Structured Abstract

Contents

• Preface
• Acknowledgments
• Technical Expert Panel
• Peer Reviewers
• Executive Summary
• Introduction
  • Background
  • Objectives
  • Key Questions
• Methods
  • Scope
  • Analytic Framework
  • Literature Search Strategy
  • Article Selection
  • Inclusion of Articles From the 2007 Report
  • Data Abstraction and Data Management
  • Individual Study Quality Assessment
  • Data Synthesis and Grading the Body of Evidence
  • Peer Review, Public Commentary, and Technical Expert Panel
• Results
  • Key Questions 1 and 1a Which QI strategies are effective in improving HAI and adherence to evidence-based preventive interventions?
  • Key Question 1b What is the cost, return on investment, or cost-effectiveness of QI strategies to improve HAI?
  • Key Question 1c Which factors are associated with the effectiveness of QI strategies?
  • Key Question 2 What is the impact of context on the effectiveness of QI strategies?
• Discussion
  • Key Findings and Strength of Evidence
  • Findings in Relationship to What Is Already Known
  • Applicability
  • Limitations of the Present Review
  • Future Research Needs
  • Conclusions
• References
• Abbreviations
• Appendix A Search Strategy
• Appendix B Excluded Studies
• Appendix C Evidence Tables
• Appendix D Evidence-Based Preventive Interventions Used in Study Selection
• Appendix E Items on Data Abstraction Forms
• Appendix F Overview Tables for Articles Not Included in Analysis
• Appendix G Details of Interrupted Time Series Analysis

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. 290-2007-10058-I. Prepared by: Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center, Chicago, IL

Suggested citation:

Mauger Rothenberg B, Marbella A, Pines E, Chopra R, Black ER, Aronson N. Prevention of Healthcare-Associated Infections. Closing the Quality Gap: Revisiting the State of the Science. Evidence Report/Technology Assessment No. 208. (Prepared by the Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center under Contract No. 290-2007-10058-I.) AHRQ Publication No. 12(13)-E012-EF. Rockville, MD: Agency for Healthcare Research and Quality. November 2012. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10058-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

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