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Showing results for "failures".

  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836854/psn-pdf
    April 06, 2022 - Medication discrepancy rates and sources upon nursing home intake: a prospective study. April 6, 2022 Patterson ME, Bollinger S, Coleman C, et al. Medication discrepancy rates and sources upon nursing home intake: a prospective study. Res Social Adm Pharm. 2022;18(5):2830-2836. doi:10.1016/j.sapharm.2021.06.013. …

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74163/psn-pdf
    December 08, 2008 - Follow-up of abnormal screening mammograms among low-income ethnically diverse women: findings from a qualitative study. December 8, 2008 Allen JD, Shelton RC, Harden E, et al. Follow-up of abnormal screening mammograms among low-income ethnically diverse women: findings from a qualitative study. Patient Educ Coun…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47000/psn-pdf
    May 09, 2018 - 'Broken hospital windows': debating the theory of spreading disorder and its application to healthcare organizations. May 9, 2018 Churruca K, Ellis LA, Braithwaite J. 'Broken hospital windows': debating the theory of spreading disorder and its application to healthcare organizations. BMC Health Serv Res. 2018;18(1…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37362/psn-pdf
    December 01, 2010 - Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2007. December 1, 2010 Oakbrook Terrace, IL: Joint Commission; 2007. https://psnet.ahrq.gov/issue/improving-americas-hospitals-joint-commissions-annual-report-quality-and- safety-2007 This report summarizes the quality …

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/851348/psn-pdf
    July 12, 2023 - Widespread misinterpretation of advance directives and Portable Orders for Life-Sustaining Treatments threatens patient safety and causes undertreatment and overtreatment. July 12, 2023 Mirarchi FL, Pope TM. Widespread misinterpretation of advance directives and Portable Orders for Life- Sustaining Treatments thr…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866907/psn-pdf
    October 09, 2024 - A review of modifiable health care factors contributing to inpatient suicide: an analysis of coroners' reports using the Human Factors Analysis and Classification System for Healthcare October 9, 2024 Sweeting P, Finlayson M, Hartz D. A review of modifiable health care factors contributing to inpatient suicide: a…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42087/psn-pdf
    March 06, 2013 - 'Matching Michigan': a 2-year stepped interventional programme to minimise central venous catheter-blood stream infections in intensive care units in England. March 6, 2013 Bion J, Richardson A, Hibbert P, et al. 'Matching Michigan': a 2-year stepped interventional programme to minimise central venous catheter-blo…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41858/psn-pdf
    November 21, 2012 - Disorganized care: the findings of an iterative, in-depth analysis of surgical morbidity and mortality. November 21, 2012 Anderson CI, Nelson CS, Graham CF, et al. Disorganized care: the findings of an iterative, in-depth analysis of surgical morbidity and mortality. J Surg Res. 2012;177(1):43-8. doi:10.1016/j.jss.…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39581/psn-pdf
    January 03, 2017 - An implementation strategy for a multicenter pediatric rapid response system in Ontario. January 3, 2017 Buist MD, Shearer W. Rapid Response Systems: A Mandatory System of Care or an Optional Extra for Bedside Clinical Staff? The Joint Commission Journal on Quality and Patient Safety. 2016;36(6). doi:10.1016/s1553…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35853/psn-pdf
    May 20, 2015 - What practices will most improve safety? Evidence-based medicine meets patient safety. May 20, 2015 Leape L, Berwick DM, Bates DW. What practices will most improve safety? Evidence-based medicine meets patient safety. JAMA. 2002;288(4):501-7. https://psnet.ahrq.gov/issue/what-practices-will-most-improve-safety-evi…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/865710/psn-pdf
    May 01, 2024 - Managers' perceptions of the factors affecting resident and patient safety work in residential settings and nursing homes: a qualitative systematic review. May 1, 2024 Kiljunen O, Savela R?M, Välimäki T, et al. Managers' perceptions of the factors affecting resident and patient safety work in residential settings …

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73704/psn-pdf
    September 15, 2021 - TRIAD IX: can a patient testimonial safely help ensure prehospital appropriate critical versus end-of-life care? September 15, 2021 Mirarchi FL, Cammarata C, Cooney TE, et al. TRIAD IX: can a patient testimonial safely help ensure prehospital appropriate critical versus end-of-life care? J Patient Saf. 2021;17(6):4…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36334/psn-pdf
    October 26, 2010 - Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from 4 liability insurers. October 26, 2010 Kachalia A, Gandhi TK, Puopolo AL, et al. Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from 4 liability insurers. Ann Emerg Me…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38964/psn-pdf
    November 27, 2009 - Development of a measure of patient safety event learning responses. November 27, 2009 Ginsburg LR, Chuang Y-T, Norton PG, et al. Development of a measure of patient safety event learning responses. Health Serv Res. 2009;44(6):2123-47. doi:10.1111/j.1475-6773.2009.01021.x. https://psnet.ahrq.gov/issue/development-…

  15. Guide for Developing a Community-Based Patient Safety Advisory Council | Agency for Healthcare Research and Quality

    www.ahrq.gov/research/findings/final-reports/advisorycouncil/adcouncilapa.html
    April 01, 2018 - Guide for Developing a Community-Based Patient Safety Advisory Council Appendix A. Project Goals and Objectives Before they meet regularly, patient advisory councils need to establish project goals. Examples of project goals and objectives for small and large patient advisory councils follow. A. Scope for a…

  16. Pain Management Summary Clincial Decision Support Toolkit For Repository 0 (xls file)

    cds.ahrq.gov/sites/default/files/cds/artifact/476/Pain%20Management%20Summary%20Clincial%20Decision%20Support%20Toolkit_for%20Repository_0.xlsx
    January 01, 2003 - TOC Pain Management Summary CDS Tool UAT TOOL KIT Tool Kit TOC Display Instructions: • Select individual test plan from TOC • Record who is performing the testing for the individual test plan in the "Tester" field • Record the status after performing UAT in the "Testing Status" field. If the individual test pl…

  17. Disposition of Comments for Pharmacokinetic/Pharmacodynamic Measures for Guiding Antibiotic Treatment for Hospital-Acquired Pneumonia (pdf file)

    effectivehealthcare.ahrq.gov/sites/default/files/related_files/pneumonia-antibiotic-treatment_disposition-comments.pdf
    November 24, 2014 - of different dosing levels on clinical responses and outcomes including ventilator days, treatment failures

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33863/psn-pdf
    August 01, 2018 - In Conversation With… Matthew Weinger, MD August 1, 2018 In Conversation With… Matthew Weinger, MD. PSNet [internet]. 2018. https://psnet.ahrq.gov/perspective/conversation-matthew-weinger-md Editor's note: Dr. Weinger is Director of the Center for Research and Innovation in Systems Safety and Professor of Anesthes…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49717/psn-pdf
    September 01, 2014 - A Lot of Pain (Medications) September 1, 2014 Herzig SJ. A Lot of Pain (Medications). PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/lot-pain-medications Case Objectives Appreciate the challenges of managing acute pain in hospitalized patients on chronic opioids. Describe the importance of understanding th…

  20. Don't Dismiss the Dangerous: Obstetric Hemorrhage | PSNet

    psnet.ahrq.gov/web-mm/dont-dismiss-dangerous-obstetric-hemorrhage
    August 21, 2024 - SPOTLIGHT CASE Don't Dismiss the Dangerous: Obstetric Hemorrhage Citation Text: Main EK. Don't Dismiss the Dangerous: Obstetric Hemorrhage. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016. Copy Citation Format: …
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