Results

Total Results: 3,255 records

Showing results for "form".

161. AHRQ Request for Synthetic Healthcare Database for Research (SyH-DR) (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Application-062724.pdf
     June 02, 2025 - for Research (SyH-DR) SyH-DR Data Request 1 Please submit any questions, the completed request form … Synthetic Healthcare Database for Research (SyH-DR) INSTRUCTIONS FOR COMPLETING THE SYH-DR REQUEST FORM … Please reference the below terms and definitions as you complete the SyH-DR request form and DUA: • … The Data Requester should enter this name on the SyH-DR request form, and the Data Custodian and Data … SyH-DR Data Request 2 Please submit any questions, the completed request form, and signed DUA(s) to

162. Create a Culture of Safety Around Antibiotic Prescribing | Agency for Healthcare Research and Quality
     www.ahrq.gov/antibiotic-use/long-term-care/safety/index.html
     January 01, 2024 - Antibiotic Use Commitment Poster (DOCX, 870 KB) Staff Safety Assessment Form  (DOCX, 330 KB) Implementation … Guide  (PDF, 402 KB) Learning From Antibiotic–Associated Adverse Events Form (DOCX, 227 KB) Gap … Analysis Tool  (DOCX, 382 KB) The Four Moments of Antibiotic Decision Making Form and Guide

163. Appendix 6: Central Line Maintenance Audit Form | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/clabsi-tools/appendix-6.html
     March 01, 2018 - Appendix 6: Central Line Maintenance Audit Form Tools for Reducing Central Line-Associated Blood

164. Hospital Survey on Patient Safety Culture Database: Hospital-Identifiable Research Abstract Form (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/2024-hsops-identifiable-conf-agreement.pdf
     January 01, 2024 - Hospital Survey on Patient Safety Culture Database: Hospital-Identifiable Research Abstract Form

165. PowerPoint Presentation
     www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/changing-system-slides.pptx
     June 01, 2021 - Learning From Antibiotic-Associated Adverse Events Form Changing the System 12 What Happened? … Form an intervention to address an identified failure. … Use the Learning From Antibiotic-Associated Adverse Events form to develop a plan.   … Introduce the Four Moments of Antibiotic Decision Making Form. … Supporting Materials Staff Safety Assessment Four Moments of Antibiotic Decision Making Form Completion

166. Recruitment Process Diagram Northwest (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/results/research/recruitment-timeline-nw.pdf
     June 19, 2015 - Diagram Northwest Draft H2N Recruitment Process Flow June 19, 2015 Practice completes interest form … Interest form is received in H2N email box Recruiter sends an email to practice scheduling … • Conduct rapid HIT assessment • Link to online practice assessments (begin completing forms … Page does not require timed responses Navigation links Passed Navigation links are not repetitive Forms … Rule Name Status Description Tagged form fields Passed All form fields are tagged Field descriptions

167. Tool 2. Chart Audit Form and Instructions | Agency for Healthcare Research and Quality
     www.ahrq.gov/ncepcr/tools/obesity/obpcp-tool2.html
     May 01, 2014 - Chart Audit Form and Instructions Previous Page Next Page Table of Contents Integrating … Chart Audit Form and Instructions Tool 3. Clinical Care Observation Guide Tool 4.  … Sample Community Inventory Form Tool 9. Sample Prescription Pad Tool 10. 

168. 2.a-2 Practice Focus Group Guide (Preintervention) | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/crctoolkit/crctool2a2.html
     April 01, 2018 - Electronic Record Review 4.a-1 Introduction Letter to Patients With Instructions for Completing SEA Form … Spanish) 4.a-2 Screening Eligibility Assessment (SEA) Form  (incl. … Spanish) 5.a-1 Master Patient Database Elements 5.d-1 Chart Audit Review Form 6.a-1 Feedback Form … for Stool Test Positive 6.a-2 Feedback Form for Stool Test Negative 6.b-1 Feedback Form for CDE … Before we begin, I would like to hand out this consent form for you all to sign, if you still would like

169. 4.b-1 Invitation to Screen Letter to Patients (Version 1—Kit Enclosed) (incl. Spanish) | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/crctoolkit/crctool4b1.html
     April 01, 2018 - Electronic Record Review 4.a-1 Introduction Letter to Patients With Instructions for Completing SEA Form … Spanish) 4.a-2 Screening Eligibility Assessment (SEA) Form  (incl. … Spanish) 5.a-1 Master Patient Database Elements 5.d-1 Chart Audit Review Form 6.a-1 Feedback Form … for Stool Test Positive 6.a-2 Feedback Form for Stool Test Negative 6.b-1 Feedback Form for CDE … If you returned the Eligibility Form and have already been screened, or did not wish to be screened,

170. Final Progress Report: Show Your Work: Do Prescription Annotations Impact Near-miss Medication Errors? (pdf file)
     www.ahrq.gov/sites/default/files/2024-01/johnson-baughman-report.pdf
     January 01, 2024 - the original callback reporting form. … Electronic version of the callback form used for this project. … visits were made to each outpatient pharmacy by the research assistant to collect completed callback forms … Results Phase 1 Findings In total, 449 prescription callback forms were collected from the three Vanderbilt … Of note, 25 callback forms submitted were missing prescription type documentation. Table 2.

171. 3 Tk1 T5-Draft Policies And Procedures For The Antimicrobial Stewardship Program Final (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/nhguide/3_TK1_T5-Draft_Policies_and_Procedures_for_the_Antimicrobial_Stewardship_Program_final.docx
     October 01, 2016 - stewardship program intervention] DATE: [Date] Purpose and Scope This procedure covers the use of [name of form … Implement, Monitor, & Sustain a Program Toolkit 1/Tool 5 4 Sample Policy for Medical Record Referral Form … Nurses completely fill out the Medical Record Referral Form. … The form should be used to collect and convey information. … The form is used on an as needed basis any time an infection is suspected, regardless of type of infection

172. Copyright-Release (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/research/publications/pubcomguide/copyright-release.docx
     July 01, 2024 - AHRQ Publishing and Communications Guidelines Release Form for AHRQ To Use Copyrighted Material Instructions … This form must be completed by Contractors when requesting use of copyrighted materials from publishers … Some publishers have their own forms to request use of copyrighted materials. … Provide copies of signed forms to the managing editor. … Release Form for AHRQ To Use Copyrighted Material The undersigned hereby grants permission to the Agency

173. Identify Defects Through Sensemaking | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cusp/modules/identify/identify.html
     December 01, 2012 - Sensemaking Tools Discovery Form Root Cause Analysis Failure Mode and Effects Analysis … Causal Tree Worksheet Coding defects or errors Learn From Defects Form Eindhoven Model … The conversation is the mechanism that combines that knowledge into a new, more understandable form for … Engage the senior executive in addressing the safety issues identified on the form. Step 2. … Keep the project leader apprised of the information on this form.

174. 116-Evaluating-Cleaning-Data-Collection-Tool (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/116-evaluating-cleaning-data-collection-tool.docx
     April 01, 2025 - Evaluating Environmental Cleaning With Fluorescent Gel: Data Collection Instructions and Form Surgical … check mark under the “Day 1” column of the Environmental Cleaning With Fluorescent Gel: Data Collection Form … NR, or N/A on the “Day 2” column of the Environmental Cleaning with Fluorescent Gel: Data Collection Form … surface is no longer in the patient room) ENVIRONMENTAL CLEANING WITH FLUORESCENT GEL: DATA COLLECTION FORM … Safety Program for MRSA Prevention ENVIRONMENTAL CLEANING WITH FLUORESCENT GEL: DATA COLLECTION FORM

175. Delivering Quality Reports in Print | Agency for Healthcare Research and Quality
     www.ahrq.gov/talkingquality/distribute/media/printed-report.html
     September 01, 2019 - Printed reports typically take the form of stand-alone documents. … Several quality reports designed for Medicaid audiences, for example, take the form of brief brochures

176. Table 3-6. Examples of Instructions, Phrasing, and Terminology to Capture Race and Ethnicity Data | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/iomracereport/reldata3tab3-6.html
     May 01, 2018 - Recommended forms for the instruction are "Mark one or more" and "Select one or more" Response options … African American, Native Hawaiian or Other Pacific Islander (NHOPI), White   Census 2000 long form … (paper form) Is Person 1 of Hispanic, Latino, or Spanish origin? … ; NHOPI; American Indian or Alaska Native   Application for a Social Security Card (paper form … Standard Certificate of Death (paper form) Decedent of Hispanic origin?

177. Be Prepared. Be Engaged. [Patient Note Sheet] (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/beprepared-patient-notesheet-final508.pdf
     June 02, 2025 - Page does not require timed responses Navigation links Passed Navigation links are not repetitive Forms … Rule Name Status Description Tagged form fields Passed All form fields are tagged Field descriptions … Passed All form fields have description Alternate Text Rule Name Status Description Figures alternate

178. Implementation Guide for the Toolkit To Improve Antibiotic Use in Long-Term Care (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/ltc-implementation-guide.pdf
     June 01, 2021 - are directed at ASP leaders and cover the concept of using both technical and adaptive approaches to form … “Tracking and Measuring Antibiotic Use” includes an introduction to a comprehensive data collection form … and a link to the form, which will help track antibiotic use as well as orders for urine cultures and … Two forms are provided to assist with these discussions between ASPs and frontline staff: − The Learning … From Antibiotic-Associated Adverse Events form is similar to a root cause analysis form and can be

179. Strategy 1: Working with Patients & Families as Advisors (Tool 13) (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy1/Strat1_Tool_13_ShortTerm_HO_508.pdf
     June 02, 2025 - Patient and family advisors can work with you to help create or revise forms, letters, handouts, instructions … involvement of patient and family advisors, please fill out the Request for Patient and Family Advisors form … project, along with anticipated meeting times  Complete the Request for Patient and Family Advisors form … Guide to Patient and Family Engagement :: 3 Request for patient and family advisors Complete this form … Please submit this form to: [NOTE: Insert staff liaison name and contact information] Examples

180. Strategy 1: Working with Patients & Families as Advisors (Tool 13) (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy1/Strat1_Tool_13_ShortTerm_HO_508.docx
     June 02, 2025 - Patient and family advisors can work with you to help create or revise forms, letters, handouts, instructions … involvement of patient and family advisors, please fill out the Request for Patient and Family Advisors form … project, along with anticipated meeting times Complete the Request for Patient and Family Advisors form … , conference call, or progress report) Request for patient and family advisors Complete this form … Please submit this form to: [NOTE: Insert staff liaison name and contact information] Guide to Patient