-
www.ahrq.gov/sites/default/files/2024-04/baernholdt-report.pdf
January 01, 2024 - in US hospitals. … and HACs in rural hospitals is inconclusive. … -
acquired
conditions
Fall rate All falls within a quarter falls per 1000 patient-days
5
Hospital-acquired … (205 rural and 4111 urban) in 601 hospitals (60 rural and 541 urban). … the West region and in hospitals with
fewer than 100 beds.
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psnet.ahrq.gov/issue/npsd-data-spotlight-patterns-fall-interventions
September 13, 2023 - Falls are a frequently reported sentinel event. … Free full text (PDF)
Related dashboard
Related resource: NPSD Data Spotlight - Falls: Associated … January 14, 2024
Burnout in Primary Care: Assessing and Addressing It in Your Practice … October 27, 2021
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Hospitals
Hospital … Medicine
Nurse Care
Patient Falls
Error Reporting and Analysis
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pso.ahrq.gov/sites/default/files/wysiwyg/working-with-pso-webinar-value-hospitals.pdf
January 01, 2020 - and analysis helped prevent future
patient safety events
OIG Report: Patient Safety Organizations: Hospital … Privilege of PSWP
• PSWP Security Policies and Procedures
• Responding to Requests for PSWP
• CHS PSO Hospital … techniques from high-risk industries such as nuclear power and aviation, CHS is creating
inherently safe hospital … /Unassisted Falls
o By Diagnosis Group
• Injuries Resulting from
Falls/Unassisted Falls
o By Diagnosis … • COVID-19 Experience
• Flexibility and Teamwork in the age of COVID
• Reduction in Catheter-Associated
-
psnet.ahrq.gov/issue/patient-safety-culture-and-association-safe-resident-care-nursing-homes
September 19, 2018 - structure ( safety culture ), a process (use of physical restraints), and an outcome (incidence of falls … statistically significant association between higher safety culture scores, lower use of restraints, and fewer falls … the Children's Hospitals' Solutions for Patient Safety Collaborative. … a study of U.S. hospitals. … WebM&M Cases
Failure to Ensure Patient Safety Leads to Patient Falls
-
psnet.ahrq.gov/issue/impact-short-notice-accreditation-assessments-hospitals-patient-safety-and-quality-culture
January 10, 2024 - Review
Impact of short-notice accreditation assessments on hospitals' patient safety … August 18, 2010
Postdischarge adverse events for 1-day hospital admissions in older adults … May 22, 2024
Evaluation of a patient-centered fall-prevention tool kit to reduce falls … February 22, 2023
Cost of inpatient falls and cost-benefit analysis of implementation … Improving Diagnostic Safety and Quality
April 26, 2023
For children admitted to hospital
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/2014finalhacreport-cx.pdf
December 01, 2016 - hospitals in 2014 as a
result of the decline in HACs compared with the number of deaths that would … estimated 17 percent reduction in HACs from 2010 to 2014 indicates that hospitals have
made substantial … less frequent at hospitals that have implemented a full EHR. … expanded its efforts in order to extend the success that hospitals have
achieved to all health care … MPSMS
(2014)
In-Hospital Patient Falls 260,000 7.9
Obstetric
Adverse
Events
PSI (2014) OB Trauma
-
digital.ahrq.gov/sites/default/files/docs/publication/action-cp-cds-training.pdf
February 15, 2008 - Reviewing the Fall Prevention Process in the EHR
Screen all adults for Fall Risk:
Hx of Falls
Altered … Assessment
(Morse Fall Scale)
No
Implement
Environmental
Safety
Management
(to prevent
accidental … , the status of the
interventions, and their history of falls during the current
hospital stay. … Risk for falls in adults in acute care: A synthesis. … National Patient
Safety Goals - Hospital [Electronic Version], p. 10-11.
-
psnet.ahrq.gov/node/72670/psn-pdf
January 27, 2021 - issue/system-issues-leading-found-floor-incidents-multi-incident-analysis
Patients who have fallen in … issue/system-issues-leading-found-floor-incidents-multi-incident-analysis
https://psnet.ahrq.gov/primer/falls … https://psnet.ahrq.gov/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-60-united-states-hospitals-descriptive-study
-
hcup-us.ahrq.gov/reports/statbriefs/sb156.jsp
May 01, 2013 - to another hospital; or died in the ED). … Although falls were the most common type of injury that resulted in an ED visit for all age groups, falls … Types of hospitals included in HCUP
HCUP is based on data from community hospitals, which are defined … as short-term, non-Federal, general, and other hospitals, excluding hospital units of other institutions … Community hospitals included in the Nationwide Emergency Department Sample (NEDS) have hospital-based
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/natlhacratereport-rebaselining2014-2016_0.pdf
January 01, 2016 - hospitals. … MPSMS In-Hospital Patient Falls
Obstetric
Adverse
Events
PSI OB Trauma in Vaginal Delivery
(PSI … MPSMS In-Hospital Patient Falls 238,965 8.03
Obstetric
Adverse
Events
PSI OB Trauma in Vaginal … MPSMS In-Hospital Patient
Falls
5238,96 8.03 224,693 7.55 218,399 7.34
Obstetric
Adverse
Events … 2015, hospitals began using ICD-10 coded data in place of ICD-9 coded data.
-
psnet.ahrq.gov/issue/strategies-improve-patient-safety-outcome-indicator-preventing-or-reducing-falls
March 24, 2021 - Strategies to improve the patient safety outcome indicator: preventing or reducing falls … Strategies to improve the patient safety outcome indicator: preventing or reducing falls. … Strategies to improve the patient safety outcome indicator: preventing or reducing falls. … caregivers to improve safety and facilitate person- and family-centered care during transitions from hospital … July 10, 2019
Techniques to improve patient safety in hospitals: what nurse administrators
-
psnet.ahrq.gov/issue/association-shift-level-nurse-staffing-adverse-patient-events
October 06, 2016 - In this study conducted at military hospitals, greater nursing experience and skill mix was associated … December 12, 2012
Families as partners in hospital error and adverse event surveillance … May 4, 2015
Influence of unit-level staffing on medication errors and falls in military … hospitals. … care hospital units.
-
www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-hcfd-rev.pdf
November 01, 2023 - and fall risk) in hospital rooms of older
patients … (STFs) and
offered a proactive problem-solving approach to reduce STFs in acute care hospitals. … hospitals. … three hospitals. … The second study examined the effect of hospital bed
height as it relates to falls for patients with
-
www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-hcfd.pdf
November 01, 2023 - and fall risk) in hospital rooms of older
patients … (STFs) and
offered a proactive problem-solving approach to reduce STFs in acute care hospitals. … hospitals. … three hospitals. … The second study examined the effect of hospital bed
height as it relates to falls for patients with
-
psnet.ahrq.gov/issue/environmental-changes-increase-hospital-safety-dementia-patients
January 10, 2011 - Improving patients' perceptions of safety in hospitals. … August 24, 2022
Care quality, patient safety, and nurse outcomes at hospitals serving … in a Canadian regional hospital system: a retrospective time series analysis. … December 2, 2015
Reducing falls and fall-related injuries in mental health: a 1-year … multihospital falls collaborative.
-
psnet.ahrq.gov/issue/root-cause-analysis-serious-adverse-events-among-older-patients-veterans-health
August 02, 2015 - Frequent incidents were falls, delays in diagnosis or treatment, and medication errors . … November 21, 2012
Root cause analysis of reported patient falls in ORs in the Veterans … August 21, 2013
Using root cause analysis to reduce falls with injury in community settings … August 21, 2013
Using root cause analysis to reduce falls with injury in the psychiatric … February 17, 2010
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Hospitals
Health
-
psnet.ahrq.gov/node/46009/psn-pdf
September 13, 2017 - Use of standard risk screening and assessment forms to
prevent harm to older people in Australian hospitals … Use of standard risk screening and assessment forms to prevent harm to older
people in Australian hospitals … screening tools are frequently used to assess risk among hospitalized older patients to
prevent harm from falls … long-term-outcomes-medication-intervention-using-screening-tool-older-persons-potentially
https://psnet.ahrq.gov/issue/preventing-falls-and-fall-related-injuries-health-care-facilities
-
www.ahrq.gov/sites/default/files/publications2/files/interimhacrate2014_cx.pdf
November 19, 2015 - hospitals in 2014 as
a result of the decline in HACs compared with the number of deaths that would … 17 percent reduction in HACs from 2010 to 2014 indicates that hospitals have
made substantial progress … at hospitals that have implemented a full EHR. … expanded its efforts in order to extend the success that hospitals have
achieved to all health care … MPSMS
(2014)
In-Hospital Patient
Falls
260,000 7.9
Obstetric
Adverse
Events
PSI (2013) OB
-
www.ahrq.gov/sites/default/files/publications/files/interimhacrate2014_2.pdf
November 19, 2015 - hospitals in 2014 as
a result of the decline in HACs compared with the number of deaths that would … 17 percent reduction in HACs from 2010 to 2014 indicates that hospitals have
made substantial progress … at hospitals that have implemented a full EHR. … expanded its efforts in order to extend the success that hospitals have
achieved to all health care … MPSMS
(2014)
In-Hospital Patient
Falls
260,000 7.9
Obstetric
Adverse
Events
PSI (2013) OB
-
psnet.ahrq.gov/issue/delirium-hospitalized-older-adults
December 15, 2008 - the hospital. … April 7, 2021
The overlooked danger of delirium in hospitals. … May 24, 2015
Reducing falls and fall-related injuries in mental health: a 1-year multihospital … falls collaborative. … May 1, 2009
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Hospitals
Health