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161. Medication Dashboard Data 2024 (xls file)
     www.ahrq.gov/sites/default/files/wysiwyg/npsd/Medication_Dashboard_Data_2024.xlsx
     January 01, 2024 - (e.g., sustained release instead of immediate release) No Harm 568 96.3% Incorrect dosage form (e.g … (e.g., sustained release instead of immediate release) Administering 223 19.7% Incorrect dosage form … (e.g., sustained release instead of immediate release) Transcribing 73 6.4% Incorrect dosage form ( … e.g., sustained release instead of immediate release) Dispensing 57 5.0% Incorrect dosage form (e.g. … instead of immediate release) Storing * * Incorrect dosage form (e.g., sustained release instead of

162. Medication Management: Sample Process for Medication Management Strategy (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/medication-mgmt-sample-process.pdf
     June 02, 2025 - Using the Medication List form, go through the prescription medications one by one: a. … Check whether the medication is expired and note that on the Medication List form. d. … Indicate on the Medication List form whether the patient is taking the medication as prescribed. … 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

163. Patient Exit Survey (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/resources/diagnostic-toolkit/11a-pfe-patient-survey.pdf
     August 01, 2021 - communication effectiveness using the Communication Observation Form. … The Communication Observation Form was adapted from the AHRQ Health Literacy Precautions Toolkit2 and … The observation form can be completed by patients after the visit, by staff observing the encounter, … The observer form takes only minutes to complete. References 1. … Communication Observation Form.

164. Data Request Guide (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Data-Request-Guide-Oct24update.pdf
     October 01, 2024 - The appendixes to this document include the required SyH-DR application and data use agreement forms. … Fill out the SyH-DR Request Form found in Appendix A of this document. … If possible, do not submit handwritten request forms. Jump to Appendix A. 3. … SyH-DR Request Form 2 Please submit any questions, the completed request form, and signed DUA( … request form, and signed DUA(s) to DataInnovations@ahrq.hhs.gov.

165. Exhibit 5-8. Measure 8: Plan of care includes at least one public and/or private community service/resource (Wrap-Around Observation Form-2) | Agency for Healthcare Research and Quality
     www.ahrq.gov/prevention/resources/chronic-care/clinical-community-relationships-measures-atlas/ccrm-atlas-ex58.html
     March 01, 2013 - care includes at least one public and/or private community service/resource (Wrap-Around Observation Form … Question 2 of the 48-item Wrap-Around Observation Form-2, which elicits information from a trained observer … practice: Other Denominator: Number of patients or families eligible for wraparound services and form … Reliability of the Wraparound Observation Form—Second Version: An instrument designed to assess the fidelity

166. Exhibit 5-7. Measure 7: Information about area (community) resources is offered by clinician (Wrap-Around Observation Form-2) | Agency for Healthcare Research and Quality
     www.ahrq.gov/prevention/resources/chronic-care/clinical-community-relationships-measures-atlas/ccrm-atlas-ex57.html
     March 01, 2013 - Measure 7: Information about area (community) resources is offered by clinician (Wrap-Around Observation Form … Question 1 of the 48-item Wrap-Around Observation Form-2, which elicits information from a trained observer … practice: Other Denominator: Number of patients or families eligible for wraparound services and form … Reliability of the Wraparound Observation Form—Second Version: an instrument designed to assess the fidelity

167. 2.b-1 Academic Detailing Slides | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/crctoolkit/crctool2b1.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

168. Medication Management: Checklist: Creating a Medication List (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/medication-mgmt-staff-checklist.pdf
     June 02, 2025 - Creating the Medication List � Complete the Medication List form for each prescription medication. … � Complete the Medication List form for each over-the-counter medication, vitamin, and supplement … 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

169. Getting Recognition for Your AHRQ-Funded Study | Agency for Healthcare Research and Quality
     www.ahrq.gov/funding/grant-mgmt/recognition_ahrq-funded_study.html
     November 01, 2021 - Please use this PDF form  [153.4 KB] to submit the information below. … Contact  journalpublishing@ahrq.hhs.gov with any questions or assistance with this form. … The fillable PDF form linked above contains the following fields to submit information.   … This page cannot submit information, and is intended only to identify the information requested in the form

170. Standardized handoff report form in clinical nursing education: an educational tool for patient safety and quality of care. | PSNet
     psnet.ahrq.gov/issue/standardized-handoff-report-form-clinical-nursing-education-educational-tool-patient-safety
     August 20, 2014 - Commentary Standardized handoff report form in clinical nursing education: an educational … Standardized handoff report form in clinical nursing education: An educational tool for patient safety … This commentary describes a standardized change-of-shift form designed to help improve nursing students … Standardized handoff report form in clinical nursing education: An educational tool for patient safety

171. Use of an anatomic marking form as an alternative to the Universal Protocol for Preventing Wrong Site, Wrong Procedure and Wrong Person Surgery. | PSNet
     psnet.ahrq.gov/issue/use-anatomic-marking-form-alternative-universal-protocol-preventing-wrong-site-wrong
     March 02, 2011 - Commentary Use of an anatomic marking form as an alternative to the Universal Protocol … Use of an anatomic marking form as an alternative to the Universal Protocol for Preventing Wrong Site … This article describes how an anatomic marking form was developed, discusses its use, and reveals the … Use of an anatomic marking form as an alternative to the Universal Protocol for Preventing Wrong Site

172. Tool 8. Sample Community Inventory Form | Agency for Healthcare Research and Quality
     www.ahrq.gov/ncepcr/tools/obesity/obpcp-tool8.html
     May 01, 2014 - Sample Community Inventory Form 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.  … Basic Yoga Studio is willing to fill out any appropriate forms, although must be client initiated due

173. II. Hotline Design and Development | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/reports/hotline/design2.html
     May 01, 2016 - Creating the Event Reporting Form We used multiple methods to develop the new event reporting form … In June 2012, RAND submitted the Web and phone reporting forms, the phone interview protocol for the … The Final Reporting Form The final prototype patient reporting form has several innovative qualities … At least two forms of legal protection are applicable: First, the confidentiality provisions of the statute … terms that are well understood by patients and caregivers, and these should be used in event reporting forms

174. Tool 2.b-3 Screening Tracking Sheet for Practices | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/crctoolkit/crctool2b3.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

175. 4.b-3 Web Links to CDC Patient Information on CRC Screening | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/crctoolkit/crctool4b3.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

176. 4.b-4 Stool Test Kit Request Card | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/crctoolkit/crctool4b4.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

177. Acute Respiratory Infection | Digital Healthcare Research
     digital.ahrq.gov/health-it-tools-and-resources/pediatric-resources/pediatric-documentation-templates/acute-respiratory-infection
     January 01, 2023 - Executive Summary The Partners Pediatric Acute Respiratory Infection (ARI) smart form … The form is designed to assist with the assessment and management of non-specific upper respiratory infections … The form provides check boxes for symptoms and physical examination specifically related to ARIs; therefore … This web site includes views of each page of the ARI smart form, as well as a preview of the note.

178. Section 7. Tools and Resources (continued) | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu7c.html
     October 01, 2014 - The form can be completed by registered nurses and nursing assistants. … Instruction: Complete the form for all patients with information on the number of pressure ulcers present … Use the standardized skin inspection form, using one form for each month. … Instructions: Complete the form by following the case inclusion and exclusion criteria outlined below

179. Section 7. Tools and Resources (continued) | Agency for Healthcare Research and Quality
     www.ahrq.gov/es/patient-safety/settings/hospital/resource/pressureulcer/tool/pu7c.html
     October 01, 2014 - The form can be completed by registered nurses and nursing assistants. … Instruction: Complete the form for all patients with information on the number of pressure ulcers present … Use the standardized skin inspection form, using one form for each month. … Instructions: Complete the form by following the case inclusion and exclusion criteria outlined below

180. Table 2. Assessment Protocol Step and Tools | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/crctoolkit/crctkittab2.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