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psnet.ahrq.gov/issue/implementing-root-cause-analysis-and-action-integrating-human-factors-create-strong
December 23, 2020 - November 24, 2021
Root cause analysis using the prevention and recovery information system
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psnet.ahrq.gov/issue/speaking-about-safety-concerns-multi-setting-qualitative-study-patients-views-and-experiences
May 18, 2016 - Innovations
Preventing Falls Through Patient and Family Engagement to Create Customized Prevention
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psnet.ahrq.gov/issue/incidence-and-nature-hospital-adverse-events-systematic-review
March 24, 2011 - October 29, 2012
Examining causes and prevention strategies of adverse events in deceased
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psnet.ahrq.gov/issue/room-hazards-comparison-differences-safety-hazard-recognition-among-various-hospital-based
April 01, 2020 - October 12, 2022
Improving hospital safety culture for falls prevention through interdisciplinary
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psnet.ahrq.gov/issue/effect-quality-improvement-intervention-daily-round-checklists-goal-setting-and-clinician
June 25, 2014 - Innovations
Preventing Falls Through Patient and Family Engagement to Create Customized Prevention
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psnet.ahrq.gov/issue/systematic-review-methods-medical-record-analysis-detect-adverse-events-hospitalized-patients
December 14, 2022 - January 12, 2022
Examining causes and prevention strategies of adverse events in deceased
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psnet.ahrq.gov/issue/i-pass-illness-diversity-identifies-patients-risk-overnight-clinical-deterioration
November 16, 2022 - Innovations
Preventing Falls Through Patient and Family Engagement to Create Customized Prevention
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psnet.ahrq.gov/issue/health-care-safety-during-pandemic-and-beyond-building-system-ensures-resilience
July 20, 2022 - , and catheter-associated urinary tract infection (CAUTI): the urgent need to refocus on hardwiring prevention
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psnet.ahrq.gov/issue/adequacy-hospital-discharge-summaries-documenting-tests-pending-results-and-outpatient-follow
September 23, 2020 - Innovations
Preventing Falls Through Patient and Family Engagement to Create Customized Prevention
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psnet.ahrq.gov/issue/multiple-meanings-resilience-health-professionals-experiences-dual-element-training
August 10, 2022 - Innovations
Preventing Falls Through Patient and Family Engagement to Create Customized Prevention
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psnet.ahrq.gov/issue/graded-autonomy-medical-education-managing-things-go-bump-night
July 22, 2020 - September 1, 2021
Improving hospital safety culture for falls prevention through interdisciplinary
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psnet.ahrq.gov/issue/prevalence-medical-error-related-end-life-communication-canadian-hospitals-results
November 23, 2016 - Innovations
Preventing Falls Through Patient and Family Engagement to Create Customized Prevention
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psnet.ahrq.gov/node/74867/psn-pdf
February 23, 2022 - Health care safety during the pandemic and beyond--
building a system that ensures resilience.
February 23, 2022
Fleisher LA, Schreiber M, Cardo D, et al. Health care safety during the pandemic and beyond--building a
system that ensures resilience. N Engl J Med. 2022;386(7):609-611. doi:10.1056/nejmp2118285.
https…
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psnet.ahrq.gov/node/60228/psn-pdf
April 15, 2020 - How safety is compromised when hospital equipment is a
poor fit for patients who are obese.
April 15, 2020
Kukielka E. How safety is compromised when hospital equipment is a poor fit for patients who are obese.
Patient Saf J. 2020;2(1):48-56. doi:10.33940/data/2020.3.4.
https://psnet.ahrq.gov/issue/how-safety-comp…
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psnet.ahrq.gov/node/74833/psn-pdf
February 16, 2022 - Performance of a trigger tool for detecting drug-related
hospital admissions in older people: analysis from the
OPERAM trial.
February 16, 2022
Zerah L, Henrard S, Thevelin S, et al. Performance of a trigger tool for detecting drug-related hospital
admissions in older people: analysis from the OPERAM trial. Age Ag…
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/GC9cvM3tps6UBntyWrXNF4
Screening for Impaired Visual Acuity in Older Adults: Clinical Summary
Screening for Impaired Visual Acuity in Older Adults: Clinical Summary
Population Adults 65 years or older who do not present with vision problems
Recommendation No recommendation.
Grade: I (insufficient evidence)
Risk Assessment
Older ag…
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psnet.ahrq.gov/issue/patient-safety-tools-improving-safety-point-care-0
September 08, 2021 - Multi-use Website
Patient Safety Tools: Improving Safety at the Point of Care.
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November 14, 2011
Produced in conjunction with it…
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/booklets/hip-knee-surgery-booklet.pdf
November 01, 2023 - ■ Put nightlights in the bathroom and hallways so you don’t fall. … It’s better
to have a shoe with a back that’s more secure,
so you don’t fall. … Hip or Knee Replacement Surgery Patient Education Guide 17
Call, Don’t Fall! … ■ You may be lightheaded and could fall.
■ Press the call button. A nurse will help you get
up. … F Put nightlights in the hallways so you don’t fall.
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www.ahrq.gov/news/events/nac/2017-11-nac/nacmtg1117-minutes.html
February 01, 2018 - Chesley Richards, M.D., M.P.H., FACP, Centers for Disease Control and Prevention
AHRQ Staff Members … Topics addressed in new draft recommendations included screening for cervical cancer, prevention of falls … and prevention of fractures, preventive medication for vitamin D, calcium, or combined supplementation … for the primary prevention of fractures in adults, and behavioral counseling to prevent skin cancer. … They address prevention, training, education, treatment, and overdose.
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psnet.ahrq.gov/node/49785/psn-pdf
February 01, 2017 - Throughout his
admission, he was assessed as a very high fall risk on a standard risk scale. … l, the staff's level of concern was heightened, in that a fall could be associated with
dangerous bleeding … alerted the primary care team of the patient's declining mental status and their concern about
increased fall