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Showing results for "incidents".

  1. Adverse event reporting: harnessing residents to improve patient safety. | PSNet

    psnet.ahrq.gov/issue/adverse-event-reporting-harnessing-residents-improve-patient-safety
    July 02, 2019 - Study Adverse event reporting: harnessing residents to improve patient safety. Citation Text: Tevis SE, Schmocker RK, Wetterneck TB. Adverse Event Reporting. J Patient Saf. 2020;16(4):294-298. doi:10.1097/pts.0000000000000333. Copy Citation Format: DOI Google Scholar BibTeX…

  2. Review of alternatives to root cause analysis: developing a robust system for incident report analysis. | PSNet

    psnet.ahrq.gov/issue/review-alternatives-root-cause-analysis-developing-robust-system-incident-report-analysis
    November 14, 2018 - Review Review of alternatives to root cause analysis: developing a robust system for incident report analysis. Citation Text: Hagley G, Mills PD, Watts B, et al. Review of alternatives to root cause analysis: developing a robust system for incident report analysis. BMJ Open Qual. 2019;8(…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867046/psn-pdf
    October 30, 2024 - The future of safety and quality in radiation oncology. October 30, 2024 Talcott W, Covington E, Bazan J, et al. The future of safety and quality in radiation oncology. Semin Radiat Oncol. 2024;34(4):433-440. doi:10.1016/j.semradonc.2024.07.008. https://psnet.ahrq.gov/issue/future-safety-and-quality-radiation-oncol…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47099/psn-pdf
    May 16, 2018 - Defense Health Agency Should Improve Tracking of Serious Adverse Medical Events and Monitoring of Required Follow-up. May 16, 2018 Washington, DC: United States Government Accountability Office; April 2018. Publication GAO-18-378. https://psnet.ahrq.gov/issue/defense-health-agency-should-improve-tracking-serious-a…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40324/psn-pdf
    April 14, 2011 - To what extent are adverse events found in patient records reported by patients and healthcare professionals via complaints, claims and incident reports? April 14, 2011 Christiaans-Dingelhoff I, Smits M, Zwaan L, et al. To what extent are adverse events found in patient records reported by patients and healthcare …

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74169/psn-pdf
    December 08, 2021 - Pointing fingers: verbosity of patient safety narratives is associated with attribution of blame. December 8, 2021 Ackerman RS, Patel SY, Costache M, et al. Anesthesiology News. November 21, 2021. https://psnet.ahrq.gov/issue/pointing-fingers-verbosity-patient-safety-narratives-associated-attribution- bl…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33571/psn-pdf
    March 15, 2025 - Reporting Patient Safety Events March 15, 2025 Reporting Patient Safety Events. PSNet [internet]. 2019. https://psnet.ahrq.gov/primer/reporting-patient-safety-events PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that they reflect current research and practice in th…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45292/psn-pdf
    September 07, 2016 - Electronic approaches to making sense of the text in the adverse event reporting system. September 7, 2016 Benin AL, Fodeh SJ, Lee K, et al. Electronic approaches to making sense of the text in the adverse event reporting system. J Healthc Risk Manag. 2016;36(2):10-20. doi:10.1002/jhrm.21237. https://psnet.ahrq.go…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36515/psn-pdf
    May 27, 2011 - Nurses' perceptions of causes of medication errors and barriers to reporting. May 27, 2011 Ulanimo VM, O'Leary-Kelley C, Connolly PM. Nurses' perceptions of causes of medication errors and barriers to reporting. J Nurs Care Qual. 2007;22(1):28-33. https://psnet.ahrq.gov/issue/nurses-perceptions-causes-medication-e…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836853/psn-pdf
    April 06, 2022 - Use of e-triggers to identify diagnostic errors in the paediatric ED. April 6, 2022 Lam D, Dominguez F, Leonard J, et al. Use of e-triggers to identify diagnostic errors in the paediatric ED. BMJ Qual Saf. 2022;31(10):735-743. doi:10.1136/bmjqs-2021-013683. https://psnet.ahrq.gov/issue/use-e-triggers-identify-diag…

  11. Final Research Plan: Osteoporosis to Prevent Fractures: Screening | United States Preventive Services Taskforce

    www.uspreventiveservicestaskforce.org/uspstf/document/final-research-plan/osteoporosis-screening
    November 18, 2021 - Share to Facebook Share to X Share to WhatsApp Share to Email Print Final Research Plan Osteoporosis to Prevent Fractures: Screening November 18, 2021 Recommendations made by the USPSTF are independent of the U.S. government. They should not b…

  12. Final Progress Report: Addressing Preventable Medication Use Variance in Mississippi (pdf file)

    www.ahrq.gov/sites/default/files/2024-01/brown-report.pdf
    January 01, 2024 - Methods: We improved the existing mechanism for data collection on incidents of medication use variance … Methods In keeping with AHRQ’s goals, our study design included the following: (1) Data collection on incidents

  13. Archived: Final Evidence Summary: Sexually Transmitted Infections: Behavioral Counseling | United States Preventive Services Taskforce

    www.uspreventiveservicestaskforce.org/uspstf/document/final-evidence-summary44/sexually-transmitted-infections-behavioral-counseling-2008
    October 15, 2008 - Share to Facebook Share to X Share to WhatsApp Share to Email Print archived Final Evidence Summary Sexually Transmitted Infections: Behavioral Counseling October 15, 2008 Recommendations made by the USPSTF are independent of the U.S. gover…

  14. Data-Points 2 Diabetic-Foot-Ulcers Data 02-2011 (pdf file)

    effectivehealthcare.ahrq.gov/sites/default/files/data-points_2_diabetic-foot-ulcers_data_02-2011.pdf
    January 01, 2011 - Annual Incidence of Foot Ulcer Among Diabetic Medicare Parts A and B Fee-for-Service (FFS) Beneficiaries, 2006-2008, by Age, Gender, and Race, and Broken Down by Diagnosis of Peripheral Artery Disease (PAD) Algorithm 3: 12-month period of continuous enrollment and continuous FFS enrollment throughout the year. Age…

  15. Surveillance for Adverse Drug Events in Ambulatory Pediatrics - 2010 | Digital Healthcare Research

    digital.ahrq.gov/ahrq-funded-projects/surveillance-adverse-drug-events-ambulatory-pediatrics/annual%20summary/2010
    January 01, 2010 - Surveillance for Adverse Drug Events in Ambulatory Pediatrics - 2010 Project Name Surveillance for Adverse Drug Events in Ambulatory Pediatrics Principal Investigator Bailey, Thomas Organization Washington University Funding Mechanism RFA: HS07-002: Ambulatory and S…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74059/psn-pdf
    January 01, 2022 - Medication dose calculation errors and other numeracy mishaps in hospitals: analysis of the nature and enablers of incident reports. November 10, 2021 Mulac A, Hagesaether E, Granas AG. Medication dose calculation errors and other numeracy mishaps in hospitals: analysis of the nature and enablers of incident repor…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43678/psn-pdf
    April 22, 2015 - 'Connecting the dots': leveraging visual analytics to make sense of patient safety event reports. April 22, 2015 Ratwani RM, Fong A. 'Connecting the dots': leveraging visual analytics to make sense of patient safety event reports. J Am Med Inform Assoc. 2015;22(2):312-7. doi:10.1136/amiajnl-2014-002963. https://ps…

  18. Development and interrater agreement of a novel classification system combining medical and surgical adverse event reporting. | PSNet

    psnet.ahrq.gov/issue/development-and-interrater-agreement-novel-classification-system-combining-medical-and
    September 20, 2011 - Study Development and interrater agreement of a novel classification system combining medical and surgical adverse event reporting. Citation Text: Stone A, Jiang ST, Stahl MC, et al. Development and interrater agreement of a novel classification system combining medical and surgical adve…

  19. Mind the gap between recommendation and implementation—principles and lessons in the aftermath of incident investigations: a semi-quantitative and qualitative study of factors leading to the successful implementation of recommendations. | PSNet

    psnet.ahrq.gov/issue/mind-gap-between-recommendation-and-implementation-principles-and-lessons-aftermath-incident
    March 11, 2020 - Study Mind the gap between recommendation and implementation—principles and lessons in the aftermath of incident investigations: a semi-quantitative and qualitative study of factors leading to the successful implementation of recommendations. Citation Text: Wrigstad J, Bergström J, Gusta…

  20. Radiologic safety events within a pediatric emergency medicine network. | PSNet

    psnet.ahrq.gov/issue/radiologic-safety-events-within-pediatric-emergency-medicine-network
    August 01, 2018 - Study Radiologic safety events within a pediatric emergency medicine network. Citation Text: Blumberg SM, Mahajan P, OʼConnell KJ, et al. Radiologic Safety Events Within a Pediatric Emergency Medicine Network. Pediatr Emerg Care. 2017;33(2):92-96. doi:10.1097/PEC.0000000000000684. Copy…
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