improvement activities.
• Observational Audits: A Pathway to Improving Infection Prevention and Preventing the Spread of COVID-19. This step-by-step guide helps facilities establish a process for observational auditing to provide a true assessment of performance in the actual work environment, and helps facilities collect data to support improvements in infection prevention.

The new tools are provided as part of the AHRQ ECHO National Nursing Home COVID-19 Action Network. A partnership between AHRQ, the University of New Mexico’s ECHO Institute and the Institute for Healthcare Improvement, the network provides free training and mentorship on infection prevention and safety practices.

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:

• COVID-19 increased the risk of ICU-acquired bloodstream infections: a case-cohort study from the multicentric OUTCOMEREA network.
• Medical crisis checklists in the emergency department: a simulation-based multi-institutional randomised controlled trial.
• Toward the development of the perfect medical team: critical components for adaptation.

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).

Physicians Express Reluctance To Recommend Discontinuing Medications That Increase Fall Risks

Some physicians are reluctant to initiate potentially contentious conversations with patients who may not want to stop taking medications that could increase their risk of falls, according to an AHRQ-funded study in the Journal of General Internal Medicine. Interviews with primary care physicians indicated that some patients misunderstood a fall as an isolated event rathe successfully treating unrelated conditions even if they increased fall risk. Resources to facilitate conversations between physicians and patients may ease possible tensions associated with discontinuing inappropriate medication use. Access the abstract.

Community Characteristics Predict Opioid and Antibiotic Prescribing by Dentists

Certain community characteristics, such as more dentists per capita and a higher proportion of female residents, were associated with higher prescribing rates for opioids and antibiotics by dentists between 2012 and 2017, according to an AHRQ-funded study published in the American Journal of Preventive Medicine. Further, dental opioid prescribing rates decreased while antibiotic prescribing rates increased over the period of time studied. The authors analyzed prescriptions written by dentists, along with demographic data from 2,900 U.S. counties. They suggest that data on prescribing patterns can help target interventions to improve dental prescribing. Access the abstract.

New Research and Evidence From AHRQ

• Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain – Quarterly Progress Report: February 2021.

AHRQ in the Professional Literature

Susceptibility Provision Enhances Effective De-escalation (SPEED): utilizing rapid phenotypic susceptibility testing in Gram-negative bloodstream infections and its potential clinical impact. Schneider JG, Wood JB, Schmitt BH, et al. J Antimicrob Chemother 2019 Jan 1;74(Suppl 1):i16-i23. Access the abstract on PubMed®.

Shared decision making in patients with suspected uncomplicated ureterolithiasis: a decision aid development study. Schoenfeld EM, Houghton C, Patel PM, et al. Acad Emerg Med 2020 Jul;27(7):554-65. Epub 2020 Feb 16. Access the abstract on PubMed®.

Growing disparities in patient-provider messaging: trend analysis before and after supportive policy. Senft N, Butler E, Everson J. J Med Internet Res 2019 Oct 7;21(10):e14976. Access the abstract on PubMed®.

Feasibility and reliability testing of manual electronic health record reviews as a tool for timely identification of diagnostic error in patients at risk. Soleimani J, Pinevich Y, Barwise AK, et al. Appl Clin Inform 2020 May;11(3):474-82. Epub 2020 Jul 15. Access the abstract on PubMed®.

The emergency department trigger tool: validation and testing to optimize yield. Griffey RT, Schneider RM, Todorov AA. Acad Emerg Med 2020 Dec;27(12):1279-90. Epub 2020 Sep 1. Access the abstract on PubMed®.

Higher Medicare Advantage Star Ratings are associated with improvements in patient outcomes. Meyers DJ, Trivedi AN, Wilson IB, et al. Health Aff 2021 Feb;40(2):243-50. Access the abstract on PubMed®.

The cost of a fall among older adults requiring emergency services. Newgard CD, Lin A, Caughey AB, et al. J Am Geriatr Soc 2021 Feb;69(2):389-98. Epub 2020 Oct 12. Access the abstract on PubMed®.

Novel strategies for predicting healthcare-associated infections at admission: implications for nursing care. Zachariah P, Sanabria E, Liu J, et al. Nurs Res 2020 Sep/Oct;69(5):399-403. Access the abstract on PubMed®.