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psnet.ahrq.gov/node/60977/psn-pdf
January 08, 2020 - filled the incorrectly prescribed
medication), and 4) the provider and nurse (who failed to provide adequate
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psnet.ahrq.gov/node/846975/psn-pdf
March 28, 2023 - It
took a long time before I had adequate support to address these feelings.
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psnet.ahrq.gov/node/33587/psn-pdf
June 15, 2024 - First, missed nursing care is primarily a problem of time pressure and competing demands, and adequate
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psnet.ahrq.gov/web-mm/painful-medication-reconciliation-mishap
May 01, 2008 - patients report postoperative pain.( 1 ) Over 60% of emergency department visits are related to pain.( 2 ) Adequate … pain.( 3 ) However, studies have shown that fewer than half of postoperative pain patients receive adequate
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psnet.ahrq.gov/node/49388/psn-pdf
February 01, 2003 - These include: noise, interruptions, fatigue and
lack of adequate rest, poor lighting, and poor information … Clinical Management of Apnea
Ensure adequate oxygenation and ventilation
If the error in drug administration
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psnet.ahrq.gov/web-mm/bad-writing-wrong-medication
March 01, 2015 - medication safety: (i) access to patient-specific information; (ii) access to drug information; (iii) adequate … improvements that could be made to mitigate chances of recurrence.( 19 ) First, the pharmacist may have lacked adequate
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psnet.ahrq.gov/issue/impact-rapid-response-system-implementation-critical-deterioration-events-children
November 06, 2015 - Study
Impact of rapid response system implementation on critical deterioration events in children.
Citation Text:
Bonafide CP, Localio R, Roberts KE, et al. Impact of rapid response system implementation on critical deterioration events in children. JAMA Pediatr. 2014;168(1):25-33. doi:1…
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psnet.ahrq.gov/issue/nurse-staffing-and-education-and-hospital-mortality-nine-european-countries-retrospective
January 04, 2015 - Study
Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study.
Citation Text:
Aiken LH, Sloane DM, Bruyneel L, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational …
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psnet.ahrq.gov/issue/medicares-decision-withhold-payment-hospital-errors-devil-details
March 13, 2013 - Commentary
Classic
Medicare's decision to withhold payment for hospital errors: the devil is in the details.
Citation Text:
Wachter R, Foster NE, Dudley A. Medicare's decision to withhold payment for hospital errors: the devil is in the det. Jt Comm J Qual Patie…
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psnet.ahrq.gov/web-mm/management-cardiac-arrest-unconventional-locations
June 14, 2023 - fewer complications. 7 However, bag-mask ventilation without an advanced airway device may not allow adequate … area where critical ACLS equipment (i.e., crash cart) is available, including an electrical outlet and adequate
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psnet.ahrq.gov/node/33669/psn-pdf
May 01, 2018 - Insights such as these may be missed without adequate evaluation of provider response.
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.2_slideshow.ppt
February 01, 2003 - intravenous magnesium
Neurological impairment or injury
Clinical Management of Apnea
Ensure adequate
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.221_slideshow.ppt
July 01, 2010 - *
Perioperative Risk Reduction
Hypertension and diabetes require special attention to achieve adequate
-
psnet.ahrq.gov/node/49464/psn-pdf
December 27, 2020 - Laparoscopic surgery requires a complex illumination system to
provide adequate visualization of an
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psnet.ahrq.gov/issue/frequency-failure-inform-patients-clinically-significant-outpatient-test-results
April 24, 2018 - Study
Frequency of failure to inform patients of clinically significant outpatient test results.
Citation Text:
Casalino LP, Dunham D, Chin MH, et al. Frequency of failure to inform patients of clinically significant outpatient test results. Arch Intern Med. 2009;169(12):1123-9. doi:10…
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psnet.ahrq.gov/issue/identification-hospital-complications-claims-data-it-valid
June 13, 2011 - Study
Classic
Identification of in-hospital complications from claims data. Is it valid?
Citation Text:
Lawthers AG, McCarthy EP, Davis RB, et al. Identification of in-hospital complications from claims data. Is it valid? Med Care. 2000;38(8):785-95.
Copy Cit…
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psnet.ahrq.gov/issue/validity-agency-healthcare-research-and-quality-patient-safety-indicators-and-centers
June 14, 2017 - Review
Classic
Validity of the Agency for Healthcare Research and Quality Patient Safety Indicators and the Centers for Medicare and Medicaid Hospital-acquired Conditions: a systematic review and meta-analysis.
Citation Text:
Winters BD, Bharmal A, Wilson RF, et…
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psnet.ahrq.gov/issue/exploration-automated-approach-receiving-patient-feedback-after-outpatient-acute-care-visits
September 07, 2011 - Study
Exploration of an automated approach for receiving patient feedback after outpatient acute care visits.
Citation Text:
Berner ES, Ray MN, Panjamapirom A, et al. Exploration of an automated approach for receiving patient feedback after outpatient acute care visits. J Gen Intern Med.…
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psnet.ahrq.gov/issue/communication-practices-4-harvard-surgical-services-surgical-safety-collaborative
September 29, 2017 - Study
Communication practices on 4 Harvard surgical services: a surgical safety collaborative.
Citation Text:
Elbardissi AW, Regenbogen SE, Greenberg CC, et al. Communication practices on 4 Harvard surgical services: a surgical safety collaborative. Ann Surg. 2009;250(6):861-5. doi:10.…
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psnet.ahrq.gov/issue/patients-and-family-members-views-how-clinicians-enact-and-how-they-should-enact-incident
September 29, 2017 - Study
Patients' and family members' views on how clinicians enact and how they should enact incident disclosure: the "100 patient stories" qualitative study.
Citation Text:
Iedema R, Allen S, Britton K, et al. Patients' and family members' views on how clinicians enact and how they shoul…