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www.ahrq.gov/hai/tools/surgery/tools/surgical-complication-prevention/glucose-control-audit.html
December 01, 2017 - Question 4: Document the patient’s most recent blood glucose within 30 days prior to surgery. … If the patient did not have a blood glucose measurement above 180 gm/dL on postoperative days 0, 1, … Most recent preoperative blood glucose (<30 days preoperative).
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/central-catheter-maintenance-notes.docx
April 01, 2022 - Over the next few days, Mrs. … The physicians and nurses in the ICU realize that her central venous catheter could have been removed days … , or loose, both the CDC and Infusion Nurses Society recommend changing the gauze dressings every 2 days … , and to change transparent dressings every 7 days. … (interquartile range 3.8-10.9) to 2.5 per 1,000 catheter-days (1.4 to 4.8) after implementation of bundles
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www.ahrq.gov/sites/default/files/publications/files/universalicu.pdf
September 01, 2013 - through 2 days after ICU discharge. … /denominator of ICU patient days) by 1,000 = total events per 1,000 ICU patient days. … • 5 days of nasal mupirocin. … ICU discharge (if prior to 5 days).
6. … Do this twice a day for 5 days during ICU stay.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/qi-action-slides.pptx
April 01, 2022 - because these four patients had chronic obstructive pulmonary disease
Average line dwell time is 12.4 days … ; staff relay most left in “just in case”
Median time from insertion to infection is 9 days; 8 of 10 … had time from insertion to infection >7 days
Neither unit nor hospital has insertion criteria; criteria … 10
Data From Defects Analyses – CAUTI
CAUTI – 6 cases reviewed
Average catheter dwell time is 6 days … and output (I&O) and retained when transferred to floor
Median time from insertion to infection is 5 days
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/central-catheter-indications-notes.docx
April 01, 2022 - He is treated supportively and is doing well, and is extubated a few days later. … is inappropriate for infusion of peripherally compatible infusate unless duration of treatment > 15 days … For a CVC in critical illness, it is appropriate if duration of therapy is between 6 and 15 days or the … patient is hemodynamically unstable or monitoring is required for less than 14 days. … MAGIC criteria, site selection once a short-term CVC—that is, one that is in place for less than 14 days—has
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/HAP-slides.pptx
November 01, 2019 - In a double-blind clinical trial conducted in 51 French ICUs, patients were randomized to 8 or 15 days … day and 15-day groups
Multidrug-resistant bacteria emerged less frequently in patients who received 8 days … of antibiotics compared with those who received 15 days.
16
HAP
AHRQ Safety Program for Improving … hours
Change to oral therapy after clinical improvement is seen and when patient can tolerate PO
Seven days … Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/VAP-slides.pptx
November 01, 2019 - In a double-blind clinical trial conducted in 51 French ICUs, patients were randomized to 8 or 15 days … Multidrug-resistant bacteria emerged less
frequently in patients receiving 8 days of
antibiotics compared … with those receiving
15 days.
18
VAP
AHRQ Safety Program for Improving Antibiotic Use – Acute Care … Change to oral therapy after clinical improvement is seen and when able to tolerate oral agents
Seven days … Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized
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www.ahrq.gov/hai/universal-icu-decolonization/universal-icu-apd.html
September 01, 2013 - Administer mupirocin to patient twice a day, starting on day 1 of ICU admission, for 5 days or until … ICU discharge (if prior to 5 days). … Do this twice a day for 5 days.
Avoid contact with eyes and other intranasal products.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/data-change-slides.pptx
April 01, 2022 - Data – A Run Chart
Neighborhood Community Hospital (NCH) MICU CLABSI Rate by Month per 1,000 Device Days … Date: 4/29 – 5/5
(Information posted 5/7)
Days since last central line-associated bloodstream infection … 257
Days since last catheter-associated urinary tract infection 86
Days since last ventilator-associated
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/medread-tools.pdf
July 28, 2016 - within 10 days of discharge
# of readmissions between days 0‐30 of discharge
% of readmissions in … 0‐4 days
% of readmissions in 0‐10 days
% of readmissions in 0‐30 days
All
625
1275
2550
25% … What percentage of readmissions occurs within 4 days of discharge? Within 10 days? … occur within 10 days
Figure 3. … 50%
% of readmissions in 0‐10 days
% of readmissions in 0‐30 days
30%
20%
10%
0%
40%
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/antibiotic-targets-slides.pptx
June 01, 2021 - antibiotics for too long
Forgetting to stop antibiotics when they are not needed
Accidentally miscounting days … Identifying Targets
7
Case #1, continued
8
The laboratory faxes the urine culture results 2 days later … Identifying Targets
8
Case #1, continued
9
5 days later, the resident develops back pain and a fever
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/changing-system-slides.pptx
June 01, 2021 - After 3 days in the hospital, he is transferred back to the long-term care facility. … He already received 3 days of antibiotics in the hospital.
His legs are improved but not better. … They are both still discolored.
10 days later, he complains of itching.
9
Changing the System
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www.ahrq.gov/sites/default/files/wysiwyg/hai/abate/faqs/faq-iodophor.docx
March 01, 2022 - Does iodophor continue or start over for 5 days? … (electronic or otherwise) to track the duration of decolonization doses to ensure that a total of 5 days … more than two doses of iodophor are missed, the protocol should be restarted and a new count for 5 days
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-196-section-6.pdf
January 01, 2006 - Tables 7-10
Table 7: Ratio of All MRI to All CT Scans within 30 days of Evaluation for Atraumatic Headache … CT scans among children ages 1 through 17 years old who
undergo imaging of the head on or within 30 days
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-tables7-10.pdf
January 01, 2006 - Children with Atraumatic Seizure: Table 7 - 10
Table 7: Ratio of All MRI to All CT Scans within 30 days … CT scans among children ages 1 through 17 years old
who undergo imaging of the head on or within 30 days
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www.ahrq.gov/hai/tools/mvp/modules/technical/subglottic-fact-sheet.html
January 01, 2017 - Reduction in length of stay by 1.5 days.
Reduction of time on ventilator by 1.1 days.
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www.ahrq.gov/hai/tools/mvp/modules/cusp/structuralasst-tool.html
January 01, 2017 - .
___ Routinely changed at regular interval; please specify in days ___________. … changed unless soiled or malfunctioning.
___ Routinely changed at regular interval; please specify in days
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www.ahrq.gov/news/newsroom/case-studies/201501.html
March 01, 2015 - Nearly 20 percent of Medicare patients are readmitted to the hospital within 30 days of discharge. … introduced the teach-back method around patient medications, made follow-up calls to patients within days
-
www.ahrq.gov/policymakers/chipra/overview/background/next-steps2.html
December 01, 2009 - This NCQA measure assesses whether a strep test was administered in the 7-day period from 3 days prior … through 3 days after the first eligible episode date. … The measure counts children ages 2-18 who were continuously enrolled 30 days prior to the episode date … through 3 days after the episode date. … for 120 days prior to IPSD through 30 days after the IPSD.
-
www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0206-technicalspecs.pdf
May 01, 2016 - assesses the number of computed tomography (CT) scans obtained without indication on
or within 30 days … is calculated as follows:
The percentage of CT scans obtained without indication on or within 30 days … prior to imaging
o Imaging study obtained on the day of or within 180 days following neurosurgical … prior to imaging
o Vascular disease (Table IMG8) on the day of or within 365 days prior to imaging … o Infections that would warrant imaging on the day of or within the 365 days before the
atraumatic