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psnet.ahrq.gov/issue/supporting-patient-safety-and-clinical-pharmacy-services-collaborative
February 08, 2023 - December 19, 2018
1,300 days and counting: a risk model approach to preventing retained … August 1, 2018
A retrospective audit of postoperative days alive and out of hospital,
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psnet.ahrq.gov/node/60363/psn-pdf
March 01, 2021 - as the Care Transitions Intervention, a Transitions Coach works directly
with participants for 30 days … visit and telephone contact: Patients and families work with the Transitions
Coach for the first 30 days … Periodic telephone calls: The Transitions Coach calls the patient three times during the first 30
days … Participants were approximately 50 percent less likely to be rehospitalized at 30, 90, and 180
days … Training: Transitions Coaches undergo highly experiential training that lasts 2 days.
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psnet.ahrq.gov/node/50611/psn-pdf
October 30, 2019 - He required two prescriptions for rivaroxaban (per protocol), one for
15 mg twice a day for 10 more days … Ten days later, the patient's wife returned to the pharmacy requesting a refill of the rivaroxaban 15 … recurrence during this initial period), and then transition to the 20 mg
daily dose for the next 7 days … Moreover,
the exact calculation of how many remaining days for the starter pack might vary depending … on how many
days of inpatient treatment a patient had already received in the hospital before discharge
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psnet.ahrq.gov/web-mm/miscommunication-or-leads-anticoagulation-mishap
May 08, 2019 - Six days prior to surgery, as instructed by the surgeon, he stopped taking his aspirin and clopidogrel … that postoperatively the patient would be therapeutically anticoagulated with enoxaparin for several days … Five days later, the epidural catheter was removed. … that no safety checks at a systems level were in place to help providers identify this issue for 5 days
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psnet.ahrq.gov/node/73106/psn-pdf
April 01, 2021 - improvements in processes of care.1,2
As an example, Figure 1 shows a histogram that depicts the number of days … Figure 1: Histogram tracking number of days post-hospitalization that discharge summaries were sent to … In a run
chart, data are displayed over a specific period in consistent units (days, weeks, months, … Benchmarking is when a ward or hospital’s measure of quality, such as
the CLABSI rate per 1,000 central line-days
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psnet.ahrq.gov/web-mm/real-heartache
October 01, 2018 - Two days later, the patient made an unscheduled return visit to the ED, now in severe distress. … Two days later, the patient had a cardiac arrest and could not be resuscitated. … translates to an 8.2% (95% CI 5.27 to 11.04) incidence of cardiovascular morbidity or mortality at 30 days—clearly … have been either immediate stress testing, expedited outpatient stress testing (in the next 1 to 2 days … stenosis) • Two or more anginal episodes in the preceding 24 hours • Aspirin use in the 7 days
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psnet.ahrq.gov/issue/characteristics-initial-prescription-episodes-and-likelihood-long-term-opioid-use-united
April 24, 2018 - cumulative dose ≥ 700 mg morphine equivalent), provided prescriptions with longer duration (more than 10 days … The authors recommend prescribing fewer than 7 days of opioids for acute pain and adhering to the Centers
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.227_slideshow.ppt
November 01, 2010 - relate to complications from the recent hospitalization
20% of Medicare patients re-admitted within 30 days … poor access to follow-up care after discharge
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Case: Treatment after Discharge (3)
Eleven days … *
*
Although these test results became available 2 days after the patient’s discharge, they … His second hospitalization lasted 7 days.
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psnet.ahrq.gov/issue/7-year-analysis-attributable-costs-healthcare-associated-infections-network-community
April 24, 2018 - Event rates ranged from 0.34 events per 1,000 patient days (CDI-HO) to 0.87 events per 1,000 procedures … May 22, 2019
Healthy life-years lost and excess bed-days due to 6 patient safety incidents
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psnet.ahrq.gov/node/49739/psn-pdf
August 21, 2015 - A few days later, the patient became increasingly agitated due to delirium. … from prolonged intubation.(5) Some authors promote early tracheostomy (for patients
with more than 4 days … Standardized
processes for skin care, including removing sutures at 5–7 days and placement of a skin-barrier … All tracheostomy changes within 5 days of insertion should be performed with surgical
equipment available … During the first 5–7 days after tracheostomy, before the stoma is well formed, dislodgement of the tube
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psnet.ahrq.gov/web-mm/sweet-case-hidden-hydrogen-ions
November 30, 2023 - ketoacidosis (DKA) in a patient with type 1 diabetes; the correct diagnosis was not established until 3 days … Inadequate education about how to dose insulin on sick days and how to recognize early symptoms of DKA … Patients with type 1 diabetes should also be educated about management of their sick days, how to trouble-shoot … Cases
When Taking an SGLT2 inhibitor, Remember To SSTOP (Stop SGLT2 Inhibitor Three days … Cases
When Taking an SGLT2 inhibitor, Remember To SSTOP (Stop SGLT2 Inhibitor Three days
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psnet.ahrq.gov/curated-library/diagnostic-errors-case-studies
September 15, 2025 - Three days later, the patient returned to the same ED with similar symptoms and again was found to have … However, due to delays in receiving those results, another sample was tested two days later with a newly … The patient was discharged in stable clinical condition but was advised to quarantine for 14 days. … Two days after the patient’s discharge, the commercial and state lab tests were both reported as negative … Ten days later, she presented to a community hospital with fever, inability to walk, and numbness from
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psnet.ahrq.gov/web-mm/postpartum-woman-erroneous-sars-cov-2-test
December 23, 2020 - However, due to delays in receiving those results, another sample was tested two days later with a newly … positive for SARS-CoV-2, but clinically healthy, she was advised to isolate herself at home for 14 days … Two days after the mother’s discharge, the commercial and state lab tests were both reported as negative … These impacts may include: 1) unnecessary isolation, including unnecessarily missed work or school days … test sensitivity ranging from 0% on the day after exposure to SARS-CoV-2 to 80-89% in the first four days
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psnet.ahrq.gov/web-mm/hazards-loading-doses
December 01, 2003 - Two days after discharge, she presented to the emergency department (ED) complaining of headache, abdominal … Three days after admission, the patient developed somnolence, severe ataxia, and dysarthria. … The patient's neurologic symptoms persisted for 3 days after discontinuation of phenytoin. … drugs (e.g., digoxin, amiodarone) may require multiple loading doses administered over several hours to days
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psnet.ahrq.gov/web-mm/chemotherapy-administration-safety-standards
March 30, 2016 - with cancer was admitted to the hospital to begin a chemotherapy cycle of IV etoposide (daily for 3 days … pharmacist switched the duration of therapy for the two agents, entering a single dose of etoposide and 3 days … correct doses on the first day (since the transposition didn't affect this); however, the subsequent days … In subsequent days, the patient's renal function began to deteriorate, and she required hemodialysis
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psnet.ahrq.gov/node/49663/psn-pdf
September 01, 2012 - He was given intravenous (IV) diuretics and improved
over the first 4 days in the hospital. … , there was a standard protocol that called for all
peripheral IV catheters to be replaced after 4 days … The peripheral IV was kept in
place for 2 more days. … and add-on devices,
should be changed no more frequently than every 96 hours, but at least every 7 days … Routine resite of peripheral intravenous devices
every 3 days did not reduce complications compared
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psnet.ahrq.gov/node/33743/psn-pdf
December 01, 2012 - protocolized exercise and mobilization (with physical and occupational
therapy) at a median of 1.5 days … following intubation, compared to 7.4 days for control patients. … Patients received therapy for 87% of study days, and experienced an average of 2 fewer days of
delirium … , 2 more ventilator-free days, and were able to get out of bed almost 5 days earlier. … Days of delirium are associated
with 1-year mortality in an older intensive care unit population.
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psnet.ahrq.gov/node/49486/psn-pdf
August 21, 2005 - 35 hours, which means that when a fixed dose is administered orally, it takes
approximately 7 to 9 days … The computer modeling predicts that if
10 mg is given on each of the next 2 days, the INR value will … The model predicts that it takes 5 days
to achieve an INR of just over 2.0; it would take approximately … 12 days to attain the predicted steady-state
INR of 4.7. … engine would show a steady-state dose prediction and
the expected value of the INR over the next 2 days
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psnet.ahrq.gov/web-mm/breakage-picc-line
June 21, 2023 - After 40 days of parenteral therapy, the antecubital site and the upper arm became red, swollen, and … in 109 of 112 attempts (97.3%) in 53 patients, and they were followed for a total of 11,797 catheter days … Because more than 70% of such complications occurred more than 30 days after placement, the authors concluded … The median time from insertion to discovery of the PICC fracture was 93 days, consistent with the hypothesis … Transparent dressings should be changed every 7 days except when the risk of dislodging the catheter
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psnet.ahrq.gov/issue/effect-digital-tools-promote-hospital-quality-and-safety-adverse-events-after-discharge
October 16, 2024 - May 4, 2022
Medication-related hospital readmissions within 30 days of discharge: prevalence … Failure to follow medication changes made at hospital discharge is associated with adverse events in 30 days