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psnet.ahrq.gov/node/39670/psn-pdf
July 07, 2010 - called for states to publicly report never
events—medical errors that resulted in death or severe disability
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psnet.ahrq.gov/node/39655/psn-pdf
July 07, 2010 - studies and data from malpractice claims, which may over-represent
diagnoses that cause death or serious disability
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psnet.ahrq.gov/node/36907/psn-pdf
September 14, 2012 - ., wrong-site surgery), device events (e.g., air
embolism), care management events (e.g., death or disability
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psnet.ahrq.gov/periodic-issue/periodic-issue-426
February 28, 2024 - quality and safety of care provided by hospitals to children and young people with an intellectual disability … Children with intellectual disability are known to be at increased risk of poor quality of care and patient … This qualitative study, which included parents of children with intellectual disability, explored patient … coordination to foster trust, and care environments and providers with the resources and training to promote disability-specific
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psnet.ahrq.gov/print/pdf/node/867461
January 31, 2024 - Gaps
An invisible disability: communication, patient safety and dual sensory impairment in older persons … reconceptualizing-patient-safety-beyond-harm-insights-mixed-methods-qualitative-inquiry
https://psnet.ahrq.gov/issue/invisible-disability-communication-patient-safety-and-dual-sensory-impairment-older-persons … An invisible disability: communication, patient safety and dual sensory impairment in older persons. … designing-intervention-improve-medication-safety-nursing-home-residents-based-experiential
https://psnet.ahrq.gov/issue/invisible-disability-communication-patient-safety-and-dual-sensory-impairment-older-persons
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psnet.ahrq.gov/issue/dangers-diagnostic-overshadowing
October 26, 2022 - commentary describes an incident involving diagnostic error and substandard care of a patient with disability
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psnet.ahrq.gov/node/48097/psn-pdf
July 17, 2019 - accounted for 21% of 55,377 claims analyzed, and the majority of these cases resulted in permanent
disability
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psnet.ahrq.gov/issue/some-hospitals-call-911-save-their-patients
January 18, 2023 - April 27, 2016
Medication Safety and Hospital Referrals: A Report by the Health and Disability
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psnet.ahrq.gov/issue/diagnostic-error-stroke-reasons-and-proposed-solutions
March 01, 2023 - Stoke misdiagnosis can result in lasting patient disability.
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psnet.ahrq.gov/periodic-issue/periodic-issue-407
September 27, 2023 - Potentially inappropriate medication use is associated with increased risk of incident disability … , this study evaluated the impact of PIM use in community-dwelling older adults without significant disability … Participants with at least one PIM were at increased risk of physical disability and hospitalization … think about the quality and safety of care provided to children and young people with an intellectual disability
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psnet.ahrq.gov/issue/quality-australian-health-care-study
February 02, 2022 - adverse events were categorized by clinical type, patient characteristics, extra bed-days attributable, disability
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psnet.ahrq.gov/node/33561/psn-pdf
September 15, 2024 - are
unambiguous (clearly identifiable and measurable), serious (resulting in death or significant disability … laboratory,
pathology, or radiology test results
Environmental events
Patient or staff death or serious disability
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psnet.ahrq.gov/issue/five-hospitals-release-data-inspections
August 24, 2016 - November 2, 2012
Medication Safety and Hospital Referrals: A Report by the Health and Disability
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psnet.ahrq.gov/issue/surgical-fire-united-states-2000-2020
March 03, 2021 - Surgical fires, while rare, can result in the injury , permanent disability, or death of patients or
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psnet.ahrq.gov/issue/risk-assessment-acute-stroke-diagnostic-process-using-failure-modes-effects-and-criticality
July 21, 2021 - A missed or delayed diagnosis of stroke places patients at risk of permanent disability or death.
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psnet.ahrq.gov/issue/adverse-outcomes-polypharmacy-older-people-systematic-review-reviews
May 29, 2019 - conflicting evidence on associating polypharmacy with adverse outcomes, including adverse drug events and disability
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psnet.ahrq.gov/issue/how-safe-do-dying-people-feel-home-patients-perception-safety-while-receiving-specialist
June 23, 2021 - Patients reported that physical disability, physical and psychological symptoms, and side effects or
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psnet.ahrq.gov/issue/ed-misdiagnosis-cerebrovascular-events-era-modern-neuroimaging-meta-analysis
August 19, 2020 - Delayed diagnosis of stroke can lead to preventable disability.
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psnet.ahrq.gov/issue/how-and-when-organization-identification-promotes-safety-voice-among-healthcare-professionals
September 15, 2021 - In this study, staff members from a disability healthcare organization in Australia responded to a questionnaire
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psnet.ahrq.gov/issue/identifying-list-healthcare-never-events-effect-system-change-systematic-review-and-narrative
April 24, 2019 - Never events are catastrophic adverse events resulting in patient death or significant disability that