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421. Physician-Reported Adverse Events and Medical Errors in Obstetrics and Gynecology (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-November_45.pdf
     January 01, 2007 - • Need for general anesthesia when a scrub technician suffered a syncopal episode during a cesarean

422. Cognitive Load Theory and Its Impact on Diagnostic Accuracy: Issue Brief (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/diagnostic/resources/issue-briefs/dxsafety-cognitive-load-theory.pdf
     May 01, 2024 - laparoscopic performance50 and increasing educational workload is associated with reduced vigilance during anesthesia … Multiple measures of anesthesia workload during teaching and nonteaching cases.

423. Final Progress Report: Creating Safe Ambulatory Care: The Path to Resilience (pdf file)
     www.ahrq.gov/sites/default/files/2025-04/nemeth-report.pdf
     January 01, 2025 - because they were high-volume and high-quality data sources and had established relationships with anesthesia

424. AHRQ Safety Program for Perinatal Care: Labor and Delivery Unit Safety
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/labor-delivery-unit/ldusafety.pptx
     May 01, 2017 - information C/S procedure Indications Anticipated complications Risk Medical history Fetal status Type of anesthesia

425. Final Progress Report: Impacts of Alcohol and Fatigue on Paramedic ALS Skills (pdf file)
     www.ahrq.gov/sites/default/files/2024-09/becker-marques-report.pdf
     January 01, 2024 - deprivation in hospital-house officers are those of Denisco, Drummond, and Gravenstein (1987), in which anesthesia … Anesthesia residents who slept no more than 30 minutes per night displayed impaired innovative thinking

426. Planning Grants Final Evaluation Report: Longitudinal Evaluation of the PSML Reform Demonstration Program (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/psml-planning-grants-final-report.pdf
     May 01, 2016 - In addition, decision aids have been developed for use with anesthesia patients but have not yet been … In addition, decision aids have been developed for use with anesthesia patients but have not yet been … informed consent or SDM were more commonly associated with clinical procedures (e.g., surgery) and anesthesia

427. Planning Grants Final Evaluation Report: Longitudinal Evaluation of the PSML Reform Demonstration Program (pdf file)
     www.ahrq.gov/sites/default/files/publications/files/psml-planning-grants-final-report.pdf
     May 01, 2016 - In addition, decision aids have been developed for use with anesthesia patients but have not yet been … In addition, decision aids have been developed for use with anesthesia patients but have not yet been … informed consent or SDM were more commonly associated with clinical procedures (e.g., surgery) and anesthesia

428. The National Action Alliance to Advance Patient Safety Summer Webinar Series - PowerPoint Presentation (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/public-action-alliance-slides-040323_LOCKED.pdf
     May 25, 2023 - Institute, ASA) • Coordinate with the National Steering Committee for Patient Safety • AANA – developed anesthesia

429. Safe Medication Administration: Oxytocin | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/medication/tool-safe-oxytocin.html
     July 01, 2023 - Assess the need for increased analgesia or epidural anesthesia. 7.

430. Final Progress Report: Leveraging Existing Assessments of Risk Now (LEARN) Final Report (pdf file)
     www.ahrq.gov/sites/default/files/2025-02/woods2-report.pdf
     January 01, 2025 - By applying these methods, the medical field of anesthesia reduced death rates associated with anesthesia

431. Diagnostic Excellence in U.S. Rural Healthcare: A Call to Action (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/diagnostic/resources/issue-briefs/dx-safety-rural-healthcare.pdf
     July 01, 2024 - designing and implementing a program to support the transition of new graduate nurses into a post anesthesia … A competency-based orientation (CBO) protocol enhances competency among newly hired peri anesthesia

432. Final Progress Report: Proactive Risk Assessment of Primary Care of the Elderly (pdf file)
     www.ahrq.gov/sites/default/files/2024-12/karsh-report.pdf
     January 01, 2024 - . - Permanent dialysis - Major surgery with general anesthesia - PTSD - Prolonged hospitalization 7 … hospitalization to stabilize -Cardiac cath -Short-term dialysis -Invasive procedure but no general anesthesia

433. ChartBook On Patient Safety (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/chartbooks/patientsafety/qdr2015-ptschartbook.pdf
     March 04, 2016 - (n=42,507) Surgery (n=36,845) Obstetrics (n=10,555) Medication (n=8,287) Monitoring (n=5,329) Anesthesia … (n=42,507) Surgery (n=36,845) Obstetrics (n=10,555) Medication (n=8,287) Monitoring (n=5,329) Anesthesia … Patient Safety  Anesthesia … one-third of harm in payments related to monitoring (49.9%), diagnosis (39.3%), medication (38.3%), and anesthesia

434. AHRQ-Funded Patient Safety Project Highlights: Improving Healthcare Safety by Enhancing Teamwork and Leadership (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-teamwork-leadership-2025.pdf
     January 01, 2025 - Purpose: To use simulation learning to evaluate and improve communication and coordination between anesthesia … providers and nurses as care is transitioned from the operating room to the post-anesthesia care unit … and Improved Teamwork (STRAIT), a comprehensive intervention to improve patient handovers between anesthesia

435. PowerPoint Presentation: Learn From Defects Through Sensemaking
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/implementation/imp_learn_from_defects.pptx
     December 01, 2017 - Everyone in the operating room, from preoperative to post-anesthesia care unit (PACU) staff, can and … SAY: If the patient was part of the defect process (e.g., alert, rather than under anesthesia), ask the

436. Implementation Guide: MRSA and SSI Prevention (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-surgery/147-implementation-guide.pdf
     April 01, 2025 - This includes the post-anesthesia care unit (PACU) and may include other postoperative inpatient settings

437. Final Progress Report: Pursuing Perfection in Pediatric Therapeutics (pdf file)
     www.ahrq.gov/sites/default/files/2024-01/lannon1-report.pdf
     January 01, 2024 - Pain Service added Post Period Intervention Period Pre/Baseline Period January 2008 - Began post-anesthesia

438. 7-Implementation-Guide (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/surgery/7-implementation-guide.docx
     June 01, 2023 - your hospital’s ISCR pathway ISCR team ISCR Pathway Worksheet ISCR evidence reviews: surgery and anesthesia

439. Leadership To Improve Diagnosis: A Call to Action - Issue Brief 5 (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/reports/issue-briefs/dx-leadership-cx.pdf
     June 03, 2021 - Associate Professor, Anesthesia and Critical Care Medicine Johns Hopkins School of Medicine Armstrong

440. Preventing CAUTI in the ICU Setting Facilitator’s Guide Transcript | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cauti-tools/facil-guide/preventing-cauti-icu-setting-transcript.html
     February 01, 2023 - contiguous structures of genitourinary tract Anticipated prolonged surgery duration (removed in post-anesthesia