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Total Results: 411 records

Showing results for "bedside shift report".

181. Introducing the New AHRQ WebM&M and AHRQ Patient Safety Network (PSNet) | PSNet
     psnet.ahrq.gov/perspective/introducing-new-ahrq-webmm-and-ahrq-patient-safety-network-psnet
     April 01, 2005 - , To Err is Human, placed the issue of medical errors squarely in the public eye.( 1 ) The report led … reporting system, the Web site allowed clinicians from around the country (and the world) to safely submit reports … dozens of studies on patient safety are published every month, along with books, tools, surveys, and reports … of direct observations of the interns, daily chart reviews by ICU nurse data abstractors, voluntary reports … part of the century has been that, in order to be well trained as a physician, you need to be at the bedside

182. In Conversation with…Christopher P. Landrigan, MD | PSNet
     psnet.ahrq.gov/perspective/conversation-withchristopher-p-landrigan-md
     April 01, 2005 - of direct observations of the interns, daily chart reviews by ICU nurse data abstractors, voluntary reports … part of the century has been that, in order to be well trained as a physician, you need to be at the bedside … , To Err is Human, placed the issue of medical errors squarely in the public eye.( 1 ) The report led … reporting system, the Web site allowed clinicians from around the country (and the world) to safely submit reports … dozens of studies on patient safety are published every month, along with books, tools, surveys, and reports

183. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/851971/psn-pdf
     July 31, 2023 - adolescents.2 Iron replacement stops the craving for non- nutritive substances in the majority of reports … Less likely in this patient’s case, malingering is the conscious and fraudulent production or report … Important information can be lost during these handoffs and shift changes. … When a new nurse is assuming care at shift change or break time, it is prudent for the physician to confirm … Implementing bedside handoff in the emergency department: a practice improvement project.

184. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33615/psn-pdf
     June 01, 2005 - There is a dichotomy—some quality experts are far removed from the bedside. … Their theories, which are often very elegant, are just not always applicable to bedside reality. … One real benefit that physicians working in this area bring is that we still practice at the bedside … As a matter of fact, the goal is to put my team out of business—to shift the work to the caregivers

185. The Manitoba Institute for Patient Safety. | PSNet
     psnet.ahrq.gov/issue/manitoba-institute-patient-safety
     March 06, 2005 - April 18, 2018 Shift to Safety. … December 13, 2017 Diagnostic Strategy for the COVID-19 Pandemic – Bench to Bedside to … failures, and lessons learned, October 27, 2021 Patient Safety Authority Annual Reports … Safer Workplace October 31, 2023 Adverse Health Events in Minnesota: Annual Reports … May 22, 2019 Shift to Safety.

186. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49493/psn-pdf
     November 01, 2005 - The Commentary Medication errors by nurses occur frequently, largely due to their bedside role in patient … floating” and the underlying challenge of assuring staff competence, and (ii) the nurse’s failure to report … Workers’ reluctance to report errors may stem from a punitive work environment and the stigma that error … Take-Home Points Due to their proximity at the bedside, nurses are frequently involved in medication … Readers should not interpret any statement in this report as an official position of AHRQ or of the

187. Electrocardiogram Results: ***READ ME*** | PSNet
     psnet.ahrq.gov/web-mm/electrocardiogram-results-read-me
     May 01, 2019 - At 6:00 AM, a nursing assistant obtained the ordered ECG and placed it in the patient's bedside chart … On questioning the patient, she did report intermittent chest pressure overnight that was less severe … in bold capital letters at the top of a tracing and realize it deserves immediate attention from the bedside … Before leaving this case, it is worth a final note regarding the accuracy of computer-generated ECG reports … October 19, 2022 Does a unit shift report "blackout" period improve patient safety?

188. Signout Fallout | PSNet
     psnet.ahrq.gov/web-mm/signout-fallout
     November 16, 2022 - After discussions with her family, care was withdrawn, and she died with her family at her bedside. … improvement was accomplished without any time cost; resident time conducting handoffs, time at the bedside … Adapting the I-PASS handoff program for emergency department inter-shift handoffs. … Readers should not interpret any statement in this report as an official position of AHRQ or of the U.S … December 19, 2018 Association of patient and family reports of hospital safety climate

189. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49723/psn-pdf
     January 01, 2015 - Traditionally, FHR monitors were analog devices located at the patient's bedside.(5) Signals were traced … Previously when FHR tracings occurred only at the bedside, a nurse or physician would have to visit … the bedside frequently, and it was not possible to continuously monitor all patient tracings for signs … The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal … Readers should not interpret any statement in this report as an official position of AHRQ or of the

190. In Conversation With… Maureen Bisognano | PSNet
     psnet.ahrq.gov/perspective/conversation-maureen-bisognano
     February 26, 2025 - It was well before the publication of the IOM reports on safety and quality. … It was a shift from a sense of seeing events as only very rare lapses to seeing the whole system. … And they very much took their eye off the ball of what was happening at the bedside. … attention to the little everyday events (like a unit that doesn't have enough staffing on the night shift … Readers should not interpret any statement in this report as an official position of AHRQ or of the U.S

191. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49810/psn-pdf
     November 01, 2017 - On the night shift, the bedside nurse went to see the patient at 3:00 AM to administer the next scheduled … He died peacefully with his family at the bedside. … adequate documentation convey the crucial information to everybody on the care team, including the night shift … Readers should not interpret any statement in this report as an official position of AHRQ or of the … authors has any affiliation or financial involvement that conflicts with the material presented in this report

192. Failure to Adhere to Dietary Restrictions Leading to Complications and Poor Follow-up | PSNet
     psnet.ahrq.gov/web-mm/failure-adhere-dietary-restrictions-leading-complications-and-poor-follow
     March 29, 2023 - adolescents. 2 Iron replacement stops the craving for non-nutritive substances in the majority of reports … Less likely in this patient’s case, malingering is the conscious and fraudulent production or report … Important information can be lost during these handoffs and shift changes. … When a new nurse is assuming care at shift change or break time, it is prudent for the physician to confirm … Implementing bedside handoff in the emergency department: a practice improvement project .

193. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33787/psn-pdf
     January 01, 2018 - It was well before the publication of the IOM reports on safety and quality. … It was a shift from a sense of seeing events as only very rare lapses to seeing the whole system. … And they very much took their eye off the ball of what was happening at the bedside. … attention to the little everyday events (like a unit that doesn't have enough staffing on the night shift … So we're very focused on keeping that connection between the boardroom and the bedside tight.

194. Periodic Issue | PSNet
     psnet.ahrq.gov/periodic-issue/periodic-issue-393
     June 28, 2023 - issue highlights what's new this week in patient safety literature, news, conferences, reports … Staffing and nursing time at the bedside play a role in missed nursing care. … Cognitive bias, fatigue, and shift work can increase diagnostic errors in radiology. … Book/Report Clinical Investigation Booking Systems Failures: Written Communications … This report examines language discordance in National Health Service written scheduling communications

195. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49635/psn-pdf
     September 01, 2011 - Before leaving, she prepared a new bottle of lipids and left it at the bedside, as the current bottle … The problem was not discovered until the nurses on the next shift made rounds and checked the patient's … Numerous reports have documented unintentional failures to connect the correct tubing between intravenous … tubing connection is a routine, familiar, and common task in nursing, often performed many times on one shift … Readers should not interpret any statement in this report as an official position of AHRQ or of the

196. Infused, Not Ingested | PSNet
     psnet.ahrq.gov/web-mm/infused-not-ingested
     February 01, 2017 - The Commentary Medication errors by nurses occur frequently, largely due to their bedside role in patient … floating” and the underlying challenge of assuring staff competence, and (ii) the nurse’s failure to report … Workers’ reluctance to report errors may stem from a punitive work environment and the stigma that error … Take-Home Points Due to their proximity at the bedside, nurses are frequently involved in medication … Readers should not interpret any statement in this report as an official position of AHRQ or of the U.S

197. Monitoring Fetal Health | PSNet
     psnet.ahrq.gov/web-mm/monitoring-fetal-health
     September 08, 2010 - Traditionally, FHR monitors were analog devices located at the patient's bedside.( 5 ) Signals were traced … Previously when FHR tracings occurred only at the bedside, a nurse or physician would have to visit the … bedside frequently, and it was not possible to continuously monitor all patient tracings for signs of … The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal … Readers should not interpret any statement in this report as an official position of AHRQ or of the U.S

198. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49819/psn-pdf
     February 01, 2018 - After discussions with her family, care was withdrawn, and she died with her family at her bedside. … Handoffs occur in the hospital every time providers change shift and whenever a patient changes locations … improvement was accomplished without any time cost; resident time conducting handoffs, time at the bedside … Adapting the I-PASS handoff program for emergency department inter-shift handoffs. … Readers should not interpret any statement in this report as an official position of AHRQ or of the

199. High-Risk Medications, High-Risk Transfers | PSNet
     psnet.ahrq.gov/web-mm/high-risk-medications-high-risk-transfers
     December 21, 2017 - The bedside nurse received education about treprostinil, with special instructions not to flush the line … However, research to date has primarily concentrated on intradisciplinary sign-offs among physicians, shift … An analysis of the reports submitted to the Australian Incident Monitoring Study in Intensive Care. … December 21, 2017 The content and context of change of shift report on medical and surgical … September 1, 2016 WebM&M Cases Dangerous Shift

200. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/857259/psn-pdf
     November 30, 2023 - barcode label and administered about 8 ounces of the dialysis liquid orally before the end of her shift … https://psnet.ahrq.gov/issue/medical-error-third-leading-cause-death-us https://psnet.ahrq.gov//#2 bedside … , where one individual hands off a medication to another for administration, either at a change of shift … that medications are verified by a pharmacy staff member before a replacement label is issued for the bedside … Readers should not interpret any statement in this report as an official position of AHRQ or of the