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ahrqpubs.ahrq.gov/news/newsletters/e-newsletter/813.html
May 01, 2022 - Patient Safety found no evidence of the so-called “July Effect,” an increase in patient safety and adverse … patient records abstracted and analyzed using the Medicare Patient Safety Monitoring System, changes in adverse … Identifying over-the-counter information to prioritize for the purpose of reducing adverse drug reactions
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ahrqpubs.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/safe-electronic-slides.html
July 01, 2023 - Professional Liability
EFM interpretation and management are a common issue in litigation involving adverse … Slide 13: Key Safety Elements: Learn From Defects
Debrief and analyze near misses and adverse events … Disclosing any unintended outcomes using unit policy for adverse events. … Past adverse events related to EFM use.
Synergy with related or similar initiatives.
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ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/patient-safety/reports/issue-briefs/state-of-science.pdf
April 02, 2020 - Measuring errors and adverse events in health care. … Lessons
from a patient partnership intervention to prevent adverse drug events. … Consensus building for
development of outpatient adverse drug event triggers. … Computerized surveillance of adverse drug events
in hospital patients. … Adverse events during hospitalization: results of a patient survey.
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ahrqpubs.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/safe-electronic-fac-guide.html
July 01, 2023 - Liability
Say:
Further, EFM interpretation and management is a common issue in litigation involving adverse … unit-established parameters for provider notification of EFM findings ensures that signs of potential adverse … Informal debriefings can be used by the clinical team immediately following a near miss or actual adverse … Finally, unit staff should disclose any unintended outcomes related to EFM use using unit policy for adverse … Past adverse events related to EFM use.
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ahrqpubs.ahrq.gov/research/findings/making-healthcare-safer/mhs4/index.html
April 01, 2024 - Cards and Outcome Measurements
Report
Protocol
Opioid Stewardship
Report
Protocol
Reducing Adverse … Deprescribing
Report
Protocol
Computerized Clinical Decision Support To Prevent Medication Errors and Adverse
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ahrqpubs.ahrq.gov/news/newsletters/e-newsletter/848.html
January 01, 2023 - published in the journal Cancer found that 10 percent of children with leukemia or lymphoma experienced adverse … systematic review, from AHRQ’s Effective Health Care Program, also found PBI had significantly fewer acute adverse … events than WBI, though there was no apparent difference in late adverse events.
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ahrqpubs.ahrq.gov/sites/default/files/2024-01/quintana-report.pdf
January 01, 2024 - improve patient and family
engagement and self-efficacy, improving care coordination and reducing adverse … Adverse drug events and medication errors in Australia. … Incidence and Preventability of Adverse Drug Events Among Older
Persons in the Ambulatory Setting. … Incidence and preventability of adverse drug events among older
persons in the ambulatory setting. … Adverse reactions as a cause of hospital admission in the aged. Drugs Aging. 1992;2(4):356-367.
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ahrqpubs.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module4/mod4-facguide.html
March 01, 2017 - Slide 28: Communicating Adverse Events
Say:
Communication following an adverse event can been especially … Each facility has policies and procedures to follow after an adverse event occurs, and most involve working … Slide 30: How To Communicate About An Adverse Event
Say:
It is important to remember that residents … and family members can experience a number of emotions when an adverse event occurs, so communication … about an adverse event should be compassionate and sensitive.
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ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/rapid-response/rapidresponse.pptx
October 01, 2017 - Perinatal Safety
13
Key Safety Elements: Learn From Defects
Debrief and analyze near misses and adverse … Response Call Log can facilitate a debrief
Have a process in place to review serious maternal or neonatal adverse … Consider these factors:
Unit data suggesting adverse events or near misses that may have been minimized
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ahrqpubs.ahrq.gov/research/findings/studies/index.html?page=1
January 01, 2024 - 1279)
2015
(1430)
2014
(662)
2013
(195)
Topics
Access to Care
(417)
Adverse … Drug Events (ADE)
(321)
Adverse Events
(736)
Alcohol Use
(61)
Ambulatory Care and Surgery … Seelye SM , Kipnis P Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse … Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse events. … Keywords: Medication: Safety, Medication, Patient Safety, COVID-19, Adverse Drug Events (ADE), Adverse
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ahrqpubs.ahrq.gov/research/findings/studies/index.html?page=2
January 01, 2024 - 1279)
2015
(1430)
2014
(662)
2013
(195)
Topics
Access to Care
(417)
Adverse … Drug Events (ADE)
(321)
Adverse Events
(737)
Alcohol Use
(61)
Ambulatory Care and Surgery … Seelye SM , Kipnis P Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse … Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse events. … Keywords: Medication: Safety, Medication, Patient Safety, COVID-19, Adverse Drug Events (ADE), Adverse
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ahrqpubs.ahrq.gov/nursing-home/materials/vaccination/index.html
September 01, 2023 - the vaccine manufacturer, additional primary dose and booster shots, dates each shot is administered, adverse … the vaccine manufacturer, additional primary dose and booster shots, dates each shot is administered, adverse
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ahrqpubs.ahrq.gov/funding/grantee-profiles/grtprofile-walsh.html
October 01, 2023 - Walsh is working to prevent medication errors and adverse drug events among children, particularly those … Her team found that 10 percent of children with leukemia or lymphoma experienced adverse drug events
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ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a2_combo_boardpresentation.pdf
October 01, 2015 - • AHRQ QIs are indicators of hospital quality and
adverse events that patients may experience as … • Pediatric Quality Indicators (PDIs) reflect quality of care
inside hospitals and adverse events … • The PSIs are a set of 18 hospital-level indicators of
safety-related adverse events following operations … and Safety
• The PDIs are a set of 16 indicators that reflect quality
of care inside hospitals and adverse
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ahrqpubs.ahrq.gov/talkingquality/measures/setting/hospitals/measurement-sets.html
February 01, 2023 - The Patient Safety Indicators (PSIs) identify adverse events occurring during hospitalization. … They provide information on potential in-hospital complications and adverse events following surgeries
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ahrqpubs.ahrq.gov/health-literacy/improve/pharmacy/medication-mgt.html
September 01, 2020 - (MTM) is a patient-centric and comprehensive approach to improve medication use, reduce the risk of adverse
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ahrqpubs.ahrq.gov/research/findings/evidence-based-reports/search.html?page=1
November 01, 2023 - Permanente Research Affiliates Report Status: Final
Efficacy of Dental Services for Reducing Adverse … Scientific Resource Center Report Status: Final
Efficacy of Dental Services for Reducing Adverse
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ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/research/findings/ta/topicrefinement/obesity_topic-refinement.pdf
May 22, 2014 - Adverse effects of interventions
● Activity-related injury
● Adverse effects of medication ( diarrhea … joint disease (i.e., knee, hip)
● Respiratory disease (i.e., asthma, COPD)
● Sleep apnea
o BMI
o Adverse … effects
● Activity-related injuries, including fracture
● Adverse effects of medications (e.g., diarrhea … later
● Among trials that report on clinical outcomes, for BMI, health-related quality of life,
and adverse
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ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/topics/dx-safety-workgroup-roster-2023dec.pdf
December 21, 2023 - Medical Officer
Name Department/Agency Title
Michael Lee, Pharm.D.,
BCPS, CAPT, USPHS
IHS IHS Adverse
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ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/hospital-v2-resourcelist.pdf
April 01, 2023 - • Implement a Care for the Caregiver program for providers involved in adverse events. … • Investigate and analyze an adverse event to learn from it and prevent future adverse
events. … Staff can use this decision tree when analyzing
an error or adverse event in an organization to help … Patient Safety Primer: Medication Errors and Adverse Drug Events
https://psnet.ahrq.gov/primers/primer … Patient Safety Primer: Medication Errors and Adverse Drug Events
23.