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Showing results for "form".

261. 5 Tk2 T6-Using Nursing Home Antibiograms To Choose The Right Antibiotic Data Entry Form (xls file)
     www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_T6-Using_Nursing_Home_Antibiograms_to_Choose_the_Right_Antibiotic_Data_Entry_Form.xlsx
     May 01, 2014 - Antibiograms To Choose the Right Antibiotic Toolkit 2: Concise Antibiogram Toolkit / Tool 6: Excel Data Entry Form … Helpful Hints Using Nursing Home Antibiograms to Choose the Right Antibiotic Tool 6: Excel Data Entry Form

262. Toolkit Implementation Guide for Acute Care Antibiotic Stewardship Programs (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/improve/acute_care_implementation_guide.pdf
     November 01, 2019 - portion of patients receiving antibiotics; this can be guided by use of the Team Antibiotic Review Form … includes information about initiating an antibiotic time out and use of the Team Antibiotic Review Form … Two forms are provided to assist with these discussions between ASPs and frontline staff: o “Identifying … Antibiotic-Associated Adverse Events Form” is brief and can be used at meetings or left on units for … o “Learning From Antibiotic-Associated Adverse Events Form” is similar to a root cause analysis form

263. Attachment A: CHIPRA Pediatric Quality Measures Proram (PQMP) Candidate Measure Submission Form (CPCF) (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/CHIPRA0087-NCINQSexualActivityStatusForm.pdf
     February 06, 2012 - Attachment A: CHIPRA Pediatric Quality Measures Proram (PQMP) Candidate Measure Submission Form (CPCF … Attachment A: CHIPRA Pediatric Quality Measures Program (PQMP) Candidate Measure Submission Form … complete a specific field. << >> indicates the name of a text field in the online version of this form … . + indicates an upload field in the online version of this form. … Data Source [Online form will have radio buttons] a.

264. Appendix A: Draft Key Informant Interview Protocol | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/ptfamilyscan/ptfamilyapa.html
     July 01, 2018 - Email or fax consent form and brief survey (attachment 1) to participant before interview. … Procedures for obtaining informed consent FOR TELEPHONE: Participant will be sent an informed consent form … At start of interview, interviewer will ask if participant has any questions about the consent form and … Did you read the consent form that was sent to you? Do you have any questions?

265. Tool 5. BMI Protocol Template | Agency for Healthcare Research and Quality
     www.ahrq.gov/ncepcr/tools/obesity/obpcp-tool5.html
     May 01, 2014 - Chart Audit Form and Instructions Tool 3. Clinical Care Observation Guide Tool 4.  … Sample Community Inventory Form Tool 9. Sample Prescription Pad Tool 10.  … clinicians for patients with a BMI > 25 or BMI >30 by starting a community-based resource referral form

266. Section 6: Operating a Care Management Program | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm6.html
     October 01, 2014 - The clinic might predict that "Use of self-management forms will increase if physicians find them easy … Introduce the self-management form to a physician. Do. … Learn that the questions on the form are unclear and that the form fails to evaluate patient commitment … Revise the form and test again. … Introduce the form to the physician. Do.

267. I. Introduction | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/crctoolkit/crctoolkit1.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

268. Register Your Practice-based Research Network | Agency for Healthcare Research and Quality
     www.ahrq.gov/ncepcr/communities/pbrn/registry/register.html
     August 01, 2024 - Please use the online PBRN Registration form to register. … To update PBRN information in an already-registered PBRN, please use the online PBRN Update form .

269. 2.a-1 Preintervention Survey of Clinicians and Practice Staff | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/crctoolkit/crctool2a-1.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

270. Appendix, Post-Implementation Strategies to Increase and Sustain Compliance | Agency for Healthcare Research and Quality
     www.ahrq.gov/es/patient-safety/settings/hospital/match/appendix/app-11.html
     July 01, 2022 - ordering phase that creates a forcing function for physicians to complete the medication reconciliation form … Monitor physician compliance for completing the medication reconciliation form

271. Appendix, Post-Implementation Strategies to Increase and Sustain Compliance | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/hospital/match/appendix/app-11.html
     July 01, 2022 - ordering phase that creates a forcing function for physicians to complete the medication reconciliation form … Monitor physician compliance for completing the medication reconciliation form

272. Audio and Video Products | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/publications/pubcomguide/pcguide-avdevelopment.html
     July 01, 2024 - Release Forms Appendix 1-B. Trademarks Appendix 1-C. … Submit the completed Audio/Visual Concept Proposal form or ask for assistance in filling out the form … The following forms are also available in Appendix 1-A. Release Forms . … All forms can be completed electronically. … Release Form for AHRQ To Use Copyrighted Material (Word, 42 KB).

273. Develop a Culture of Safety Around Antibiotic Prescribing | Agency for Healthcare Research and Quality
     www.ahrq.gov/antibiotic-use/acute-care/safety/index.html
     June 01, 2021 - Poster (DOCX) Antibiotic Time Out Tool (DOCX) Identifying Antibiotic–Associated Adverse Events Form … (DOCX) Learning From Antibiotic–Associated Adverse Events Form (DOCX)

274. Implementation Quick Start Guide: Be Prepared To Be Engaged (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/beprepared-quick-start-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

275. Create a Safe Medicine List Together: Scripts (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/medicinelist-scripts-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

276. Interactive Urinary Incontinence Care Pathway Flowchart (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/projects/urinary/empower-ui-care-flowchart.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

277. Staff Safety Assessment | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module2/safety-assessment.html
     March 01, 2017 - This form can be filled out by anyone who works here at any time. … At a minimum, everyone should complete this form twice a year.  

278. AHRQ Safety Program for Perinatal Care: Labor and Delivery Unit Safety Issues Worksheet for Senior Executive Partnership (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/supporting/worksheet.docx
     May 01, 2017 - Health care providers and senior leader(s) How to complete this form: Provide as much detail as possible … When to complete this form: It should be completed at least semiannually.

279. Measures From the CAHPS Health Literacy Item Sets | Agency for Healthcare Research and Quality
     www.ahrq.gov/cahps/surveys-guidance/item-sets/literacy/measures.html
     May 01, 2017 - Blood test, x-ray, or other test results were easy to understand Ease of Filling Out Forms H-HL25 … Staff explained the purpose of a form before patient signed it H-HL27. … Staff offered patient help in filling out a form H-HL28. … Forms were easy for patient to fill out H-HL29. … Patient was given enough time to fill out forms Please note: The CAHPS Health Literacy Item Set for

280. PowerPoint Presentation
     www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/stewardship-slides.pptx
     June 01, 2021 - Providers Hold monthly Antibiotic Stewardship Team meeting Analyze data from the Monthly Data Collection Form … Use the Staff Safety Assessment and Learning From Antibiotic Adverse Events forms to identify problems … staff to complete the Staff Safety Assessment   Apply the Four Moments of Antibiotic Decision Making Form … through the Learn Best Practices section of the toolkit  Four Moments of Antibiotic Decision Making Form … Monthly Data Collection Form Sustaining Stewardship 21 Disclaimer The findings and recommendations