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Showing results for "happen".

  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33644/psn-pdf
    December 01, 2006 - Establishing a Safety Culture: Thinking Small December 1, 2006 Hoff TJ. Establishing a Safety Culture: Thinking Small. PSNet [internet]. 2006. https://psnet.ahrq.gov/perspective/establishing-safety-culture-thinking-small Perspective Safety cultures are the holy grail in any risky industry. Like all holy grails, th…

  2. Module 4: How To Implement the Pressure Injury Prevention Program in Your Organization | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/hospital/resource/pressureinjury/workshop/slides4.html
    October 01, 2017 - Module 4: How To Implement the Pressure Injury Prevention Program in Your Organization Slide Presentation Slide 1: How To Implement the Pressure Injury Prevention Program in Your Organization ADD Hospital Name here Module 4 Slide 2: What We Have Done Thus Far Up to this point, you have: Look…

  3. Patient and Family-Centered Care | Agency for Healthcare Research and Quality

    www.ahrq.gov/hai/cauti-tools/archived-webinars/patient-family-centered-care-slides.html
    December 01, 2017 - Patient and Family-Centered Care Slide Presentation Slide 1 Patient and Family-Centered Care Christine Goeschel ScD, MPA, MPS, RN, FAAN Assistant Professor, Johns Hopkins School of Medicine Joint Appointment, Schools of Public Health and Nursing And Gail Panoff Chair, Patient and Community Engage…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49866/psn-pdf
    June 01, 2019 - If You Say So: Taking a Syringe at Face Value in the Operating Room June 1, 2019 Lyndon A, Lim S. If You Say So: Taking a Syringe at Face Value in the Operating Room. PSNet [internet]. 2019. https://psnet.ahrq.gov/web-mm/if-you-say-so-taking-syringe-face-value-operating-room The Case A 43-year-old woman was admi…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866621/psn-pdf
    August 28, 2024 - Application of Safety-II Principles August 28, 2024 Venkatesan C, Helak K, Sousane Z, et al. Application of Safety-II Principles. PSNet [internet]. 2024. https://psnet.ahrq.gov/perspective/application-safety-ii-principles Traditional approaches to patient safety have often been reactive rather than proactive, seeki…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49448/psn-pdf
    June 01, 2004 - Listen to the Family June 1, 2004 Campbell D. Listen to the Family. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/listen-family The Case Vascular surgery was consulted for placement of a dialysis catheter in a patient on the medical floor. The surgical resident examined the patient, an elderly woman with …

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33850/psn-pdf
    January 01, 2018 - EHR Copy and Paste and Patient Safety January 1, 2018 Dean SM. EHR Copy and Paste and Patient Safety. PSNet [internet]. 2018. https://psnet.ahrq.gov/perspective/ehr-copy-and-paste-and-patient-safety Perspective Although the ability to copy and paste text is a central benefit of computing in general, and electronic…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49390/psn-pdf
    February 01, 2003 - Flying Object Hits MRI February 1, 2003 Gosbee JW, Gosbee LL. Flying Object Hits MRI. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/flying-object-hits-mri The Case A child was brought to the Magnetic Resonance Imaging (MRI) room for a brain scan. Accompanied by an anesthesiologist, the child was receiving…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49697/psn-pdf
    December 01, 2013 - Check the Anesthesia Machine December 1, 2013 Saddawi-Konefka D, Cooper JB. Check the Anesthesia Machine. PSNet [internet]. 2013. https://psnet.ahrq.gov/web-mm/check-anesthesia-machine The Case A 62-year-old man with weight of 134 kg (body mass index [BMI] of 40) and history of hypertension, diabetes, sleep apnea…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49428/psn-pdf
    January 01, 2004 - To Resuscitate or Not? January 1, 2004 Wu AW, Pronovost P. To Resuscitate or Not? PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/resuscitate-or-not The Case A critically ill end-stage AIDS patient was hospitalized for end-of-life care. Given the state of his disease, his code status was Do Not Resuscitate/…

  11. Measurement of Patient Safety | PSNet

    psnet.ahrq.gov/primer/measurement-patient-safety
    September 15, 2024 - Measurement of Patient Safety Citation Text: Measurement of Patient Safety. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged Pu…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33593/psn-pdf
    June 15, 2024 - Measurement of Patient Safety June 15, 2024 Measurement of Patient Safety. PSNet [internet]. 2019. https://psnet.ahrq.gov/primer/measurement-patient-safety PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that they reflect current research and practice in the patient …

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867845/psn-pdf
    February 26, 2025 - Combined Proactive Risk Assessment (CPRA) – 4-Step Technique Innovation Summary February 26, 2025 https://psnet.ahrq.gov/innovation/combined-proactive-risk-assessment-cpra-4-step-technique-innovation- summary Summary This innovation describes the Veteran Health Administration (VHA) National Center for Patient Saf…

  14. Combined Proactive Risk Assessment (CPRA) – 4-Step Technique Innovation Summary | PSNet

    psnet.ahrq.gov/innovation/combined-proactive-risk-assessment-cpra-4-step-technique-innovation-summary
    February 26, 2025 - Combined Proactive Risk Assessment (CPRA) – 4-Step Technique Innovation Summary Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL February 26, 2025 Innovation Contact …

  15. Selection Criteria and Honorarium Information | PSNet

    psnet.ahrq.gov/Webmm/submit-case-info
    August 10, 2025 - Selection Criteria and Honorarium Information How it works Health care professionals may submit de-identified cases that highlight medical errors or other patient safety/quality issues. Note that you can choose to submit cases either …

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49773/psn-pdf
    July 01, 2016 - Near Miss With Neonate October 1, 2016 Malana J, Lyndon A. Near Miss With Neonate. PSNet [internet]. 2016. https://psnet.ahrq.gov/web-mm/near-miss-neonate The Case A 37-year-old pregnant woman was admitted to the hospital for scheduled induction of labor for postterm dates. Early the next morning, intravenous oxy…

  17. CAHPS Clinician & Group Adult Survey 3.0 (doc file)

    www.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/item-sets/PCMH/adult-eng-cg30-pcmh-2352a.docx
    October 30, 2020 - CAHPS Clinician & Group Adult Survey 3.0 CAHPS® Clinician & Group Survey with Patient-Centered Medical Home Items Version: 3.0 Population: Adult Language: English Notes · Patient-Centered Medical Home (PCMH) items. This version of the Clinician & Group Survey includes the 3.0 version of PCMH items. PCMH item…

  18. Charcoal Lavage of the Lungs | PSNet

    psnet.ahrq.gov/web-mm/charcoal-lavage-lungs
    January 01, 2016 - Charcoal Lavage of the Lungs Citation Text: Wigton RS. Charcoal Lavage of the Lungs. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote …

  19. Situation Monitoring: Obstetric Hemorrhage (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hemorrhage_4-situation-monitoring-speaker-notes.pdf
    July 01, 2023 - individual awareness of Shared Situation Understanding Monitoring what’s going on and what is likely to happen … Unfortunately, the reality of patient care is such that sometimes surprises happen or a case is complex … the patient's clinical status, what interventions have been performed thus far, and what needs to happen

  20. What Exactly Is Patient Safety? (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Emanuel-Berwick_110.pdf
    July 02, 2008 - Second, in open, interacting systems, unpredictable events will happen. … This is not because errors will not be made and adverse events will never happen, but because the health … Where does patient safety happen? The ultimate locus of patient safety is the microsystem.
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