Results

Total Results: over 10,000 records

Showing results for "identified".

141. Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesis. | PSNet
     psnet.ahrq.gov/issue/barriers-and-facilitators-improving-patient-safety-learning-systems-systematic-review
     October 16, 2024 - This systematic review of 22 studies identified barriers and facilitators influencing how health systems … January 24, 2024 Quality gaps identified through mortality review.

142. Flow of information contributing to medication incidents in home care- an analysis considering incident reporters' perspectives. | PSNet
     psnet.ahrq.gov/issue/flow-information-contributing-medication-incidents-home-care-analysis-considering-incident
     May 01, 2024 - Four types of issues were identified – (1) information management such as incomplete medication lists … November 24, 2021 An observational study of how patients are identified before medication

143. Quality and reporting of large-scale improvement programmes: a review of maternity initiatives in the English NHS, 2010–2023. | PSNet
     psnet.ahrq.gov/issue/quality-and-reporting-large-scale-improvement-programmes-review-maternity-initiatives-english
     February 07, 2024 - The authors identified poor reporting of evidence base supporting the interventions, limited descriptions … September 29, 2021 Risk controls identified in action plans following serious incident

144. Disruptive behaviour in the perioperative setting: a contemporary review. | PSNet
     psnet.ahrq.gov/issue/disruptive-behaviour-perioperative-setting-contemporary-review
     March 06, 2024 - Examining the literature on disruptive behavior in the operating room , this review identified intrapersonal … Author(s) Clinician responses to disruptive intraoperative behaviour: patterns and norms identified

145. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/866589/psn-pdf
     August 28, 2024 - Among 566 cases identified via medical record review and direct observation of medication administration … , the multidisciplinary panel identified actual harm in 89 cases, with three-quarters of actual harm

146. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/866115/psn-pdf
     June 12, 2024 - This scoping review examined how polypharmacy is defined, identified, and addressed across 157 articles … The authors also identified considerable variability in the types of interventions used to address polypharmacy

147. The Submit a Case Process | PSNet
     psnet.ahrq.gov/submit-case
     April 05, 2025 - Submit a Case Process PSNet’s Submit a Case feature allows health care professionals to submit de-identified

148. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/50729/psn-pdf
     December 11, 2019 - It identified new types of active measures and related concepts present in the evidence base. … The authors also identified advancing the science of diagnostic error as an emerging area of focus.

149. Diagnostic discrepancies in the emergency department: a retrospective study. | PSNet
     psnet.ahrq.gov/issue/diagnostic-discrepancies-emergency-department-retrospective-study
     October 04, 2023 - This retrospective study conducted at one academic medical center evaluated identified diagnostic errors … The researchers identified a difference in diagnosis between the ED physician and the discharge diagnosis

150. Medicines management support to older people: understanding the context of systems failure. | PSNet
     psnet.ahrq.gov/issue/medicines-management-support-older-people-understanding-context-systems-failure
     October 04, 2023 - The authors identified concerns around decision-making, recording information, and acting on abnormal … December 21, 2014 Risk controls identified in action plans following serious incident

151. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/867012/psn-pdf
     October 23, 2024 - More than half of the identified studies focused on medication safety, such as workarounds related to … Organizational factors, including workload and time pressure, were identified in 93% of studies.

152. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/837422/psn-pdf
     June 15, 2022 - In this study, researchers qualitatively analyzed hospital incident reporting data and identified incidents … medication-intravenous fluid issues, communication failures, clinical deterioration, and care issues identified

153. A tool for the concise analysis of patient safety incidents. | PSNet
     psnet.ahrq.gov/issue/tool-concise-analysis-patient-safety-incidents
     August 09, 2018 - Once identified , adverse events require investigation to understand underlying causes. … November 10, 2010 The harm susceptibility model: a method to prioritise risks identified

154. Surgical never events and contributing human factors. | PSNet
     psnet.ahrq.gov/issue/surgical-never-events-and-contributing-human-factors
     August 20, 2018 - Cognitive failures were identified in about half the events. … More Related Resources Retained Swabs Following Invasive Procedures: Themes Identified

155. Adverse events detected by clinical surveillance on an obstetric service. | PSNet
     psnet.ahrq.gov/issue/adverse-events-detected-clinical-surveillance-obstetric-service
     September 11, 2009 - Investigators identified more than 100 triggers, and while very few serious adverse events were described … April 22, 2011 Quality gaps identified through mortality review.

156. Prospective risk analysis and incident reporting for better pharmaceutical care at paediatric hospital discharge. | PSNet
     psnet.ahrq.gov/issue/prospective-risk-analysis-and-incident-reporting-better-pharmaceutical-care-paediatric
     June 27, 2011 - This method identified more errors than traditional incident reporting , as expected given the known … View More Related Resources Wrong drug and wrong dose dispensing errors identified

157. Barriers to implementation of patient safety systems in healthcare institutions: leadership and policy implications. | PSNet
     psnet.ahrq.gov/issue/barriers-implementation-patient-safety-systems-healthcare-institutions-leadership-and-policy
     July 14, 2010 - The top seven barriers are identified, including competition for scare resources and a lack of resources … The authors advocate for the use of these identified barriers in supporting leadership decisions, both

158. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/50888/psn-pdf
     February 12, 2020 - preventable-closed-claims-aana-foundation-closed-malpractice-claims- database This thematic analysis identified … Among the factors identified as being associated with preventable events were communication failures

159. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/865970/psn-pdf
     May 29, 2024 - Retrospective chart reviews are a common way to validate administrative datasets, and this review identified … A variety of methods, sampling strategies, and accuracy rates were identified.

160. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/862601/psn-pdf
     February 14, 2024 - This system review highlights 20 studies on healthcare simulation to characterize types of errors identified … All 13 studies that identified systems-related errors were conducted in situ, underscoring the importance