Elaine Larson's research while affiliated with Columbia University and other places

Publications (547)

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Background The training and mentoring of pre- and post-doctoral trainees in nursing research is essential to feed the pipeline of nurses prepared to launch an independent program of research. Purpose The purpose of this report is to describe a one-on-one grant writing Partnership developed in a school of nursing targeting pre- and post-doctoral tr...
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Background Acute respiratory infections (ARI) are the most common infectious diseases globally. Community surveillance may provide a more comprehensive picture of disease burden than medically-attended illness alone. Methods In this longitudinal study conducted from 2012-2017 in the Washington Heights/Inwood area of New York City, we enrolled 405...
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Background Stroke patients are at increased risk for acquiring infections in the hospital and risk of readmission. We aimed to examine whether an infection acquired during the initial stroke admission contributes to increased risk of readmission and infection during readmission. Methods We performed a retrospective cohort study incorporating all a...
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Background: Despite tremendous efforts, the incidence of surgical site infection (SSI) following the surgical treatment of pediatric spinal deformity remains a concern. Although previous studies have reported some risk factors for SSI, these studies have been limited by not being able to investigate multiple risk factors at the same time. The aim...
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While long-term care (LTC)¹ facilities serving older adults have long struggled with low employee morale and high rates of staff turnover, the COVID-19 pandemic brought unprecedented challenges to these facilities and the frontline staff working in them. This study aimed to explore factors that influenced the personal and professional wellbeing of...
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To examine processes and programmatic elements of infection prevention and control (IPC) efforts and identify themes and promising approaches in nursing homes (NHs), an environmental scan was conducted. Data sources included a literature search, relevant listservs and websites, and expert consensus based on a virtual summit of leaders in IPC in lon...
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Importance: Hospitalizations for infections among nursing home (NH) residents remain common despite national initiatives to reduce them. Cognitive impairment, which markedly affects quality of life and caregiving needs, has been associated with hospitalizations, but the association between infection-related hospitalizations and long-term cognitive...
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Objectives The objectives of this study were (1) to develop and validate a simulation model to estimate daily probabilities of healthcare-associated infections (HAIs), length of stay (LOS), and mortality using time varying patient- and unit-level factors including staffing adequacy and (2) to examine whether HAI incidence varies with staffing adequ...
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Review of clinical research by institutional review boards (IRBs) is integral to the protection of human subjects and necessary for the conduct of legal and ethical research. Because such review is time and resource intensive, it is critical to identify common issues that contribute to delayed review and approval of research. Hence, the aim of this...
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Background Differentiating activities that are research or quality improvement (QI) is challenging. Purpose Compare tools that distinguish research from QI and evaluate the utility of tools to determine whether institutional review board (IRB) approval is required for a test‐project. Methods Scoping review of the literature to identify tools that...
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Background Antimicrobial resistance is a continued global threat to public health. In recognition of this threat, the executive branch of the United States government consolidated guidelines through the President's Council of Advisors on Science and Technology (PCAST) and Executive Order 13676. Method An analysis was conducted to assess the US gov...
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Objective Identify research gaps relevant to the global effort to combat antimicrobial resistance. Methods Web of Science, PubMed, Scopus, and Ovid MEDLINE were searched for reviews on antimicrobial resistance published between January 1, 2015 and December 31, 2019. Recommendations for future research were identified. Findings Seventy-four review...
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Background: In the past few decades, the epidemiology of Clostridioides difficile infection (CDI) has evolved. Given recent changes in the incidence of CDI and prevention efforts, we investigated temporal changes over a period of 8 years (2009–2016) in the incidence of and risk factors for CDI. Methods: Both pediatric and adult inpatients discharge...
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Background: Pseudomonas aeruginosa is an important nosocomial pathogen associated with intrinsic and acquired resistance mechanisms to major classes of antibiotics. To better understand clinical risk factors for drug-resistant P. aeruginosa infection, decision-tree models for the prediction of fluoroquinolone and carbapenem-resistant P. aeruginosa...
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Objective To describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits. Design Observational study of nurse hand hygiene practices. Setting and Participants: Licensed practical/vocational and registered nurse...
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Background Although antibiotic use is an established risk factor for healthcare-associated Clostridiodes difficile infection (HA-CDI), estimates of the association between infection and antibiotic use vary, depending upon how antibiotic exposure is measured. Objectives The purpose of this study is to explore the association between the frequency o...
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PhD Summit attendees, as part of moderated roundtable discussions, responded to two questions: What PhD competencies should guide the preparation of PhD prepared nurses to function in current and emerging roles? and How has innovation in programs and curricula changed the landscape to prepare and support PhD students for success? The purpose of thi...
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Background: Accurate, real-time models to predict hospital adverse events could facilitate timely and targeted interventions to improve patient outcomes. Advances in computing enable the use of supervised machine learning (SML) techniques to predict hospital-onset infections. Objectives: The purpose of this study was to trial SML methods to pred...
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Background Transmission of respiratory viruses between staff and residents of pediatric long-term care facilities (pLTCFs) can occur. We assessed the feasibility of using text or email messages to perform surveillance for acute respiratory infections (ARIs) among staff. Methods From December 7, 2016 to May 7, 2017, 50 staff participants from two p...
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Objective Given recent changes in the epidemiology of Clostridioides difficile infection (CDI) and prevention efforts, we investigated temporal changes over a period of 11 years (2006–2016) in incidence and risk factors for CDI. Design Retrospective matched case-control study. Setting/Patients Pediatric and adult inpatients (n = 694,849) discharg...
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Infection prevention is a high priority for home healthcare (HHC), but tools are lacking to identify patients at highest risk of developing infections. The purpose of this study was to develop and test a predictive risk model to identify HHC patients at risk of an infection-related hospitalization or emergency department visit. A nonexperimental st...
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Aim Describe the programmatic details and outcomes of a competitive, two-year Academic-Practice Research Fellowship for clinical nurses. Background Numerous barriers challenge clinical nurses in their ability to conduct and disseminate research. We describe and evaluate a competitive, semi-structured, two-year Academic-Practice Research Fellowship...
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Background Interdisciplinary research among health care professionals has gained importance over the last 20 years, but little is known about its impact on career development. Purpose This study examined professional development outcomes associated with interdisciplinary research. Methods An integrative review was conducted using Whittmore and Kn...
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Introduction In the United States, the number of patients with substance use disorders is steadily increasing. Individuals with a substance use disorder may be more likely to experience negative hospital outcomes, including lengthier hospital stays and frequent readmissions, which is extremely costly to patients and the government. While there are...
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Background Mapped with the guiding principles of academic-practice partnerships (APPs) outlined by the American Association of Colleges of Nursing and the American Organization for Nursing Leadership, a joint nurse scientist role between a nursing school and acute care facility at a large academic health center was developed and characterized by a...
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Background: Considerable variation exists in surgical site infection (SSI) prevention practices for pediatric patients undergoing spinal deformity surgery, but the incidence of SSI has been reported to remain high in the United States. The literature reports various risk factors associated with SSI but findings are inconsistent. The purpose of thi...
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Background: The association of nursing staffing with patient outcomes has primarily been studied by comparing high to low staffed hospitals, raising concern other factors may account for observed differences. We examine the association of inpatient mortality with patients' cumulative exposure to shifts with low registered nurse (RN) staffing, low...
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We surveyed clinical staff and on-site teachers working at pediatric long-term care facilities regarding prevention and control of acute respiratory infections and influenza in staff and residents. We uncovered knowledge gaps, particularly among teachers and clinical staff working <5 years at sites, thereby elucidating areas for targeted staff educ...
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Background Diarrheal disease is one of the top three causes of death in children <5 years old, with the majority occurring in sub-Saharan Africa and South Asia. Animals are known reservoirs of diarrheal pathogens. While previous studies have investigated companion animals and livestock as contributors to human diarrheal disease, few have investigat...
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Background The association between antibiotic exposure (AE) and healthcare-associated Clostridiodes difficile infection (HA-CDI) has been mostly quantified using cumulative AE as the predictor. However, patients receive similar durations of antibiotics in a variety of ways. We examine the relationship between HA-CDI and other dimensions of AE. Met...
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Aim: To test the feasibility of a remote writing programme, Writing to Improve Nursing Science (WINS), for nursing scholars in low- and middle-income countries and assess its impact on scholarly writing and dissemination. Background: The ability to write and publish scholarly manuscripts is critical for successful nursing research careers. Yet,...
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Background: Pocket hematoma is a common adverse event following the insertion of cardiovascular implantable electronic devices (CIEDs), but the risk of wound infections associated with a pocket hematoma is unclear. Objectives: This integrative review aims to examine the relationship between pocket hematoma and risk of wound infection in a CIED p...
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Objective: To identify and compare validated tools used to assess incivility in healthcare settings. Background: Incivility in the workforce is associated with poor quality outcomes, increased employee turnover, and decreased job satisfaction. Validated tools are essential for accurate measurement of incivility. The aim of this study was to comp...
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Aim: To investigate the collaborative networks among expert clinical nurse and midwifery researchers in eastern and southern Africa. Methods: Thirty-eight clinical nurse and midwifery researchers completed an online survey to analyse collaboration between respondents. Data were analysed using social network analysis, generating a network map and...
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Objective Multidrug-resistant organisms (MDROs) cause ~5%–10% of infections in hospitalized children, leading to an increased risk of death, prolonged hospitalization, and additional costs. Antibiotic exposure is considered a driving factor of MDRO acquisition; however, consensus regarding the impact of antibiotic factors, especially in children, i...
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BACKGROUND Staff nurse and infection preventionist (IP) workload increases in response to exposures and outbreaks. The additional time required to manage these situations may differ by pathogen and role in patient care. Understanding the time burden associated with responding to specific pathogens may improve resource allocation. The purpose of thi...
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Objective: To examine whether healthcare-associated infections (HAIs) and nurse staffing are associated using unit-level staffing data. Background: Previous studies of the association between HAIs and nurse staffing are inconsistent and limited by methodological weaknesses. Methods: Cross-sectional data between 2007 and 2012 from a large urban...
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Activities of daily living (ADLs) is an important measure of the quality of care provided in home healthcare (HHC), but few studies describe the ADLs of HHC patients. The objectives of this study were to (1) describe the types and levels of ADL dependency among patients receiving home care, (2) identify the risk factors for severe ADL dependency at...
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Introduction: Research is needed to identify influences on safe sex communication among specific culture groups. This study aimed to (1) describe sexual behaviors and indicators of sexual power among partnered Dominican women and (2) identify which of these indicators are significantly associated with safe sex communication. Methodology: Cross-sect...
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Background: Staff nurse and infection preventionist (IP) workload increases in response to exposures and outbreaks. Understanding the time burden associated with responding to specific pathogens may improve resource allocation. The purpose of this study was to evaluate workload increases reported by nurses and IPs in response to common exposures a...
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Background: Patient risk adjustment is critical for hospital benchmarking and allocation of healthcare resources. However, considerable heterogeneity exists among measures. Objectives: The performance of five measures was compared to predict mortality and length of stay (LOS) in hospitalized adults using claims data; these include three comorbid...
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Ordinal rankings of schools of nursing by research funding in total dollars awarded by the National Institutes of Health (NIH) is a common metric for demonstrating research productivity; however, these data are not based on the number of doctorally prepared faculty eligible to apply for funding. Therefore, we examined an alternative method for meas...
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Background: The risks and outcomes of acquiring a health care-associated infection (HAI) among patients with a bloodstream infection present on hospital admission (BSI-POA) have not been well described. The objective of this study was to examine the incidence of and risk factors for developing a subsequent HAI and to compare length of stay and mor...
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Background: Urinary tract infection (UTI)- related hospitalizations are a poor patient outcome in the rapidly growing home health care (HHC) arena that serves a predominantly elderly population. We examined the association between activities of daily living (ADL) and risk of UTI-related hospitalization among this population. Methods: Using a ret...
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Background and Purpose: Stroke patients are at increased risk for acquiring infections in the hospital. This study aimed to examine whether an infection acquired during the initial stroke admission contributes to increased risk of readmission and infection during readmission. Methods: Electronic data were collected retrospectively for all adult isc...
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Background: This study aimed to examine the association between colonizing respiratory tract organism and frequency, duration, and time between subsequent hospitalizations among hospitalized patients with cystic fibrosis (CF). Methods: This retrospective cohort study of 312 CF patients from 2 New York City hospitals (2006-2016) examined the effe...
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Objectives: The aim of this study is to describe and evaluate the impact of the Linking to Improve Nursing Care and Knowledge (LINK) project on increasing nurse-led clinical research. Background: Nurse-generated research is the cornerstone of evidence-based practice and continues to be a marker of nursing excellence. However, the dearth of PhD-p...
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Background Residents of pediatric chronic care facilities (PCCFs) are vulnerable to acute respiratory infections (ARIs) due to their underlying medical conditions and infection control challenges in congregate living. Methods We conducted active, prospective surveillance for ARIs (defined as ≥2 new signs/symptoms of respiratory illness) among all...
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Background Supervised machine learning (SML)-based methods could facilitate early prediction of healthcare-related adverse events. The role of SML in stratifying patient-risk of infectious events during hospitalization and their performance using limited subsets of standardized and widely available predictors is less known. Using a large cohort of...
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Background Nurses are called upon to partner in antibiotic stewardship programs (ASPs). Yet, the nurses’ role in ASPs and measures of nurses’ contributions to ASPs are poorly defined. Methods Scoping review to explore (1) interventions to enhance nurses’ role in optimizing antibiotic use in the inpatient and nursing home (NH) settings and (2) meas...
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Background Burkholderia spp. have been associated with outbreaks of healthcare-associated infections in non-CF patients, mostly attributable to point sources of contaminated solutions or medications. Fewer non-point source outbreaks have been described. Methods We conducted a matched case:control (1:3) study to assess risk factors for B. cenocepac...
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Background: Some nurse-driven interventions have successfully reduced rates of healthcare-associated infections (HAI), though incidence remains unacceptably high. Bacterial contamination in patient rooms may be a source of exposure for patients and, thus, a target for future interventions; however, few studies have investigated the role of the pat...
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Background Infection is a leading cause of hospitalization among home healthcare patients. Nurses play an important role in reducing infection among home healthcare patients by complying with infection control procedures. However, few studies have examined the compliance of home healthcare nurses with infection control practices or the range of soc...
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OBJECTIVE To evaluate the impact of universal contact precautions (UCP) on rates of multidrug-resistant organisms (MDROs) in intensive care units (ICUs) over 9 years DESIGN Retrospective, nonrandomized observational study SETTING An 800-bed adult academic medical center in New York City PARTICIPANTS All patients admitted to 6 ICUs, 3 of which in...
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Background: A barrier to influenza vaccination is the misperception that the inactivated vaccine can cause influenza. Previous studies have investigated the risk of acute respiratory illness (ARI) after influenza vaccination with conflicting results. We assessed whether there is an increased rate of laboratory-confirmed ARI in post-influenza vacci...
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With nurses and midwives providing the majority of health care globally, nursing education in all countries must prepare students for broader responsibilities to move the agenda forward for equitable care and universal health coverage. Columbia University School of Nursing developed and implemented a vibrant approach to curriculum transformation th...
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OBJECTIVE To quantify the association between having a prior bed occupant or roommate with a positive blood, respiratory, urine, or wound culture and subsequent infection with the same organism. DESIGN Case-control study. SETTING The study included 4 hospitals within an academically affiliated network in New York City, including a community hospi...
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OBJECTIVE The financial incentives for hospitals to improve care may be weaker if higher insurer payments for adverse conditions offset a portion of hospital costs. The purpose of this study was to simulate incentives for reducing hospital-acquired infections under various payment configurations by Medicare, Medicaid, and private payers. DESIGN Ma...
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Background: Pediatric long-term care facilities (pLTCF) serve a complicated and resource-intensive patient population with high usage of nutrition support. However, the relationship between nutrition support and outcomes among pLTCF residents is not well understood. We described this relationship in three metropolitan New York pLTCF and a subsampl...
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Aim: To identify and describe published, nursing-led and midwifery-led, clinical research that has been conducted in Latin America and the Caribbean. Background: Peer-reviewed published research may correspond to and elucidate country's realities, priorities, and needs. Design: A 6-stage scoping review methodology was used to search scientific...
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Introduction: Severity of illness (SOI) measures are commonly used in adults for comparison of treatment and outcomes in similar populations. Less is known about the psychometric properties of measures available to providers and healthcare systems caring for pediatric patients. The purpose of this study was to (1) identify SOI measures used for pe...
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Background: There is a growing recognition of the need to partner with nurses to promote effective antibiotic stewardship. In this study, we explored the attitudes of nurses and infection preventionists toward 5 nurse-driven antibiotic stewardship practices: 1) questioning the need for urine cultures; 2) ensuring proper culturing technique; 3) rec...
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Introduction: Patient safety culture (PSC) is an emerging construct in adult long-term care settings. No measures are validated to quantify PSC in pediatric long-term care (pLTC) settings despite the importance of safety for this vulnerable population. The study purposes are to (1) describe PSC in pLTC, (2) assess the relationship of PSC to facili...
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Purpose: Evaluate the effectiveness of an educational video vs. standard of care in improving relaxation and procedural understanding among pediatric patients undergoing a magnetic resonance imaging (MRI) procedure. Design and methods: This pilot randomized controlled trial was conducted in a large, urban academic children's hospital. Pediatric...
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Background: Surveillance of influenza-like illness (ILI) in the United States is primarily conducted through medical settings despite a significant burden of non-medically attended ILI. Objectives: To assess consistency between surveillance for respiratory viruses in outpatient and community settings using ILI surveillance from the Centers for D...
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While hospitalizations among people living with human immunodeficiency virus (PLWH) have been elevated in the past compared to their uninfected counterparts, the introduction of antiretroviral therapy (ART) has resulted in great strides in controlling symptomatic infection. However, research largely overlooks important differences among HIV-infecte...
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Background: Bloodstream infection present on hospital admission (BSI-POA) is a major cause of morbidity and mortality. The purpose of this study was to measure prevalence and describe the risk factors of patients with BSI-POA and to determine the prevalence of resistance in isolates by admission source. Methods: We conducted a retrospective coho...
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Introduction National efforts to curtail healthcare-associated infections (HAI) proliferated recently, though data detailing progress over time are limited. This retrospective cohort study aims to describe changes in incidence and antimicrobial susceptibility of HAI in four New York City hospitals over seven years. Methods Electronic data were col...
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Objectives: To determine the health literacy levels of persons living with human immunodeficiency virus (HIV) (PLWH) at a health clinic in the Dominican Republic (DR) and assess associations between health literacy, HIV-related knowledge, and health information behavior (how patients need, seek, receive, and use information). Design and sample:...
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Background Using a single measure to characterize longitudinal antibiotic exposure (AE) could underestimate variability in antibiotic use and limit understanding of the impact on clinical and microbiologic outcomes. We propose the use of the antibiotic exposure index (AEI), which combines multiple dimensions of longitudinal AE, and demonstrate its...
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Background: Adult long term care (LTC) have high rates of antibiotic use, raising concerns about antimicrobial resistance. Few studies have examined antibiotic use in paediatric LTC. Aim: We sought to describe antibiotic use in three paediatric LTC facilities and to describe the factors associated with use. Methods: A retrospective cohort stud...
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Repeat HAIs among frequently hospitalized patients may be contributing to the high rates of antibiotic resistance seen in gram-negative bacteria (GNB) in hospital settings. This systematic review examines the state of the literature assessing the association between repeat GNB HAIs and changes in antibiotic susceptibility patterns. A systematic sea...
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Background Acute respiratory infections (ARIs) are common in pediatric long-term care facility (pLTCF) residents, but little is known about the burden of ARIs in staff in these settings. We assessed the feasibility of active surveillance for ARIs among pLTCF staff who performed direct resident care. Methods We enrolled 50 staff members from 2 pLTC...