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Total Results: 2,647 records

Showing results for "analyzed".

2361. PowerPoint Presentation (ppt file)
      psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.326_slideshow.ppt
      June 01, 2014 - PowerPoint Presentation Spotlight Wandering Off the Floors: Safety and Security Risks of Patient Wandering 1 This presentation is based on the June 2014 AHRQ WebM&M Spotlight Case See the full article at http://webmm.ahrq.gov CME credit is available Commentary by: Thomas A. Smith, CHPA, CPP, President, Healthc…

2362. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/73303/psn-pdf
      May 26, 2021 - Safety Culture in EMS May 26, 2021 Cebollero C, Fitall E, Hall KK, et al. Safety Culture in EMS. PSNet [internet]. 2021. https://psnet.ahrq.gov/perspective/safety-culture-ems Defining a Just Culture A Just Culture is one that supports transparent and honest error reporting with the goal of fostering an environmen…

2363. Reporting Patient Safety Events | PSNet
      psnet.ahrq.gov/primer/reporting-patient-safety-events
      March 30, 2022 - Reporting Patient Safety Events Citation Text: Reporting Patient Safety Events. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagge…

2364. Human Factors Engineering | PSNet
      psnet.ahrq.gov/primer/human-factors-engineering
      December 15, 2024 - Human Factors Engineering Citation Text: Human Factors Engineering. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId R…

2365. Triggers and Trigger Tools | PSNet
      psnet.ahrq.gov/primer/triggers-and-trigger-tools
      September 15, 2024 - Triggers and Trigger Tools Citation Text: Triggers and Trigger Tools. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId…

2366. PSNet Curated Library (pdf file)
      psnet.ahrq.gov/print/pdf/node/848754
      January 01, 2025 - PSNet Curated Library AHRQ: Agency for Healthcare Research and Quality Implementation of Patient Safety Projects Curated Library Foundations Leading change: why transformation efforts fail. Kotter JP. Harvard Bus Rev  1995;73(2);59-67. Kotter, a professor at Harvard Business School, outlines the eight stages …

2367. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/866621/psn-pdf
      August 28, 2024 - Application of Safety-II Principles August 28, 2024 Venkatesan C, Helak K, Sousane Z, et al. Application of Safety-II Principles. PSNet [internet]. 2024. https://psnet.ahrq.gov/perspective/application-safety-ii-principles Traditional approaches to patient safety have often been reactive rather than proactive, seeki…

2368. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49409/psn-pdf
      July 01, 2003 - Feeling No Pain July 1, 2003 Bogner MS. Feeling No Pain. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/feeling-no-pain The Case A 33-year-old female underwent hysterectomy for refractory endometriosis. For pain post-operatively, the patient was placed on a Patient-Controlled Analgesia (PCA) pump containin…

2369. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49390/psn-pdf
      February 01, 2003 - Flying Object Hits MRI February 1, 2003 Gosbee JW, Gosbee LL. Flying Object Hits MRI. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/flying-object-hits-mri The Case A child was brought to the Magnetic Resonance Imaging (MRI) room for a brain scan. Accompanied by an anesthesiologist, the child was receiving…

2370. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49697/psn-pdf
      December 01, 2013 - Check the Anesthesia Machine December 1, 2013 Saddawi-Konefka D, Cooper JB. Check the Anesthesia Machine. PSNet [internet]. 2013. https://psnet.ahrq.gov/web-mm/check-anesthesia-machine The Case A 62-year-old man with weight of 134 kg (body mass index [BMI] of 40) and history of hypertension, diabetes, sleep apnea…

2371. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49839/psn-pdf
      August 01, 2018 - Mixup Beyond the Medication Label August 1, 2018 Pervanas H, VanValkenburgh D. Mixup Beyond the Medication Label. PSNet [internet]. 2018. https://psnet.ahrq.gov/web-mm/mixup-beyond-medication-label The Case An 80-year-old man was admitted to a hospital for recurrent hypoglycemia. He had been seen at another hospi…

2372. Spotlight Case July 2008 (ppt file)
      psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.203_slideshow.ppt
      August 01, 2009 - Spotlight Case July 2008 Spotlight Case Nurse Staffing Ratios: The Crucible of Money, Policy, Research, and Patient Care * Source and Credits This presentation is based on the August 2009 AHRQ WebM&M Spotlight Case See the full article at http://webmm.ahrq.gov CME/CEU credit is available Commentary by: …

2373. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33715/psn-pdf
      July 01, 2011 - Becoming a Patient Safety Organization July 1, 2011 Jaffe R. Becoming a Patient Safety Organization. PSNet [internet]. 2011. https://psnet.ahrq.gov/perspective/becoming-patient-safety-organization Perspective While I was the first employee of the California Hospital Patient Safety Organization (CHPSO), its story …

2374. National Patient Safety Goals | PSNet
      psnet.ahrq.gov/primer/national-patient-safety-goals
      January 16, 2025 - National Patient Safety Goals Citation Text: Shaikh U. National Patient Safety Goals. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2024. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote…

2375. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/866395/psn-pdf
      July 23, 2024 - Rescue Improvement Conference Innovation Summary July 23, 2024 https://psnet.ahrq.gov/innovation/rescue-improvement-conference-innovation-summary Summary The Rescue Improvement Conference (RIC)1 was designed at the University of Michigan to address failure to rescue with a particular focus on communication and com…

2376. Spotlight Case July 2008 (ppt file)
      psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.224_slideshow.ppt
      October 01, 2010 - Spotlight Case July 2008 Spotlight Case October 2010 Dangerous Dialysis * * Source and Credits This presentation is based on the October 2010 AHRQ WebM&M Spotlight Case See the full article at http://webmm.ahrq.gov CME credit is available Commentary by: Jean L. Holley, MD, University of Illinois, Urbana-…

2377. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49792/psn-pdf
      May 01, 2017 - The ED case review committee analyzed the case in detail and wondered how common diagnostic errors are

2378. Diagnostic Delay in the Emergency Department | PSNet
      psnet.ahrq.gov/web-mm/diagnostic-delay-emergency-department
      September 18, 2024 - The ED case review committee analyzed the case in detail and wondered how common diagnostic errors are

2379. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/74121/psn-pdf
      November 30, 2021 - colleagues also did a retrospective case-control study of obstetric patients admitted to an ICU and analyzed

2380. Suicide Prevention in an Emergency Department Population: ED-SAFE | PSNet
      psnet.ahrq.gov/innovation/suicide-prevention-emergency-department-population-ed-safe
      July 23, 2024 - Data were collected from 2014 to 2018 and analyzed from April 2022 to December 2022. 3 The trial included