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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45664/psn-pdf
    July 02, 2017 - Intraoperative adverse events in abdominal surgery: what happens in the operating room does not stay … Intraoperative Adverse Events in Abdominal Surgery: What Happens in the Operating Room Does Not Stay … https://psnet.ahrq.gov/issue/intraoperative-adverse-events-abdominal-surgery-what-happens-operating- … In this study, investigators found that intraoperative adverse events during abdominal surgery were … https://psnet.ahrq.gov/primer/adverse-events-near-misses-and-errors https://psnet.ahrq.gov/issue/impact-major-intraoperative-adverse-events-hospital-readmissions
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45416/psn-pdf
    August 24, 2016 - A framework to assess patient-reported adverse outcomes arising during hospitalization. … A framework to assess patient-reported adverse outcomes arising during hospitalization. … Patient reports of adverse outcomes are one critical method to detect safety hazards. … This study used patient reports of adverse outcomes to develop a framework for identifying adverse events … authors suggest that patient reports could be used as a trigger tool to prompt review of cases for adverse
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46152/psn-pdf
    May 31, 2017 - Root cause analysis of adverse events in an outpatient anticoagulation management consortium. … Root Cause Analysis of Adverse Events in an Outpatient Anticoagulation Management Consortium. … https://psnet.ahrq.gov/issue/root-cause-analysis-adverse-events-outpatient-anticoagulation-management … - consortium Anticoagulation confers a high risk of adverse drug events. … Examining root cause analyses of anticoagulation–related adverse events, this study found that the majority
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40982/psn-pdf
    March 23, 2012 - Emergency hospitalizations for adverse drug events in older Americans. … Emergency hospitalizations for adverse drug events in older Americans. … https://psnet.ahrq.gov/issue/emergency-hospitalizations-adverse-drug-events-older-americans Partnership … national surveillance database and examined nearly 100,000 emergency hospitalizations attributed to adverse … /issue/partnership-patients https://psnet.ahrq.gov/issue/incidence-adverse-drug-events-and-potential-adverse-drug-events-implications-prevention
  5. psnet.ahrq.gov/issue/trends-nursing-home-deficiencies-and-complaints
    February 18, 2009 - August 9, 2017 Adverse Events in Hospitals: Methods for Identifying Events. … November 16, 2011 Adverse Events in Hospitals: State Reporting Systems. … January 14, 2009 Adverse Events in Hospitals: Overview of Key Issues. … January 23, 2008 Adverse Events Toolkit: Medical Record Review Methodology. … February 15, 2017 National Action Plan for Adverse Drug Event Prevention.
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44493/psn-pdf
    September 19, 2016 - Interventions in health organisations to reduce the impact of adverse events in second and third victims … Interventions in health organisations to reduce the impact of adverse events in second and third victims … https://psnet.ahrq.gov/issue/interventions-health-organisations-reduce-impact-adverse-events-second-and … Many organizations lacked protocols for responding to serious adverse events, especially in primary … ://psnet.ahrq.gov/primer/second-victims-support-clinicians-involved-errors-and-adverse-events
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46924/psn-pdf
    March 07, 2018 - Factors influencing the reporting of adverse medical device events: qualitative interviews with physicians … Factors influencing the reporting of adverse medical device events: qualitative interviews with physicians … https://psnet.ahrq.gov/issue/factors-influencing-reporting-adverse-medical-device-events-qualitative- … interviews-physicians Regulatory agencies rely on physician reports of adverse events associated with … qualitative interview study found that most physicians who implant devices do not regularly report adverse
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42547/psn-pdf
    May 19, 2014 - Using AHRQ Patient Safety Indicators to detect postdischarge adverse events in the Veterans Health … https://psnet.ahrq.gov/issue/using-ahrq-patient-safety-indicators-detect-postdischarge-adverse-events … veterans-health The AHRQ Patient Safety Indicators (PSIs) have traditionally been used to detect adverse … However, in this study the PSIs were able to identify adverse events after discharge in patients who … As readmission rates are proving to be a problematic measure of discharge safety, screening for adverse
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45691/psn-pdf
    January 11, 2017 - Qualitative study about the experiences of colleagues of health professionals involved in an adverse … Qualitative Study About the Experiences of Colleagues of Health Professionals Involved in an Adverse … and physician quality management leaders about what clinicians experience after being involved in adverse … Participants acknowledged the emotional impact of adverse events on clinicians and the need for formal … https://psnet.ahrq.gov/primer/second-victims-support-clinicians-involved-errors-and-adverse-events
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44063/psn-pdf
    June 01, 2016 - Post-discharge adverse events among urban and rural patients of an urban community hospital: a prospective … Post-Discharge Adverse Events Among Urban and Rural Patients of an Urban Community Hospital: A Prospective … The period following hospitalization is known to carry high risk for adverse events. … , raising concerns that post-hospitalization adverse events have persisted despite interventions directed … https://psnet.ahrq.gov/primer/readmissions-and-adverse-events-after-discharge https://psnet.ahrq.gov
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46153/psn-pdf
    May 31, 2017 - Adverse health events related to self-medication practices among elderly: a systematic review. … Adverse health events related to self-medication practices among elderly: a systematic review. … https://psnet.ahrq.gov/issue/adverse-health-events-related-self-medication-practices-among-elderly- … The literature suggests that self-administration of medications is common and often leads to adverse … https://psnet.ahrq.gov/primer/medication-errors-and-adverse-drug-events
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45216/psn-pdf
    June 08, 2016 - Ambulatory computerized prescribing and preventable adverse drug events. … Ambulatory Computerized Prescribing and Preventable Adverse Drug Events. … Adverse drug events (ADEs) are a common source of patient harm in the ambulatory setting. … https://psnet.ahrq.gov/issue/incidence-adverse-drug-events-and-potential-adverse-drug-events-implications-prevention … https://psnet.ahrq.gov/issue/incidence-adverse-drug-events-and-potential-adverse-drug-events-implications-prevention
  13. psnet.ahrq.gov/issue/nursing-home-complaint-investigations
    September 27, 2006 - February 11, 2015 Adverse Events in Hospitals: Medicare's Responses to Alleged Serious … September 6, 2006 Adverse Events in Rehabilitation Hospitals: National Incidence Among … February 15, 2017 Adverse Events in Long-Term-Care Hospitals: National Incidence Among … October 16, 2012 Adverse Events in Hospitals: Care Study of Incidence Among Medicare … March 17, 2010 Adverse Events in Hospitals: Overview of Key Issues.
  14. psnet.ahrq.gov/issue/hospital-reporting-deaths-related-restraint-and-seclusion
    September 20, 2006 - October 31, 2014 Adverse Events in Hospitals: Care Study of Incidence Among Medicare … February 18, 2009 Adverse Events in Hospitals: State Reporting Systems. … February 11, 2015 Few Adverse Events in Hospitals Were Reported to State Adverse Event … January 20, 2010 Adverse Events in Hospitals: State Reporting Systems. … January 14, 2009 Adverse Events in Hospitals: Overview of Key Issues.
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47545/psn-pdf
    December 19, 2018 - Adverse events during dental care for children: implications for practitioner health and wellness. … Adverse events during dental care for children: implications for practitioner health and wellness. … https://psnet.ahrq.gov/issue/adverse-events-during-dental-care-children-implications-practitioner-health … This review discusses adverse events in pediatric dental patients and suggests that when they occur, … https://psnet.ahrq.gov/primer/second-victims-support-clinicians-involved-errors-and-adverse-events
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37814/psn-pdf
    April 11, 2011 - Reevaluating the safety profile of pediatrics: a comparison of computerized adverse drug event surveillance … Reevaluating the safety profile of pediatrics: a comparison of computerized adverse drug event surveillance … https://psnet.ahrq.gov/issue/reevaluating-safety-profile-pediatrics-comparison-computerized-adverse-drug … - event This study found that events captured from safety reporting systems resulted in similar adverse … balanced using the surveillance system, suggesting the value in combining these strategies to detect adverse
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47844/psn-pdf
    March 06, 2019 - Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist … Screening for Adverse Drug Events: a Randomized Trial of Automated Calls Coupled with Phone-Based Pharmacist … https://psnet.ahrq.gov/issue/screening-adverse-drug-events-randomized-trial-automated-calls-coupled- … of an automated phone call with the option of transfer to a live pharmacist on detecting potential adverse … https://psnet.ahrq.gov/issue/adverse-drug-events-ambulatory-care
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46294/psn-pdf
    October 29, 2017 - Reporting of perioperative adverse events by pediatric anesthesiologists at a tertiary children's hospital … Reporting of Perioperative Adverse Events by Pediatric Anesthesiologists at a Tertiary Children's Hospital … https://psnet.ahrq.gov/issue/reporting-perioperative-adverse-events-pediatric-anesthesiologists-tertiary … - childrens Underreporting of adverse events is a known shortcoming of incident reporting systems. … This pre–post study demonstrated an increase in reporting of perioperative adverse events through a
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37226/psn-pdf
    December 15, 2011 - Adverse drug events in pediatric outpatients. … Adverse drug events in pediatric outpatients. Ambul Pediatr. 2007;7(5):383-9. … https://psnet.ahrq.gov/issue/adverse-drug-events-pediatric-outpatients The incidence of adverse drug … https://psnet.ahrq.gov/issue/medication-errors-and-adverse-drug-events-pediatric-inpatients https:// … /issue/adverse-drug-events-ambulatory-care https://psnet.ahrq.gov/issue/adverse-drug-events-ambulatory-care
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43067/psn-pdf
    November 23, 2014 - Characterization of adverse events detected in a large health care delivery system using an enhanced … Characterization of adverse events detected in a large health care delivery system using an enhanced … https://psnet.ahrq.gov/issue/characterization-adverse-events-detected-large-health-care-delivery-system … Approximately one-third of patients experienced at least one adverse event during their hospital stay … Surgical and procedural complications accounted for a large portion of adverse events in the hospital

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