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psnet.ahrq.gov/node/33595/psn-pdf
December 15, 2024 - AHRQ funded the National Academy of
Medicine to synthesize evidence on medical resident schedules and health … In this report, fatigue is
characterized as a latent hazard and "an unsafe condition" in health care … , as well as heightened irritability—and all of these can impair
communication and coordination in health … The effects of sleep deprivation will become increasingly important as health care moves to more shift … A Sentinel Event Alert
issued by The Joint Commission in 2011 and updated in 2018, called on health
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psnet.ahrq.gov/periodic-issue/periodic-issue-473
March 25, 2025 - Assessment (SDENA) to identify behavioral barriers and enablers for implementing healthcare-acquired condition … J Health Organ Manag . 2025; Epub Jan 15 . … BMC Health Serv Res . 2025; 25 (1) :31 . … Poor electronic health record (EHR) design can result in medication errors. … Front Health Serv . 2024.
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psnet.ahrq.gov/issue/organizational-conditions-engagement-quality-and-safety-improvement-longitudinal-qualitative
November 25, 2020 - BMC Health Serv Res. 2018;18(1):783. doi:10.1186/s12913-018-3607-7. … BMC Health Serv Res . 2018; 18 (1) :783 .
View more articles from the same authors. … BMC Health Serv Res. 2018;18(1):783. doi:10.1186/s12913-018-3607-7.
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psnet.ahrq.gov/issue/fdasia-health-it-report-proposed-strategy-and-recommendations-risk-based-framework
June 29, 2016 - Government Resource
FDASIA Health IT Report: Proposed Strategy and Recommendations … Citation Text:
FDASIA Health IT Report: Proposed Strategy and Recommendations for a Risk-Based Framework … of a "Health IT Safety Center" to test, disseminate, and promote assessment tools. … Care Organizations to Improve Safety Using Health IT. … February 20, 2019
Health IT Safety Center Roadmap.
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psnet.ahrq.gov/web-mm/triage-time-bomb
September 01, 2008 - Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … The triage nurse in this scenario did not recognize the acuity of the child's condition. … Hyattsville, MD: National Center for Health Statistics; 2002. … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/perspective/conversation-withdean-schillinger-md
March 01, 2009 - done a reasonable job of doing that for anticoagulant care, but our research has shown that even this condition … Health IT can go one of two ways with respect to this health literacy issue. … to problems with the use of preventive services, delayed diagnoses, understanding of one's medical condition … Low Health Literacy: Implications for National Health Policy. [Available at]
6. … Hernandez LM; for Roundtable on Health Literacy, Board on Population Health and Public Health Practice
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psnet.ahrq.gov/issue/use-heuristics-during-clinical-decision-process-family-care-physicians-real-conditions
March 09, 2022 - September 2, 2020
Multiple meanings of resilience: health professionals' experiences … October 20, 2021
eSIMPLER: a dynamic, electronic health record-integrated checklist for … factors associated with an increased risk of being a reported case of preventable harm in first-line health
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psnet.ahrq.gov/primer/never-events
June 15, 2024 - Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … patient safety event (not primarily related to the natural course of a patient's illness or underlying condition … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/primer/missed-nursing-care
September 15, 2024 - Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … One proposed pathway is the amount of surveillance, or ongoing assessment and reassessment of patient condition … Department of Health and Human Services. … Department of Health and Human Services. … units: the results from participant observation across three mental health services.
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psnet.ahrq.gov/web-mm/framework-assessing-reasoning-about-controversial-end-life-clinical-decisions
November 30, 2023 - The patient was initially treated in the intensive care unit with broad-spectrum antibiotics; his condition … However, the patient’s condition worsened, and he suddenly developed diffuse peritonitis, signaling failure … Jonas & Kovner's Health Care Delivery in the United States . 12th ed. … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/node/33587/psn-pdf
June 15, 2024 - proposed pathway is the amount of surveillance, or ongoing assessment and
reassessment of patient condition … and evaluate nurse-initiated care to manage
patients' symptoms and responses to care, and to promote health … environment issues and burnout among providers are essential to achieving safety, quality, and value
in health … perspective/conversation-jack-needleman-phd
https://psnet.ahrq.gov/issue/nurse-staffing-burnout-and-health-care-associated-infection
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psnet.ahrq.gov/web-mm/critical-echocardiogram-result-lost-follow
July 31, 2023 - As such, the patient’s condition progressed while at a SNF until he developed fever and overt infection … healthcare organizations develop reliable processes for effective communication about a patient’s current condition … The safety of inpatient health care. … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/web-mm/pregnant-danger
January 12, 2011 - Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … aortic dissection is an uncommon disorder in a woman of childbearing age, it is a potentially lethal condition … notify of patient's impending arrival
Patient to birth center with ED tech or RN, based on patient's condition … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/primer/high-reliability
January 29, 2020 - Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … principles of high reliability go beyond standardization: high reliability is better described as a condition … High-reliability health care: getting there from here. … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/web-mm/missed-candor-implementation-opportunities
November 11, 2020 - His complex health condition was known to his wife, and given the very complex nature of the surgery, … surgeon took responsibility for this error, initially informed the patient’s wife of the patient’s condition … The role of health care liens in litigation and recovery. … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/issue/revealing-disparities-health-care-workers-observations-discrimination-against-patients
April 12, 2006 - Book/Report
Revealing Disparities: Health Care Workers’ Observations of Discrimination … Clinicians and health care workers that closely interface with patients are apt to perceive important … April 12, 2006
How Discrimination in Health Care Affects Older Americans, and What Health … March 5, 2010
Mirror, Mirror: Comparing Health Systems Across Countries. … July 26, 2023
Care Delivery within Community Mental Health Teams.
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psnet.ahrq.gov/primer/post-acute-transitional-services-safety-home-based-care-programs
April 24, 2024 - Home Health Agencies provide care by employing visiting licensed nurses, home health aides, and physical … that can only be provided by qualified licensed nurse or therapy clinicians, and that the qualifying condition … UC Davis Health vmcelroy@ucdavis.edu Ron Billano Ordona, DNP, FNP-BC, GS-C Health Sciences Assistant … National Center for Health Statistics. … Health Affairs . October 8, 2019.
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psnet.ahrq.gov/primer/fatigue-sleep-deprivation-and-patient-safety
September 15, 2024 - Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … In this report, fatigue is characterized as a latent hazard and "an unsafe condition" in health care … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.329_slideshow.ppt
August 01, 2014 - Surgery, Singapore General Hospital and Lee Gan Goh, MBBS, Division of Medicine, National University Health … www.ncbi.nlm.nih.gov/pubmed/7123497
10
History and Features
Hippocrates first alluded to a clinical condition … 5th century BC as a complication of erysipelas
Since then, numerous terms have been applied to this condition—phagedena
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psnet.ahrq.gov/node/33565/psn-pdf
September 01, 2024 - https://psnet.ahrq.gov/primer/health-care-associated-infections
PSNet primers are regularly reviewed … https://psnet.ahrq.gov/primer/health-care-associated-infections
https://psnet.ahrq.gov/issue/efforts-improve-patient-safety-result … long-term-care-healthcare-associated-infections-2023-analysis-23970-reports
https://psnet.ahrq.gov/issue/health-care-associated-infections-meta-analysis-costs-and-financial-impact-us-health-care … psnet.ahrq.gov/primer/surgical-site-infections
https://psnet.ahrq.gov/issue/multistate-point-prevalence-survey-health-care-associated-infections … sentinel event (not primarily related to the natural course of the patient's illness or underlying condition