With funding from the National Institute of Nursing Research (Distribution of the Costs of Antimicrobial Resistant Infections, R01 NR010822), we have developed a database of >319,000 patient discharges from four urban (Manhattan) hospitals for the years 2006-8. This database has been used to answer a variety of clinical questions regarding healthcare-associated infections (HAI), but to continue to be useful and relevant;we have expanded and integrated the database as a targeted research data registry into the Clinical Data Warehouse of a large health care system. The data will continue to be updated and sustained so that trends over years can be tracked.
Specific aims of this competitive renewal are to conduct three comparative effectiveness research (CER) studies on data from 2006-2012 to: (1) evaluate the effectiveness of adherence to transmission-based isolation precautions for preventing the spread of infections in acute care settings using transmission visualization techniques;(2) examine the impact of nursing organizational factors (e.g., staffing, skill mix, turnover) on rates and types of HAI among hospitalized patients;and (3 compare the effectiveness of universal contact precautions with standard practice in intensive care units (ICUs) to reduce rates of acquisition and infection caused by multidrug-resistant organisms (MDROs) and Clostridium difficile. In addition, as part of our Data Sharing Plan we propose to develop and/or adopt the following policies and procedures: data contributor and user agreements and data stewardship policies (right of first use, institutional and data confidentiality and protection, quality of the research, monitoring and integrity of data management) which will contribute to the burgeoning science of data governance. We will then make the registry more widely available to researchers for other CER project to assess practices to reduce HAI.

Public Health Relevance

Health information technology holds great promise for improving coordination and standardization of clinical care and health outcomes for individual patients and across health care settings, but its potential is yet to be fulfilled. Using data from >600,000 patient discharges, we propose to examine the effectiveness of various practices aimed at reducing healthcare-associated infections.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR010822-07
Application #
8631099
Study Section
Nursing and Related Clinical Sciences Study Section (NRCS)
Program Officer
Hardy, Lynda R
Project Start
2007-09-28
Project End
2015-12-31
Budget Start
2014-01-01
Budget End
2014-12-31
Support Year
7
Fiscal Year
2014
Total Cost
$327,823
Indirect Cost
$118,097
Name
Columbia University (N.Y.)
Department
Type
Schools of Nursing
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Rowell-Cunsolo, Tawandra L; Liu, Jianfang; Shen, Yanhan et al. (2018) The impact of HIV diagnosis on length of hospital stay in New York City, NY, USA. AIDS Care 30:591-595
Cohen, Bevin; Liu, Jianfang; Cohen, Adam Ross et al. (2018) Association Between Healthcare-Associated Infection and Exposure to Hospital Roommates and Previous Bed Occupants with the Same Organism. Infect Control Hosp Epidemiol 39:541-546
Agarwal, Mansi; Shiau, Stephanie; Larson, Elaine L (2018) Repeat gram-negative hospital-acquired infections and antibiotic susceptibility: A systematic review. J Infect Public Health 11:455-462
Aliyu, Sainfer; Cohen, Bevin; Liu, Jianfang et al. (2018) Prevalence and risk factors for bloodstream infection present on hospital admission. J Infect Prev 19:37-42
Cohen, Catherine Crawford; Liu, Jianfang; Cohen, Bevin et al. (2018) Financial Incentives to Reduce Hospital-Acquired Infections Under Alternative Payment Arrangements. Infect Control Hosp Epidemiol 39:509-515
Agarwal, Mansi; Larson, Elaine L (2018) Risk of drug resistance in repeat gram-negative infections among patients with multiple hospitalizations. J Crit Care 43:260-264
Furuya, E Yoko; Cohen, Bevin; Jia, Haomiao et al. (2018) Long-Term Impact of Universal Contact Precautions on Rates of Multidrug-Resistant Organisms in ICUs: A Comparative Effectiveness Study. Infect Control Hosp Epidemiol 39:534-540
Tchakoute, Christophe T; Liu, Jianfang; Cohen, Bevin et al. (2017) Risk Factors and Temporal Trends of Hospital-Acquired Infections (HAIs) Among HIV Positive Patients in Urban New York City Hospitals: 2006 to 2014. Rev Recent Clin Trials 12:44-50
Kelly, Ana M; D'Agostino, John F; Andrada, Lilibeth V et al. (2017) Delayed tuberculosis diagnosis and costs of contact investigations for hospital exposure: New York City, 2010-2014. Am J Infect Control 45:483-486
Cohen, Margot E; Hathway, Joanne M; Salmasian, Hojjat et al. (2017) Prophylaxis for Stress Ulcers With Proton Pump Inhibitors Is Not Associated With Increased Risk of Bloodstream Infections in the Intensive Care Unit. Clin Gastroenterol Hepatol 15:1030-1036.e1

Showing the most recent 10 out of 46 publications