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Showing results for "event".

41. Reporting of death in US Food and Drug Administration medical device adverse event reports in categories other than death. | PSNet
    psnet.ahrq.gov/issue/reporting-death-us-food-and-drug-administration-medical-device-adverse-event-reports
    April 07, 2019 - Study Reporting of death in US Food and Drug Administration medical device adverse event … Reporting of death in US Food and Drug Administration medical device adverse event reports in categories … Based on medical device adverse event data reported to the FDA's Manufacturer and User Facility Device … March 17, 2021 Disparities in adverse event reporting for hospitalized children. … used in daily workflow increases adverse event reporting by physicians.

42. I-PSI: short- and long-term efficacy of a comprehensive initiative to promote patient safety event reporting by trainees. | PSNet
    psnet.ahrq.gov/issue/i-psi-short-and-long-term-efficacy-comprehensive-initiative-promote-patient-safety-event
    November 18, 2020 - I-PSI: short- and long-term efficacy of a comprehensive initiative to promote patient safety event … I-PSI: short- and long-term efficacy of a comprehensive initiative to promote patient safety event reporting … using a combination of branding, education and outreach, and feedback – to increase patient safety event … The intervention led to increased event reporting in the short- and long-term. … June 1, 2016 Patient safety event reporting expectation: does it influence residents'

43. A narrative review of strategies to increase patient safety event reporting by residents. | PSNet
    psnet.ahrq.gov/issue/narrative-review-strategies-increase-patient-safety-event-reporting-residents
    December 02, 2020 - Review A narrative review of strategies to increase patient safety event reporting … A narrative review of strategies to increase patient safety event reporting by residents. … review, the authors examined current literature on effective strategies to increase patient safety event … A narrative review of strategies to increase patient safety event reporting by residents. … December 2, 2020 Leveraging a safety event management system to improve organizational

44. A model for medication safety event detection. | PSNet
    psnet.ahrq.gov/issue/model-medication-safety-event-detection
    May 14, 2008 - Commentary A model for medication safety event detection. … A model for medication safety event detection. … A model for medication safety event detection. … July 26, 2023 Families as partners in hospital error and adverse event surveillance. … Reevaluating the safety profile of pediatrics: a comparison of computerized adverse drug event

45. Interprofessional clinical event debriefing-does it make a difference? Attitudes of emergency department care providers to INFO clinical event debriefings. | PSNet
    psnet.ahrq.gov/issue/interprofessional-clinical-event-debriefing-does-it-make-difference-attitudes-emergency
    April 06, 2022 - Study Interprofessional clinical event debriefing-does it make a difference? … Attitudes of emergency department care providers to INFO clinical event debriefings. … Interprofessional clinical event debriefing-does it make a difference? … Attitudes of emergency department care providers to INFO clinical event debriefings. … Interprofessional clinical event debriefing-does it make a difference?

46. Connecting perspectives on quality and safety: patient-level linkage of incident, adverse event and complaint data. | PSNet
    psnet.ahrq.gov/issue/connecting-perspectives-quality-and-safety-patient-level-linkage-incident-adverse-event-and
    April 28, 2021 - Connecting perspectives on quality and safety: patient-level linkage of incident, adverse event … Connecting perspectives on quality and safety: patient-level linkage of incident, adverse event and complaint … hospitalized patients are captured in three ways: incident reports (process problems), adverse event … July 2, 2019 Families as partners in hospital error and adverse event surveillance. … February 1, 2017 Electronic approaches to making sense of the text in the adverse event

47. Adverse event and complication tracking in anaesthesiology: dependence on self-reporting despite implementation of electronic health records. | PSNet
    psnet.ahrq.gov/issue/adverse-event-and-complication-tracking-anaesthesiology-dependence-self-reporting-despite
    March 17, 2021 - Commentary Adverse event and complication tracking in anaesthesiology: dependence … Adverse event reporting and tracking are essential components to safety improvement. … This letter to the editor summarizes the barriers to accurate adverse event tracking in anesthesiology … April 7, 2019 Adverse event reviews in healthcare: what matters to patients and their … October 29, 2017 Barriers to adverse event and error reporting in anesthesia.

48. A natural language processing approach to categorise contributing factors from patient safety event reports. | PSNet
    psnet.ahrq.gov/issue/natural-language-processing-approach-categorise-contributing-factors-patient-safety-event
    April 26, 2023 - A natural language processing approach to categorise contributing factors from patient safety event … Text: A natural language processing approach to categorise contributing factors from patient safety event … This study found that natural language processing can be used to process unstructured patient safety event … reports and reduce the burden of manually identifying and extracting factors contributing to the event … Text: A natural language processing approach to categorise contributing factors from patient safety event

49. Never Events | PSNet
    psnet.ahrq.gov/primer/never-events
    June 15, 2024 - Since the initial never event list was developed in 2002, it has been revised multiple times, and now … Sentinel events are  defined  as "a patient safety event (not primarily related to the natural course … The Joint Commission mandates performance of a  root cause analysis  after a sentinel event. … , and waive all costs associated with the event. … July 12, 2023 How can never event data be used to reflect or improve hospital safety

50. How can never event data be used to reflect or improve hospital safety performance? | PSNet
    psnet.ahrq.gov/issue/how-can-never-event-data-be-used-reflect-or-improve-hospital-safety-performance
    March 30, 2022 - Study How can never event data be used to reflect or improve hospital safety performance … How can never event data be used to reflect or improve hospital safety performance? … The authors suggest that regulators focus on reducing the national never event rate through shared learning … How can never event data be used to reflect or improve hospital safety performance? … October 27, 2021 Leveraging a safety event management system to improve organizational

51. Grading recommendations for enhanced patient safety in sentinel event analysis: the recommendation improvement matrix. | PSNet
    psnet.ahrq.gov/issue/grading-recommendations-enhanced-patient-safety-sentinel-event-analysis-recommendation
    April 15, 2020 - Study Grading recommendations for enhanced patient safety in sentinel event analysis … Grading recommendations for enhanced patient safety in sentinel event analysis: the recommendation improvement … Strong recommendations coming out of sentinel event investigations are more likely to reduce recurrence … of the event. … The RIM consists of two elements—whether the intervention occurs before or after the event and whether

52. A quality improvement initiative to improve patient safety event reporting by residents. | PSNet
    psnet.ahrq.gov/issue/quality-improvement-initiative-improve-patient-safety-event-reporting-residents
    March 08, 2023 - Study A quality improvement initiative to improve patient safety event reporting … A quality improvement initiative to improve patient safety event reporting by residents. … Prior research has shown low rates of voluntary safety event reporting by resident physicians. … The QI team identified barriers to reporting (e.g., lack of awareness of the organization’s event reporting … A quality improvement initiative to improve patient safety event reporting by residents.

53. 10,000 good catches: increasing safety event reporting in a pediatric health care system. | PSNet
    psnet.ahrq.gov/issue/10000-good-catches-increasing-safety-event-reporting-pediatric-health-care-system
    April 20, 2022 - Study 10,000 good catches: increasing safety event reporting in a pediatric health … Citation Text: Crandall KM, Almuhanna A, Cady R, et al. 10,000 Good Catches: Increasing Safety Event … This study describes a quality improvement initiative to increase event reporting across a pediatric … March 2, 2022 Differences in safety report event types submitted by graduate medical … December 8, 2021 Encouraging resident adverse event reporting: a qualitative study of

54. Reporting Patient Safety Events | PSNet
    psnet.ahrq.gov/primer/reporting-patient-safety-events
    March 30, 2022 - Limitations of Event Reporting The limitations of voluntary event reporting systems have been well documented … Failure to receive feedback after reporting an event is a commonly cited barrier to event reporting by … Using Event Reports to Improve Safety A 2016 article contrasted event reporting in health care with … event reporting in other high-risk industries (such as aviation), pointing out that event reporting … analysis, rather than encouraging event reporting for its own sake.

55. Event reporting: the value of a nonpunitive approach. | PSNet
    psnet.ahrq.gov/issue/event-reporting-value-nonpunitive-approach
    June 16, 2011 - Commentary Event reporting: the value of a nonpunitive approach. … Event reporting: the value of a nonpunitive approach. … Event reporting: the value of a nonpunitive approach.

56. Common general surgical never events: analysis of NHS England never event data. | PSNet
    psnet.ahrq.gov/issue/common-general-surgical-never-events-analysis-nhs-england-never-event-data
    April 14, 2021 - Study Common general surgical never events: analysis of NHS England never event data … Common general surgical never events: analysis of NHS England never event data. … Never events , a significant type of adverse event,  should never occur  in healthcare. … Common general surgical never events: analysis of NHS England never event data. … July 27, 2022 How can never event data be used to reflect or improve hospital safety

57. 2020 Pennsylvania Patient Safety Reporting: an analysis of serious events and incidents from the nation’s largest event reporting database. | PSNet
    psnet.ahrq.gov/issue/2020-pennsylvania-patient-safety-reporting-analysis-serious-events-and-incidents-nations
    July 06, 2022 - Pennsylvania Patient Safety Reporting: an analysis of serious events and incidents from the nation’s largest event … Pennsylvania Patient Safety Reporting: an analysis of serious events and incidents from the nation’s largest event … The most common event was Error Related to Procedure/Treatment/Test (32%). … safety trends in 2021: an analysis of 288,882 serious events and incidents from the nation’s largest event … safety trends in 2022: an analysis of 256,679 serious events and incidents from the nation’s largest event

58. Central venous catheter guidewire retention: lessons from England's never event database. | PSNet
    psnet.ahrq.gov/issue/central-venous-catheter-guidewire-retention-lessons-englands-never-event-database
    September 15, 2021 - Study Central venous catheter guidewire retention: lessons from England's never event … Central venous catheter guidewire retention: lessons from England's never event database. … A retained foreign object can lead to serious clinical consequences and is considered a never event … Central venous catheter guidewire retention: lessons from England's never event database. … December 7, 2022 How can never event data be used to reflect or improve hospital safety

59. Venous thromboembolism after trauma: a never event? | PSNet
    psnet.ahrq.gov/issue/venous-thromboembolism-after-trauma-never-event
    January 12, 2022 - Study Venous thromboembolism after trauma: a never event? … Venous thromboembolism after trauma: a never event?*. … Venous thromboembolism after trauma: a never event?*. … May 13, 2021 Inpatient suicide: preventing a common sentinel event.

60. Using community detection techniques to identify themes in COVID-19-related patient safety event reports. | PSNet
    psnet.ahrq.gov/issue/using-community-detection-techniques-identify-themes-covid-19-related-patient-safety-event
    July 29, 2020 - Using community detection techniques to identify themes in COVID-19-related patient safety event … Using community detection techniques to identify themes in COVID-19-related patient safety event reports … This study used machine learning to group of more than 2,000 patient safety event (PSE) reports into … Using community detection techniques to identify themes in COVID-19-related patient safety event reports … March 3, 2021 Using event reports in real-time to identify and mitigate patient safety