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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/851201/psn-pdf
    July 05, 2023 - ‘I felt like I was dying’: how women with postpartum depression fall through the cracks of U.S. health … https://psnet.ahrq.gov/issue/i-felt-i-was-dying-how-women-postpartum-depression-fall-through-cracks-us … https://psnet.ahrq.gov/issue/i-felt-i-was-dying-how-women-postpartum-depression-fall-through-cracks-us-health-care … https://psnet.ahrq.gov/issue/i-felt-i-was-dying-how-women-postpartum-depression-fall-through-cracks-us-health-care
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46387/psn-pdf
    September 06, 2017 - A multicomponent fall prevention strategy reduces falls at an academic medical center. … A Multicomponent Fall Prevention Strategy Reduces Falls at an Academic Medical Center. … https://psnet.ahrq.gov/issue/multicomponent-fall-prevention-strategy-reduces-falls-academic-medical- … center Fall prevention remains a patient safety priority. … https://psnet.ahrq.gov/issue/multicomponent-fall-prevention-strategy-reduces-falls-academic-medical-center
  3. psnet.ahrq.gov/issue/100k-lives-falling-short
    November 11, 2015 - Newspaper/Magazine Article 100K Lives falling short. Citation Text: 100K Lives falling short. Robeznieks A. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL …
  4. psnet.ahrq.gov/web-mm/falling-between-cracks-software
    March 09, 2011 - Falling Between the Cracks in the Software Citation Text: Adler-Milstein J. Falling Between the Cracks in the Software. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016. Copy Citation Format: Google Scholar BibTeX En…
  5. www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/fallspx/highrisk.html
    October 01, 2017 -     Mental: Unsafe Behaviors Mental: Cognitive Impairment Gait and Balance Instability Fall … : 8-30 Days Fall: 31-180 Days Psychoactive Medications Other High-Risk Medications Resident … Status Change Behavior: New Unsafe New Gait/ Balance or Device Order New Fall
  6. psnet.ahrq.gov/issue/utilization-seniors-falls-investigation-methodology-identify-system-wide-causes-falls
    November 21, 2014 - November 21, 2014 Evaluation of clinical practice guidelines on fall prevention and management
  7. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/prevhosp/sampleransferandintakenotes.pdf
    June 02, 2025 - neurological/psychological, gastrointestinal/genitourinary, endocrine/nutritional/metabolic, wound and skin, fall-related … and non-fall-related injury, musculoskeletal, other changes not specified elsewhere, or treatment not … diabetes Wound & Skin  Cellulitis  Edema  Infected wound or decubitus  Jaundice  Rash Fall-Related … Injury  Major injury  Minor injury Non-Fall-Related Injury  Major injury  Minor injury Musculoskeletal … Dehydration  Dementia  Depression  Diabetes  Dysrhythmias  Electrolyte imbalance  Fever  Fall
  8. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/prevhosp/prevehosp-trans-intakenotes.pdf
    June 02, 2025 - neurological/psychological, gastrointestinal/genitourinary, endocrine/nutritional/metabolic, wound and skin, fall-related … and non-fall-related injury, musculoskeletal, other changes not specified elsewhere, or treatment not … diabetes Wound & Skin  Cellulitis  Edema  Infected wound or decubitus  Jaundice  Rash Fall-Related … Injury  Major injury  Minor injury Non-Fall-Related Injury  Major injury  Minor injury Musculoskeletal … Dehydration  Dementia  Depression  Diabetes  Dysrhythmias  Electrolyte imbalance  Fever  Fall
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45231/psn-pdf
    February 14, 2017 - 6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial. … February 14, 2017 Barker AL, Morello RT, Wolfe R, et al. 6-PACK programme to decrease fall injuries … https://psnet.ahrq.gov/issue/6-pack-programme-decrease-fall-injuries-acute-hospitals-cluster-randomised … Despite successful implementation of the fall prevention bundle, falls occurred just as frequently on … A WebM&M commentary discussed a case involving a fall resulting in injury.
  10. hcup-us.ahrq.gov/reports/statbriefs/sb80.pdf
    October 01, 2009 - ■ The cost of hospital care following an ED visit for an injurious fall among the elderly totaled … Gait variability and fall risk in community-living older adults: a 1-year prospective study. … an even higher percentage of ED visits for fall-related fractures (75.2 percent). … ED, a fall that occurred in the hospital, or an untreated fall admitted by a physician. 2 … fall-related injury seen in the ED among the elderly was fracture (41.0 percent of injurious fall-related
  11. www.ahrq.gov/sites/default/files/wysiwyg/opioids/compendium/opioids-case-study-risk-screening.pdf
    June 02, 2025 - improvement (QI) lead at Pearl Family Medicine, recognized the need to implement an opioid misuse and fall-risk … screeners linked to the annual wellness visits of older adults on LTOT: the STEADI tool for assessing fall … patients (60+): 30% 1 MD = Medical Doctor; PA = Physician Assistant. 2 The STEADI algorithm for fall … implementation progress, the Pearl team selected rates of older adults with opioid-related risk/ fall … ▶ Stopping Elderly Accidents, Deaths & Injuries (STEADI) tool for assessing fall risk.
  12. www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/fallspx/steps.html
    October 01, 2017 - Step 4: Introduce On-Time Fall Prevention The On-Time Facilitator provides technical assistance via … Step 15: Review Fall Incidence The Facilitator works with the team to generate QI monitoring reports … that identify fall rates to provide feedback to the Change Team and support reporting requirements. … Agree to Use On-Time Fall Prevention   2. … Review Fall Incidence As required 16.
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40040/psn-pdf
    December 21, 2014 - study conducted at two Australian hospitals, cognitively intact patients who received a multimodal fall … educational materials on falls and physical therapist follow-up) were significantly less likely to fall … The fall prevention evidence base was also augmented by a recent study that used an individualized fall … interventions-preventing-falls-acute-and-chronic-care-hospitals-systematic-review-and-meta https://psnet.ahrq.gov/issue/fall-prevention-acute-care-hospitals-randomized-trial … https://psnet.ahrq.gov/web-mm/another-fall
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72670/psn-pdf
    January 27, 2021 - care needs), reliance on home healthcare workers instead of rehabilitation professionals, and lack of fall … The authors recommend systems-level changes to improve fall prevention practices, such as use of electronic … issue/using-root-cause-analysis-reduce-falls-injury-community-settings https://psnet.ahrq.gov/issue/fall-prevention-implementation-strategies-use … -60-united-states-hospitals-descriptive-study https://psnet.ahrq.gov/issue/fall-prevention-implementation-strategies-use
  15. www.uspreventiveservicestaskforce.org/home/getfilebytoken/Xm5_jgUrXXGAJe8WJh_9KK
    June 01, 2024 - and 10.2% reported a fall- related injury. … In 2021, 38,742 deaths resulted from fall-related injuries. … • The Centers for Disease Control and Prevention (CDC) has guides on fall prevention interventions. … • The CDC’s STEADI (Stopping Elderly Accidents, Death, and Injuries) initiative helps reduce fall … • The National Institutes of Health provides information on falls and fall prevention.
  16. psnet.ahrq.gov/issue/national-center-patient-safety-falls-toolkit-2004
    May 24, 2017 - (1) designing a falls prevention and management program; (2) effective interventions for high-risk fall … patients; (3) implementing hip protectors for high-risk fall patients; and (4) educating patients, families … , and staff on falls and fall-injury prevention. … February 8, 2006 WebM&M Cases Another Fall April
  17. www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/tools/PCMH/pcpf-module-11-root-cause-analysis.pdf
    December 27, 2021 - Conduct a fall-out analysis to determine why individuals did not receive an indicated service. … A third process you can use with your practices to identify root causes is fall- out analysis. … Steps for Completing a Fall-Out Analysis 1. … Identify two-to-five patient cases that “fall out” of the performance metric in question. 2. … Example: Using fall-out analysis to improve diabetes care in a federally qualified health center.
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41886/psn-pdf
    April 17, 2013 - Inpatient fall prevention: use of in-room Webcams. … Inpatient fall prevention: use of in-room Webcams. … https://psnet.ahrq.gov/issue/inpatient-fall-prevention-use-room-webcams The use of Webcams and virtual … https://psnet.ahrq.gov/issue/inpatient-fall-prevention-use-room-webcams https://psnet.ahrq.gov/issue/ … fall-prevention-acute-care-hospitals-randomized-trial
  19. psnet.ahrq.gov/issue/insights-climate-safety-towards-prevention-falls-among-hospital-staff
    February 14, 2017 - This Australian study examines the relationship between safety climate and attitudes toward fall prevention … Related Resources From the Same Author(s) 6-PACK programme to decrease fall … 2014 View More Related Resources 6-PACK programme to decrease fall … May 4, 2015 Fall prevention in hospitals: an integrative review.
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46483/psn-pdf
    October 04, 2017 - Fall Prevention in Hospitals Training Program. … https://psnet.ahrq.gov/issue/fall-prevention-hospitals-training-program Falls are a primary focus of … https://psnet.ahrq.gov/issue/fall-prevention-hospitals-training-program https://psnet.ahrq.gov/primer … /falls https://psnet.ahrq.gov/issue/preventing-falls-and-fall-related-injuries-health-care-facilities … preventing-falls-hospitals-toolkit-improving-quality-care https://psnet.ahrq.gov/issue/multicomponent-fall-prevention-strategy-reduces-falls-academic-medical-center