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Showing results for "adverse events".
Users also searched for: patient safety indicators
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www.ahrq.gov/sites/default/files/2024-09/weissman-report.pdfJanuary 01, 2024 - The purpose of this study was to examine whether adverse events or complications in hospitals occur … Several recent studies, as well as an IOM report, show an increase in mortality and adverse events with … Relation between malpractice claims and adverse events due to negligence. … Incidence of adverse events and negligence in hospitalized patients. … Incidence of and risk factors for adverse events and negligent care in Colorado and Utah in 1992.
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Fact Sheet on Patient Safety Indicators (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a1b_combo_psifactsheet.pdfOctober 01, 2015 - by the Agency for Healthcare Research and Quality (AHRQ) to provide information on safety-related adverse … events occurring in hospitals following operations, procedures, and childbirth. … The provider-level indicators can be used to help hospitals identify adverse events worthy of further … study and to assess the incidence of such events for comparative purposes. … Some of these indicators also have area-level analogs designed to detect patient safety events on a -
www.ahrq.gov/teamstepps-program/resources/additional/sbar.htmlJuly 01, 2023 - how this technique, one tool in the TeamSTEPPS training program, can improve communication, reduce adverse … events, and improve care quality.
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www.ahrq.gov/patient-safety/settings/hospital/candor/demo-program/grants/summary.htmlAugust 01, 2022 - events that is not otherwise known to those analyzing the event. … and Communication Together (IMPACT) for eliciting patient and family perspectives on their harmful events … Team communication training The rates of communication-sensitive adverse events (CSAEs) were examined … events in labor and delivery (increasing from 43 to 84 reports per 1,000 births). … there was no documented followup, and a 54% reduction in the rate of serious potential safety risk events
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www.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes4.htmlAugust 01, 2022 - Do they believe the organization is aware of all the patient harm events? … Have they heard of events that should have been reported but were not reported? … Other methods of reporting CANDOR events may include in-person reporting. … The sole objective of the Event Investigation and Analysis of an adverse event or near miss is to prevent … future adverse events.
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www.ahrq.gov/teamstepps-program/evidence-base/labor.htmlMay 01, 2023 - Effect of a comprehensive obstetric patient safety program on compensation payments and sentinel events … Effects of teamwork training on adverse outcomes and process of care in labor and delivery: a randomized … Impact of a comprehensive patient safety strategy on obstetric adverse events.
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Rapid Response for Perinatal Safety: Slide Presentation | Agency for Healthcare Research and Quality
www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/rapid-response/rapid-response-slides.htmlJuly 01, 2023 - Slide 14: Key Safety Elements: Learn From Defects Debrief and analyze near misses and adverse … events, regardless of whether a rapid response was activated. … Have a process in place to review serious maternal or neonatal adverse outcomes. … Consider these factors: Unit data suggesting adverse events or near misses that may have been minimized … Debrief regularly after rapid response events, and solicit ongoing feedback from staff and patients to -
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Walsh_74.pdfMay 28, 2008 - Incidence and impact of adverse drug events in pediatric inpatients. … Medication errors and adverse drug events in pediatric inpatients. … Using chart review to screen for medication errors and adverse drug events. … Adverse drug events resulting from patient errors in older adults. … Incidence of adverse drug events and potential adverse drug events: Implications for prevention.
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Prologue: Laying the Foundation (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Prologue_Henriksen_Vol1.pdfJune 02, 2025 - and confidentiality do not exist, that reporting systems are not burdensome to use, that reported events … Challenges of reporting quickly give rise to challenges of encoding and organizing the adverse event … Strategies and efforts aimed at adverse event surveillance, creating useable taxonomies, and addressing … Another paper examines the perceptions of health care leaders and news media professionals related to adverse … Risk is treated by safety scientists as the likelihood that exposure to a hazard will lead to adverse -
www.ahrq.gov/patient-safety/reports/liability/preface.htmlAugust 01, 2017 - System in the Sanford Health System Patient, Family Member, and Clinician Perceptions of Disclosure of Adverse … Events in Labor and Delivery Patient Safety Culture and Medical Liability—Recommendations for Measurement … Transitional Care Medication Safety: Stakeholders' Perspectives Medication Discrepancies and Potential Adverse … Drug Events During Transfer of Care from Hospital to Home Since the Institute of Medicine
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www.ahrq.gov/hai/tools/mvp/modules/technical/daily-early-mobility-fac-guide.htmlFebruary 01, 2017 - events associated with mobilization occurred and, if so, what types of events occurred. … Slide 29: Events Say: The next columns are designed to help track any adverse events that might … This field allows you to document up to three events if multiple events occurred. … Slide 30: Event Codes Say: If no adverse events occurred, use "0" (the code for "none") to indicate … that no adverse events took place.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/measuredesc-dailyearlymobility-facguide.docxJanuary 01, 2017 - events associated with mobilization occurred and, if so, what types of events occurred. … Slide 28 Events SAY: The next columns are designed to help track any adverse events that might have … This field allows you to document up to three events if multiple events occurred. … Slide 29 Event Codes SAY: If no adverse events occurred, use “0” (the code for “none”) to indicate … that no adverse events took place.
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Staff COVID-19 Vaccine Administration Record (doc file)
www.ahrq.gov/sites/default/files/wysiwyg/nursing-home/materials/staff-covid-vaccine-administration-record.docxMay 01, 2022 - Contraindication: __________________________________________________________________________ Adverse … _____________________________ Refer to the CDC’s website for information on contraindications and adverse … events. 5. 6. -
www.ahrq.gov/sites/default/files/wysiwyg/nursing-home/materials/resident-covid-vaccine-administration-record.docxMay 01, 2022 - Contraindication:__________________________________________________________________________ Adverse … ______________________________ Refer to the CDC’s website for information on contraindications and adverse … events. 5. 4. 6.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Savitz.pdfMarch 01, 2004 - events. … events. … • Nurse staffing AND adverse events OR medical errors (n=11). … Nurse staffing and post-surgical adverse events: an analysis of administrative data from a sample of … The effects of nurse staffing on adverse events, morbidity, mortality, and medical costs.
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www.ahrq.gov/practiceimprovement/index.htmlJune 01, 2025 - Ulcer Prevention Tools to assist nursing homes that have electronic medical record systems to prevent adverse … events. … Communication and Optimal Resolution (CANDOR) Toolkit Process for practitioners to use when unexpected events
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www.ahrq.gov/sites/default/files/2025-03/connors-report.pdfJanuary 01, 2025 - Adverse events were not uniformly defined and wide ranges of occurrence of adverse events were described … Is it the absence of severe injury or adverse events in conjunction with the sedation that was provided … The patient did not experience sedation-related adverse events resulting in abandonment of the procedure … Adverse sedation events in pediatrics: A critical incident analysis of contributing factors. … Adverse events during pediatric dental anesthesia and sedation: a review of closed malpractice insurance
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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/safe-electronic-slides.htmlJuly 01, 2023 - Slide 13: Key Safety Elements: Learn From Defects Debrief and analyze near misses and adverse … events, and the contribution of EFM use, EFM interpretation, and communication of EFM findings. … Have a process in place to review severe maternal or neonatal morbidity and mortality 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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www.ahrq.gov/sites/default/files/2024-02/baker-report.pdfJanuary 01, 2024 - Systems analysis of adverse drug events. … Adverse drug events in hospitalized patients. … Preventing adverse drug events in hospitalized patients. … The Nature of Adverse Events in Hospitalized Patients. … Incidence of Adverse Drug Events and Potential Adverse Drug Events: Implications for Prevention.
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www.ahrq.gov/research/findings/making-healthcare-safer/comparison.htmlJune 01, 2025 - events and associated systemic and contextual factors. … Table of Contents Adverse Drug Events (ADEs): General Medication Topics ADEs: Harms Due to Anticoagulants … ADEs: Harms Due to Diabetic Agents ADEs: Reducing Adverse Drug Events in Older Adults ADEs: Harms Due … Drug Events (ADEs): General Medication Topics Patient Safety Practices MHS I (2001) MHS II (2013) MHS … Drug Events Summary of Evidence Summary of Evidence (Not reviewed) (Not reviewed) Reducing Adverse Drug
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