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441. Use of design thinking and human factors approach to improve situation awareness in the pediatric intensive care unit. | PSNet
     psnet.ahrq.gov/issue/use-design-thinking-and-human-factors-approach-improve-situation-awareness-pediatric
     January 19, 2022 - 2021 Transparency, public reporting, and a culture of change to quality and safety in cardiac … September 20, 2023 Video review of simulated pediatric cardiac arrest to identify errors

442. Preventing patient harm via adverse event review: An APSA survey regarding the role of morbidity and mortality (M&M) conference. | PSNet
     psnet.ahrq.gov/issue/preventing-patient-harm-adverse-event-review-apsa-survey-regarding-role-morbidity-and
     May 22, 2019 - Diagnosis and Treatment of an Occult Hemothorax Following Complicated Central Line Insertion Leads to Cardiac … December 2, 2014 Standardized multidisciplinary protocol improves handover of cardiac

443. Medical error: using storytelling and reflection to impact error response factors in family medicine residents. | PSNet
     psnet.ahrq.gov/issue/medical-error-using-storytelling-and-reflection-impact-error-response-factors-family-medicine
     June 05, 2019 - November 2, 2022 Application of the aviation black box principle in pediatric cardiac … surgery: tracking all failures in the pediatric cardiac operating room.

444. Tolerance of uncertainty and fears of making mistakes among fifth-year medical students. | PSNet
     psnet.ahrq.gov/issue/tolerance-uncertainty-and-fears-making-mistakes-among-fifth-year-medical-students
     December 09, 2020 - Adverse safety events in emergency medical services care of children with out-of-hospital cardiac … May 16, 2018 Safety events in pediatric out-of-hospital cardiac arrest.

445. Adjusting to duty hour reforms: residents' perception of the safety climate in interdisciplinary night-float rotations. | PSNet
     psnet.ahrq.gov/issue/adjusting-duty-hour-reforms-residents-perception-safety-climate-interdisciplinary-night-float
     June 01, 2022 - Resources From the Same Author(s) Mortality due to hospital-acquired infection after cardiac … Simulation-based training improves physicians' performance in patient care in high-stakes clinical setting of cardiac

446. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49431/psn-pdf
     January 01, 2004 - Cardiac enzymes were drawn. She was admitted to the cardiac care unit (CCU). … The first set of cardiac enzymes was equivocal, and a CPK- MB was minimally elevated. … Many such aides are available, and these improve the sensitivity and specificity of diagnosing cardiac … '(4-8) For example, one study used a formula based on seven clinical variables to predict cardiac ischemia … However, had the team incorporated all available data, they might have realized that the likelihood of cardiac

447. Crushing Chest Pain: A Missed Opportunity | PSNet
     psnet.ahrq.gov/web-mm/crushing-chest-pain-missed-opportunity
     February 01, 2007 - Cardiac enzymes were drawn. She was admitted to the cardiac care unit (CCU). … The first set of cardiac enzymes was equivocal, and a CPK-MB was minimally elevated. … Many such aides are available, and these improve the sensitivity and specificity of diagnosing cardiac … '( 4-8 ) For example, one study used a formula based on seven clinical variables to predict cardiac ischemia … However, had the team incorporated all available data, they might have realized that the likelihood of cardiac

448. 20 years later: to err is a leadership failure. | PSNet
     psnet.ahrq.gov/issue/20-years-later-err-leadership-failure
     November 30, 2016 - associated with survival for Black patients and diminishes racial disparities in survival after in-hospital cardiac … 2023 Transparency, public reporting, and a culture of change to quality and safety in cardiac

449. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49747/psn-pdf
     December 01, 2015 - His initial electrocardiogram (ECG) showed no evidence of significant ischemia, but cardiac biomarkers … types of alarms generated with hospital monitor devices: arrhythmia alarms that detect a change in cardiac … well-known academic medical center.(2) Despite repeated low heart rate alarms before the patient's cardiac … A number of different forces result in an excessive number of cardiac monitor alarms. … Cardiac monitor devices have a high sensitivity for detecting arrhythmias and vital sign changes, but

450. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49756/psn-pdf
     April 01, 2016 - While being evaluated by the emergency physician, he suddenly went into cardiac arrest. … He was successfully resuscitated and underwent emergent cardiac catheterization, which revealed multivessel … references https://psnet.ahrq.gov//#references https://psnet.ahrq.gov//#references communicated from the cardiac … Third, the cardiac care team may have been inappropriately reassured that free air on the radiograph … may have been a delay in the recognition of this complication because of a flawed transfer from a cardiac

451. Latency of ECG displays of hospital telemetry systems: a science advisory from the American Heart Association. | PSNet
     psnet.ahrq.gov/issue/latency-ecg-displays-hospital-telemetry-systems-science-advisory-american-heart-association
     March 14, 2018 - September 1, 2016 Novel approach to cardiac alarm management on telemetry units. … Enhancing patient safety with intelligent intravenous infusion devices: experience in a specialty cardiac

452. Medication errors—new approaches to prevention. | PSNet
     psnet.ahrq.gov/issue/medication-errors-new-approaches-prevention
     November 18, 2016 - May 23, 2018 Improving the quality and safety of patient care in cardiac anesthesia. … January 7, 2015 Improving the quality and safety of patient care in cardiac anesthesia

453. Recognizing and managing errors of cognitive underspecification. | PSNet
     psnet.ahrq.gov/issue/recognizing-and-managing-errors-cognitive-underspecification
     November 14, 2018 - July 22, 2020 Patient safety in the cardiac operating room: human factors and teamwork … October 7, 2013 Cardiac surgery errors: results from the UK National Reporting and Learning

454. Does simulation improve patient safety?: self-efficacy, competence, operational performance, and patient safety. | PSNet
     psnet.ahrq.gov/issue/does-simulation-improve-patient-safety-self-efficacy-competence-operational-performance-and
     May 25, 2016 - Citation Related Resources From the Same Author(s) Interdisciplinary ICU cardiac … April 6, 2012 Cold debriefings after in-hospital cardiac arrest in an international pediatric

455. The Anesthesia Patient Safety Foundation at 25: a pioneering success in safety, 25th anniversary provokes reflection, anticipation. | PSNet
     psnet.ahrq.gov/issue/anesthesia-patient-safety-foundation-25-pioneering-success-safety-25th-anniversary-provokes
     January 01, 2015 - is crying in the operating room: patient monitor and anesthesia workstation alarming patterns during cardiac … October 19, 2022 Patient safety in the cardiac operating room: human factors and teamwork

456. Burnout syndrome among healthcare professionals. | PSNet
     psnet.ahrq.gov/issue/burnout-syndrome-among-healthcare-professionals
     September 01, 2018 - 2022 Transparency, public reporting, and a culture of change to quality and safety in cardiac … November 9, 2022 Implementation of a rapid response team decreases cardiac arrest outside

457. Application of human error theory in case analysis of wrong procedures. | PSNet
     psnet.ahrq.gov/issue/application-human-error-theory-case-analysis-wrong-procedures
     November 14, 2018 - July 22, 2020 Patient safety in the cardiac operating room: human factors and teamwork … October 7, 2013 Cardiac surgery errors: results from the UK National Reporting and Learning

458. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49718/psn-pdf
     January 01, 2015 - While on the third bag of the potassium infusion, the patient went into cardiac arrest and advanced … potassium chloride for mild–moderate hypokalemia (K+ 3.1–3.5 mEq/L) and IV repletion via central line with cardiac … : necessary when the patient cannot take oral medicines or for cases of severe hypokalemia causing cardiac … administration** Oral: 60–80 mEq/day initially Intravenous: usual rate of 10–20 mEq/h with preference for cardiac … monitoring; emergency rate of 5–10 mEq over 20 min with mandatory cardiac monitoring in an ICU setting

459. The role of the anesthesiologist in perioperative patient safety. | PSNet
     psnet.ahrq.gov/issue/role-anesthesiologist-perioperative-patient-safety
     November 20, 2015 - December 19, 2014 Improving the quality and safety of patient care in cardiac anesthesia … is crying in the operating room: patient monitor and anesthesia workstation alarming patterns during cardiac

460. Harm From Alarm Fatigue | PSNet
     psnet.ahrq.gov/web-mm/harm-alarm-fatigue
     February 14, 2018 - His initial electrocardiogram (ECG) showed no evidence of significant ischemia, but cardiac biomarkers … care units over a 1-month period, we found that low-voltage QRS complexes were a major cause of false cardiac … types of alarms generated with hospital monitor devices: arrhythmia alarms that detect a change in cardiac … A number of different forces result in an excessive number of cardiac monitor alarms. … Cardiac monitor devices have a high sensitivity for detecting arrhythmias and vital sign changes, but