-
www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-reimagining-healthcare-teams-6.html
July 01, 2023 - ensuring the technology is worn, while the AI would provide daily summaries about fall risk and near falls … This information could lead to interventions to prevent falls.
-
www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/ASB-one-page.pdf
November 01, 2019 - o Delirium, insomnia, and falls alone do not indicate a UTI.
-
www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-119-section-2.pdf
June 02, 2025 - qualifying temperature (usually the
first temperature after arrival to the Level 2 or higher nursery) falls … Each is
determined by the number of children whose reported temperature falls within
the criteria for
-
www.ahrq.gov/news/newsroom/case-studies/coe1304.html
April 01, 2013 - If the information falls outside of the criteria or reveals other therapeutic issues, a child psychiatrist
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/impl-guide/implementation-guide-appendix-l.pdf
September 01, 2015 - infection, immobility (Foley is considered a "one-point
restraint"), hospital-acquired pressure ulcers, falls
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module2/module2_managingchange_slides.pptx
June 02, 2025 - Process
Change process strategies can be applied to other quality improvement (QI) efforts:
Hospital falls
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/early-mobility-icu-slides.pptx
January 01, 2017 - Mechanically Ventilated Patients
Adverse Events4
9 patients had 14 adverse events (<1% of activities)
Falls … Safety
Adverse events ranged from agitation to transient physiological events to dislodgements and to falls … (none of the falls were considered serious)
Adverse events ranged from 2.3 to 8.7 per 100 patients3-
-
www.ahrq.gov/teamstepps-program/curriculum/communication/tools/checkback.html
July 01, 2023 - Other examples of effective check-backs include:
One member of the team calls out, "BP is falling … BP is falling and at 80/48, down from 90/60."
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Campbell-R_106.pdf
April 14, 2008 - Administration (VHA) proactive medication safety surveillance studies as part of its
research focus on patient falls … It has established an international reputation in the areas of falls and safe
patient handling and movement … Because of the recognized chance of certain medications to
increase the risk of injurious falls in the … reconcile medications across the
continuum of care and to reduce the risk of patient harm resulting from falls … Drugs and
falls in community-dwelling older people: A national
veterans study.
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/multidiscplinary-rounding.pdf
April 01, 2022 - healthcare-associated infection prevention efforts
• Performance improvement specialist – safety, pressure injury, and falls
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/facilities/ltc/gdmodap2b.html
October 01, 2014 - Falls Prevention
Appendix 1-A. Suggested Slides for Module 1
Appendix 1-B.
-
www.ahrq.gov/hai/cauti-tools/impl-guide/implementation-guide-appendix-l.html
October 01, 2015 - infection, immobility (Foley is considered a "one-point restraint), hospital-acquired pressure ulcers, falls
-
www.ahrq.gov/hai/pfp/haccost2017-discuss.html
November 01, 2017 - 0.079)
0.023
CLABSI
$48,108 ($27,232–$68,983)
$18,537
0.150 (0.070–0.270)
0.185
Falls … While the estimation of additional cost per HAC remained stable for ADE, falls, and SSI, we did observe
-
www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-measure-implementation.pdf
August 01, 2025 - The analysis focused on falls per 1,000 patient days and injury falls per 1,000
patient days, using … Despite a slight decreasing trend in falls for TRIP
units, the study found no statistically significant … differences in falls or falls with injury
between pre- and post-intervention periods or between TRIP … rates, the rarity of falls events, and high
annual rate variability. … An unexpected increase in reported injury falls in TRIP units
was potentially due to improved reporting
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Kizer1.pdf
April 01, 2004 - Use of identification bracelets to alert providers of patients who are susceptible to falls.
2. … Use of specialized hospital flooring to reduce injury from patient falls.
3. … Use of medical device alarms to prevent falls.
12. … shield hip protectors padded or constructed with foam-type
materials to prevent harm from patient falls
-
www.ahrq.gov/sites/default/files/wysiwyg/research/findings/evidence-based-reports/services/quality/patientsftyupdate/ptsafetysum.pdf
March 01, 2013 - safety problems that occur approximately once per 100
hospitalizations as “common;” examples include falls … The scope must also consider the severity of each event;
for instance, most falls do not result in injury … radiation exposure or to help prevent stress-related
gastrointestinal bleeding; and moderate, for PSPs falling … Moderate
Safety Practices for Hospitalized Elders
Multicomponent interventions to prevent
in-facility falls … Encouraged patient safety practices
• Multicomponent interventions to reduce falls
• Use of clinical
-
www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/medical-office/2014/mosurv14chap6.html
June 01, 2014 - If your medical office's score is 55 percent positive, it falls above the 75th percentile (but below … If your medical office's score is 65 percent positive, it falls above the 90 th percentile, meaning
-
www.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK2_T2-Antibiotic_Pocket_Cards.pdf
May 01, 2014 - Nonspecific symptoms or signs not referable to the urinary
tract, such as falls or mental status change
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/find5.html
December 01, 2012 - with the largest State range in percentage terms are Short-Term Complications of Diabetes, Injurious Falls … Preventable Infections Composite, Bacterial Pneumonia, ACSC Acute Conditions Composite, and Injurious Falls … in the Medicaid-only population are always higher than for whites and Hispanics except in Injurious Falls … In contrast to the dually eligible, Hispanics in this population do not exhibit lower rates, falling
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Mohr.pdf
February 01, 2004 - reported in several domains: prevention,
diagnosis, treatment, patient identification, communication, falls … diagnostic, medication related, surgically
related, aftercare related, other medical treatment related
Falls … Patient falls within the clinic setting
Equipment Equipment maintenance, functioning, availability … (13)
Medical treatment 56 (38)
Patient identification 4 (3)
Communication to patient 12 (8)
Falls … (Problem type: Communication)
Falls “Pt. got tetanus shot. Claimed to be OK after.