Results

Total Results: over 10,000 records

Showing results for "incidents".

9061. Prevalence of preventable medication-related hospitalizations in Australia: an opportunity to reduce harm. | PSNet
      psnet.ahrq.gov/issue/prevalence-preventable-medication-related-hospitalizations-australia-opportunity-reduce-harm
      September 23, 2020 - Study Prevalence of preventable medication-related hospitalizations in Australia: an opportunity to reduce harm. Citation Text: Kalisch LM, Caughey GE, Barratt JD, et al. Prevalence of preventable medication-related hospitalizations in Australia: an opportunity to reduce harm. Int J Qual…

9062. IV Push Gap Analysis Tool (GAT) helps uncover national priorities for safe injection practices. | PSNet
      psnet.ahrq.gov/issue/iv-push-gap-analysis-tool-gat-helps-uncover-national-priorities-safe-injection-practices
      August 14, 2019 - Newspaper/Magazine Article IV Push Gap Analysis Tool (GAT) helps uncover national priorities for safe injection practices. Citation Text: IV Push Gap Analysis Tool (GAT) helps uncover national priorities for safe injection practices. ISMP Medication Safety Alert! Acute Care Edition. Augu…

9063. Electronic prescribing reduced prescribing errors in a pediatric renal outpatient clinic. | PSNet
      psnet.ahrq.gov/issue/electronic-prescribing-reduced-prescribing-errors-pediatric-renal-outpatient-clinic
      July 08, 2008 - Study Electronic prescribing reduced prescribing errors in a pediatric renal outpatient clinic. Citation Text: Jani Y, Ghaleb M, Marks SD, et al. Electronic prescribing reduced prescribing errors in a pediatric renal outpatient clinic. J Pediatr. 2008;152(2):214-8. doi:10.1016/j.jpeds.…

9064. Medication reconciliation in a community, nonteaching hospital. | PSNet
      psnet.ahrq.gov/issue/medication-reconciliation-community-nonteaching-hospital
      October 19, 2012 - Commentary Medication reconciliation in a community, nonteaching hospital. Citation Text: Wortman SB. Medication reconciliation in a community, nonteaching hospital. Am J Health Syst Pharm. 2008;65(21):2047-54. doi:10.2146/ajhp080091. Copy Citation Format: DOI Google Scho…

9065. Pediatric antidepressant medication errors in a national error reporting database. | PSNet
      psnet.ahrq.gov/issue/pediatric-antidepressant-medication-errors-national-error-reporting-database
      September 21, 2008 - Study Pediatric antidepressant medication errors in a national error reporting database. Citation Text: Rinke ML, Bundy DG, Shore AD, et al. Pediatric antidepressant medication errors in a national error reporting database. J Dev Behav Pediatr. 2010;31(2):129-36. doi:10.1097/DBP.0b013e…

9066. Enhancing communication in surgery through team training interventions: a systematic literature review. | PSNet
      psnet.ahrq.gov/issue/enhancing-communication-surgery-through-team-training-interventions-systematic-literature
      August 11, 2021 - Review Enhancing communication in surgery through team training interventions: a systematic literature review. Citation Text: Gillespie BM, Chaboyer W, Murray P. Enhancing communication in surgery through team training interventions: a systematic literature review. AORN J. 2010;92(6):6…

9067. A "back to basics" approach to reduce ED medication errors. | PSNet
      psnet.ahrq.gov/issue/back-basics-approach-reduce-ed-medication-errors
      September 28, 2010 - Study A "back to basics" approach to reduce ED medication errors. Citation Text: Blank FSJ, Tobin J, Macomber S, et al. A "back to basics" approach to reduce ED medication errors. Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association. 2…

9068. Developing a team performance framework for the intensive care unit. | PSNet
      psnet.ahrq.gov/issue/developing-team-performance-framework-intensive-care-unit
      December 01, 2011 - Review Developing a team performance framework for the intensive care unit. Citation Text: Reader TW, Flin R, Mearns K, et al. Developing a team performance framework for the intensive care unit. Crit Care Med. 2009;37(5):1787-1793. doi:10.1097/CCM.0b013e31819f0451. Copy Citation …

9069. Failure to report poor care as a breach of moral and professional expectation. | PSNet
      psnet.ahrq.gov/issue/failure-report-poor-care-breach-moral-and-professional-expectation
      March 05, 2025 - Commentary Failure to report poor care as a breach of moral and professional expectation. Citation Text: Ion R, Olivier S, Darbyshire P. Failure to report poor care as a breach of moral and professional expectation. Nurs Inq. 2019;26(3):e12299. doi:10.1111/nin.12299. Copy Citation …

9070. Patient safety and collaboration of the intensive care unit team. | PSNet
      psnet.ahrq.gov/issue/patient-safety-and-collaboration-intensive-care-unit-team
      February 17, 2010 - Commentary Patient safety and collaboration of the intensive care unit team. Citation Text: Despins LA. Patient safety and collaboration of the intensive care unit team. Crit Care Nurse. 2009;29(2):85-91. doi:10.4037/ccn2009281. Copy Citation Format: DOI Google Scholar Pu…

9071. VTE Surveillance Assessment_49_low_SPI (pdf file)
      effectivehealthcare.ahrq.gov/sites/default/files/related_files/blood-clots-hip-knee-surgery_surveillance.pdf
      December 01, 2012 - VTE Surveillance Assessment_49_low_SPI     CER # 49:   Comparative effectiveness review of Venous Thromboembolism Prophylaxis in Orthopedic Surgery   Original release date: March 2012 Surveillance Report: December 2012 Key Findings: • Key questions (KQs) 1-4,7-11 are uptodate …

9072. Development of a Computerized Adverse Drug Event (ADE) Monitor in the Outpatient Setting (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Seger.pdf
      January 01, 2003 - A computerized method for identifying incidents associated with adverse drug events in outpatients.

9073. Implementing Near-Miss Reporting and Improvement Tracking in Primary Care Practices: Lessons Learned | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/reports/liability/crane.html
      August 01, 2017 - Being open: communicating patient safety incidents with patients, their families and carers .

9074. AHRQ-Funded Patient Safety Highlights: Improving Healthcare Safety by Supporting Measure Implementation (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-measure-implementation.pdf
      August 01, 2025 - PSRSs) can serve as a central mechanism to identify hazards and that a variety of ICUs will submit incidents … Using the ICUSRS, staff reported 2 or more contributing factors in 3 quarters of the 2,075 incidents … A trend in the data suggests that incidents with more than 3 types of contributing factors correlated … Investigators perceived that excessive workload and insufficient staffing commonly contributed to incidents … Key Findings/Impact: Investigators identified a chain of errors documented in 77% of incidents.

9075. Appendix D: Alternate Care Facility Questionnaire—Summary of Results | Agency for Healthcare Research and Quality
      www.ahrq.gov/research/shuttered/acfselection/appendixd.html
      July 01, 2018 - Disaster Alternate Care Facilities: Report and Interactive Tools Appendix D: Alternate Care Facility Questionnaire—Summary of Results Previous Page   Table of Contents Disaster Alternate Care Facilities: Report and Interactive Tools Executive Summary Chapter 1. Objectives Chapter 2. Background…

9076. Can an Academic Health Care System Overcome Barriers to Clinical Guideline Implementation? (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Quinn.pdf
      January 01, 2004 - Can an Academic Health Care System Overcome Barriers to Clinical Guideline Implementation? 291 Can an Academic Health Care System Overcome Barriers to Clinical Guideline Implementation? Debra Quinn, Mary Cooper, Lynn Chevalier, Jerry Balentine, Lawrence Kadish, Steven Walerstein, Fredric Weinbaum, Mark Ca…

9077. Recommendation: Prevention of Dental Caries in Children Younger Than 5 Years: Screening and Interventions | United States Preventive Services Taskforce
      www.uspreventiveservicestaskforce.org/uspstf/recommendation/prevention-of-dental-caries-in-children-younger-than-age-5-years-screening-and-interventions1
      December 07, 2021 - Share to Facebook Share to X Share to WhatsApp Share to Email Print Final Recommendation Statement Prevention of Dental Caries in Children Younger Than 5 Years: Screening and Interventions December 07, 2021 Recommendations made by the USPS…

9078. Archived: Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality From Preeclampsia: Preventive Medication | United States Preventive Services Taskforce
      www.uspreventiveservicestaskforce.org/uspstf/recommendation/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication-september-2014
      September 09, 2014 - Share to Facebook Share to X Share to WhatsApp Share to Email Print archived Final Recommendation Statement Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality From Preeclampsia: Preventive Medication September 09, 2014 Re…

9079. Behavioral Counseling to Prevent Skin Cancer: USPSTF Recommendation Statement (pdf file)
      www.uspreventiveservicestaskforce.org/home/getfilebytoken/5UgQm-zskVEKmcVnczHxGY
      July 01, 2012 - Behavioral Counseling to Prevent Skin Cancer: USPSTF Recommendation Statement Behavioral Counseling to Prevent Skin Cancer: U.S. Preventive Services Task Force Recommendation Statement Virginia A. Moyer, MD, MPH, on behalf of the U.S. Preventive Services Task Force* Description: Update of the 2003 U.S. Preventive Se…

9080. Coronavirus Disease 2019 (COVID-19) and Diagnostic Error | PSNet
      psnet.ahrq.gov/primer/coronavirus-disease-2019-covid-19-and-diagnostic-error
      July 30, 2020 - Coronavirus Disease 2019 (COVID-19) and Diagnostic Error Citation Text: Desai AN, Romano PS. Coronavirus Disease 2019 (COVID-19) and Diagnostic Error. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022. Copy Citation Format: …