-
psnet.ahrq.gov/node/42828/psn-pdf
December 18, 2013 - increase risk of errors and makes recommendations to address these issues, including
using a team documentation
-
psnet.ahrq.gov/node/44964/psn-pdf
March 09, 2016 - electronic
health records in emergency care, including insufficient usability and increased risk of documentation
-
psnet.ahrq.gov/node/38468/psn-pdf
March 11, 2009 - use-pharmaceuticals-dialysis-patients-how-well-do-we-know-our-patients-
allergies
More than one-third of patients in an outpatient hemodialysis clinic lacked adequate documentation
-
psnet.ahrq.gov/node/36815/psn-pdf
March 28, 2011 - implementation-medication-reconciliation-process-ambulatory-internal-
medicine-clinic
This prospective study found improvement in medication documentation
-
psnet.ahrq.gov/web-mm/ultrasound-looked-fine-point-care-ultrasound-and-patient-safety
December 01, 2012 - program (e.g., leadership, training, competency, credentialing, quality assurance and improvement, documentation … Such a committee would work with departments to ensure proper documentation and image archiving. … The committee could also ensure all clinical documentation complies with institutional, local, regional … A point-of-care ultrasound cardiac documentation note for the patient chart would state the indication … April 1, 2016
WebM&M Cases
Lost in Sign Out and Documentation
-
psnet.ahrq.gov/node/45910/psn-pdf
March 08, 2017 - electronically-generated-medication-administration-and-electronic-medication-administration
https://psnet.ahrq.gov/issue/accuracy-medication-documentation-hospital-discharge-summaries-retrospective-analysis
-
psnet.ahrq.gov/node/42727/psn-pdf
November 13, 2013 - impact-electronic-health-record-systems-information-integrity-quality-and-safety-implications
https://psnet.ahrq.gov/issue/documentation-bad-habits-shortcuts-electronic-records-pose-risk
-
psnet.ahrq.gov/node/43984/psn-pdf
November 16, 2015 - The authors found
enhanced documentation of both verbal and written handoffs after implementation of
-
psnet.ahrq.gov/node/46659/psn-pdf
December 06, 2017 - Topics covered include the need for improvements in documentation and the radiologist's role in reducing
-
psnet.ahrq.gov/node/39059/psn-pdf
October 28, 2009 - psnet.ahrq.gov/issue/communication-and-information-deficits-patients-discharged-rehabilitation-
facilities
Documentation
-
psnet.ahrq.gov/node/43509/psn-pdf
September 10, 2014 - patient-safety-private-hospitals-known-and-unknown-risk
This report discusses issues with staffing, equipment, and documentation
-
psnet.ahrq.gov/node/837737/psn-pdf
July 27, 2022 - //psnet.ahrq.gov/issue/when-doctors-share-visit-notes-patients-study-patient-and-doctor-perceptions-documentation
-
psnet.ahrq.gov/node/72467/psn-pdf
November 18, 2020 - albeit necessary, may result in unintended consequences for
patients (e.g., less attention, suboptimal documentation
-
psnet.ahrq.gov/web-mm/chemotherapy-administration-safety-standards
March 30, 2016 - One such gap was appropriate chart documentation. … Before the first administration of a new chemotherapy regimen, chart documentation of the treatment plan … should be readily available.( 6 ) At minimum, such documentation should include the patient diagnosis … Prior to chemotherapy administration, transparent chart documentation should be available, which includes
-
psnet.ahrq.gov/node/49790/psn-pdf
April 01, 2017 - This case led to a system-wide analysis of
practices regarding allergy documentation in the EHR and … recording is it possible to understand the context
of the reaction later on in the patient's care as such documentation … If the only documentation
is "penicillin allergic" (without a description of the actual reaction and
-
psnet.ahrq.gov/node/41973/psn-pdf
January 30, 2013 - during-discharge
This commentary details the development of a medication reconciliation program to improve documentation
-
psnet.ahrq.gov/node/40944/psn-pdf
March 06, 2012 - AHRQ Patient Safety Indicators may help identify improvement opportunities for
nursing care, their documentation
-
psnet.ahrq.gov/node/34805/psn-pdf
November 07, 2017 - authors suggest that the first step in quality improvement is
quality assurance and that appropriate documentation
-
psnet.ahrq.gov/node/40624/psn-pdf
July 20, 2011 - findings reported in emergency department physician handoffs
differ from what is reported in their documentation
-
psnet.ahrq.gov/node/46234/psn-pdf
October 02, 2017 - study-clinicians-copy-and-paste-about-half-text-ehr-progress-notes
The use of copy and paste is a popular time-saving mechanism to update electronic medical
documentation