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2241. July Teleconference Transcript (pdf file)
      digital.ahrq.gov/sites/default/files/docs/July%20Teleconference%20Transcript.pdf
      June 16, 2021 - So now we did – we followed that up with calibration on falls in the hospital. … And we didn’t want falls that were not related to it – we didn’t want falls related to admission, so … and needed to be reported by hospitals. … our hospital. … s ordering where the physician orders a medication; transcription where in most hospitals still in

2242. Evaluation of Meaningful Use (2013-2015) | Digital Healthcare Research
      digital.ahrq.gov/ahrq-funded-projects/past-initiatives/evaluation-of-meaningful-use
      January 01, 2023 - Evaluation of Meaningful Use (2013-2015) Introduction AHRQ is working in … In early 2013, AHRQ solicited research applications to evaluate proposed stage 3 objectives. … Trustees of Columbia University in the City of New York USA, NY, New York City Evaluation of … USA, VA, Falls Church Evaluation of Stage 3 Meaningful Use Objectives: Analysis in Pennsylvania … Pediatric Patient Engagement as a Criteria for Meaningful Use Stage 3 Fiks, Alexander The Children's Hospital

2243. Back to basics: preventing surgical site infections. | PSNet
      psnet.ahrq.gov/issue/back-basics-preventing-surgical-site-infections
      March 17, 2021 - August 16, 2023 Using potentially preventable severe maternal morbidity to monitor hospital … November 9, 2022 Root cause analysis of reported patient falls in ORs in the Veterans … February 6, 2019 Advances in perioperative quality and safety. … June 13, 2018 Innovation in safety, and safety in innovation.

2244. Continuing Education | PSNet
      psnet.ahrq.gov/continuing-education
      February 26, 2025 - Complications (28) Delirium (4) Nosocomial Infections (3) Patient Falls … Clinic or Office (24) Home Care (4) Outpatient Pharmacy (3) Hospitals … (174) Children's Hospitals (3) General Hospitals (103) Emergency … (37) Labor and Delivery (6) Operating Room (28) Specialty Hospitals … his mid-50s presented to the hospital with a persistent headache after a sledding injury.

2245. Gossypiboma: tales of lost sponges and lessons learned. | PSNet
      psnet.ahrq.gov/issue/gossypiboma-tales-lost-sponges-and-lessons-learned
      March 24, 2021 - error patterns in unanticipated trauma deaths during 20 years: in pursuit of zero preventable deaths … March 3, 2011 Improving resident engagement in quality improvement and patient safety … November 21, 2021 Structural racism in behavioral health presentation and management. … May 17, 2023 Nurses' attitudes to a medical emergency team service in a teaching hospital … November 16, 2022 Reducing falls in hospitalized children and adolescents with cancer

2246. Back to basics: counting soft surgical goods. | PSNet
      psnet.ahrq.gov/issue/back-basics-counting-soft-surgical-goods
      March 17, 2021 - This commentary explores improvement efforts that focus on the role of teams in performing surgical … August 16, 2023 Using potentially preventable severe maternal morbidity to monitor hospital … November 9, 2022 Root cause analysis of reported patient falls in ORs in the Veterans … November 6, 2013 Thinking in three's: changing surgical patient safety practices in the … January 16, 2013 The lost sponge: patient safety in the operating room.

2247. Adverse and Temporary Harm Events in Rehabilitation Hospitals Designated in OIG Report as Clearly Preventable or Likely Preventable by Clinical Category (pdf file)
      pso.ahrq.gov/sites/default/files/wysiwyg/adverse-events-rehab-hospitals.pdf
      July 01, 2016 - Adverse and Temporary Harm Events in Rehabilitation Hospitals Designated in OIG Report as Clearly Preventable … Hospitals Designated in Office of Inspector General Report1 as Clearly Preventable or Likely Preventable … Adverse Events in Rehabilitation Hospitals: National Incidence Among Medicare Beneficiaries, OEI-06- … transfer to an acute-care hospital • Hemorrhagic cystitis in patient associated with Foley catheter … transfer to an acute-care hospital Sepsis • Cascade event in which delayed recognition of pneumonia

2248. Patient factors associated with new prescribing of potentially inappropriate medications in multimorbid US older adults using multiple medications. | PSNet
      psnet.ahrq.gov/issue/patient-factors-associated-new-prescribing-potentially-inappropriate-medications-multimorbid
      August 18, 2021 - August 18, 2021 Assessment of requests for medication-related follow-up after hospital … discharge, and the relation to unplanned hospital revisits, in older patients: a multicentre retrospective … older people prior to a potentially preventable drug-related hospital admission. … older adults with a history of falls: a qualitative study. … June 22, 2009 Risk of medication errors at hospital discharge and barriers to problem

2249. ED overcrowding is associated with an increased frequency of medication errors. | PSNet
      psnet.ahrq.gov/issue/ed-overcrowding-associated-increased-frequency-medication-errors
      August 20, 2018 - The Institute of Medicine found that hospital-based emergency care was "at the breaking point" in a seminal … Initiative to deprescribe high-risk drugs for older adults presenting to the emergency department after falls … hospital practice: factors associated with turnover, outcomes, and patient safety. … November 16, 2022 Families as partners in hospital error and adverse event surveillance … adverse events in older patients admitted to hospital: a retrospective cohort study.

2250. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/846171/psn-pdf
      July 26, 2022 - Early in his hospital stay, the patient developed hyperactive delirium and pulled out his NGT. … the Acute Care Setting Delirium is the most common psychiatric disorder in the hospital setting. … every US hospital. … Take-Home Points NGT placement is a common procedure in the hospital setting and is safe in most cases … I-DECIDED®—A decision tool for assessment and management of invasive devices in the hospital setting

2251. Preparing for and Recovering After Hip or Knee Replacement Surgery (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/booklets/hip-knee-surgery-booklet.pdf
      November 01, 2023 - The Day of Surgery: At the Hospital We’ll check you in. … In the Hospital Room You’ll go to a hospital room where your family can see you. … Find out what medications you’ll get while you’re in the hospital. … F How long you should expect to be in the hospital. … F How long you should expect to be in the hospital.

2252. Evaluation of outpatient computerized physician medication order entry systems: a systematic review. | PSNet
      psnet.ahrq.gov/issue/evaluation-outpatient-computerized-physician-medication-order-entry-systems-systematic-review
      February 14, 2024 - The authors reviewed the literature on computerized physician order entry (CPOE) in the outpatient … October 18, 2023 Electronic health record-based prediction models for in-hospital adverse … A laboratory experiment and field study in cardiac rehabilitation. … April 12, 2017 Potentially inappropriate medications and their effect on falls during … hospital admission.

2253. Family conferences to facilitate deprescribing in older outpatients with frailty and with polypharmacy: the COFRAIL cluster randomized trial. | PSNet
      psnet.ahrq.gov/issue/family-conferences-facilitate-deprescribing-older-outpatients-frailty-and-polypharmacy
      July 29, 2020 - July 29, 2020 Inappropriate hospital admission as a risk factor for the subsequent development … care units and hospital emergency services. … older adults with a history of falls: a qualitative study. … primary care and its association with hospital admission: longitudinal study. … June 28, 2017 The effect of medication reconciliation in elderly patients at hospital

2254. Appendix A: References and Available Abstracts | Agency for Healthcare Research and Quality
      www.ahrq.gov/research/shuttered/acfselection/appendixa.html
      July 01, 2018 - All acute care hospitals in the State were selected for inclusion in this study. … In general, hospitals in the State of Mississippi, like a number of hospitals throughout the United States … Everyone in the population falls into one of these five categories. … This article addresses a population approach to SEIRV-based triage in which decision making falls under … and 22 hospitals in Katrina-affected areas.

2255. Microsoft PowerPoint - FINAL June-Spotlight Case Slides_06.12.2020.pptx (pdf file)
      psnet.ahrq.gov/sites/default/files/2020-06/final_june-spotlight_case_slides_06.12.2020.pdf
      January 01, 2020 - adverse events including falls, central nervous system depression and respiratory depression – Due … Needed/Quality Improvement Approach (2) • New, inexperienced nurses are often placed on night shift – Hospitals … experienced nurses and supervisors to provide oversight • Strong orientation and onboarding to both the hospital … most community hospitals, there may be few physicians or pharmacy staff available to inpatient units … Sleep Deprivation and Error in Nurses who Work the Night Shift.

2256. Effective Treatment of Leading Causes of Morbidity and Mortality | Agency for Healthcare Research and Quality
      www.ahrq.gov/research/findings/nhqrdr/2014chartbooks/womenhealth/wm-eff.html
      September 01, 2015 - Admissions With Acute Myocardial Infarction Deaths per 1,000 hospital admissions with acute myocardial … a hospital to reduce the risk of serious heart damage and death ( Collins-Sharp, 2012 ). … hospital admissions with acute myocardial infarction than men. … With the burden of suicide falling most heavily on adults of working age, the cost to the economy results … hospital admissions than males.

2257. Table 8G: HCBS Population Age 65 | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8g.html
      February 01, 2023 -   Min s s s s s   Max 8,542 18,831 29,268 21,622 s Injurious Falls … 1,051 1,628 s   Max 12,315 10,606 s 11,115 13,261 11,132 11,243 Injurious Falls … All outcome indicators expressed as potentially avoidable hospital stays per 100,000 persons in the HCBS … Eligibility for Medicare defined as inclusion in Medicare Denominator File. … Medicaid only = part of Medicaid HCBS population but not enrolled in Medicare.

2258. Table 8A: National HCBS Population | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8.html
      February 01, 2023 -   Min 1,506 s s s s   Max 6,772 17,194 10,853 27,397 s Injurious Falls … 1,473 1,015   Max 10,449 9,085 8,475 11,115 13,261 9,525 8,445 Injurious Falls … All outcome indicators expressed as potentially avoidable hospital stays per 100,000 persons in the HCBS … Eligibility for Medicare defined as inclusion in Medicare Denominator File. … Medicaid only = part of Medicaid HCBS population but not enrolled in Medicare.

2259. Table 8E: Serious Mental Illness Subpopulation | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8e.html
      February 01, 2023 -   Min s s s s s   Max 9,819 25,000 60,870 21,053 s Injurious Falls … 485 s   Max 13,223 10,425 7,934 16,685 41,237 12,441 11,765 Injurious Falls … All outcome indicators expressed as potentially avoidable hospital stays per 100,000 persons in the HCBS … Eligibility for Medicare defined as inclusion in Medicare Denominator File. … Medicaid only = part of Medicaid HCBS population but not enrolled in Medicare.

2260. Table 8D: Intellectual/Developmental Disabilities Subpopulation | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8d.html
      February 01, 2023 - 894   Min s s s s s   Max 3,665 6,218 6,218 13,974 s Injurious Falls … s 482 s   Max 4,720 3,827 3,566 11,374 25,641 4,261 4,038 Injurious Falls … All outcome indicators expressed as potentially avoidable hospital stays per 100,000 persons in the HCBS … Eligibility for Medicare defined as inclusion in Medicare Denominator File. … Medicaid only = part of Medicaid HCBS population but not enrolled in Medicare.