Results

Total Results: 2,105 records

Showing results for "included".

41. Using simulation to augment root cause analysis for patient safety incidents at a tertiary care women's and children's hospital: a qualitative feasibility study. | PSNet
    psnet.ahrq.gov/issue/using-simulation-augment-root-cause-analysis-patient-safety-incidents-tertiary-care-womens
    January 22, 2025 - Barriers included concerns over simulation being punitive , for example, to justify firing staff involved

42. Using a learning system approach to improve safety for prone-position ventilation patients. | PSNet
    psnet.ahrq.gov/issue/using-learning-system-approach-improve-safety-prone-position-ventilation-patients
    January 10, 2024 - Issues identified included medical device-related pressure injuries and device dislodgement, concerns

43. The impact of pharmacists-led medicines reconciliation on healthcare outcomes in secondary care: a systematic review and meta-analysis of randomized controlled trials. | PSNet
    psnet.ahrq.gov/issue/impact-pharmacists-led-medicines-reconciliation-healthcare-outcomes-secondary-care-systematic
    August 07, 2024 - meta-analysis examined the efficacy of pharmacist-led medication reconciliation across 18 trials that included

44. Are interventions to reduce interruptions and errors during medication administration effective?: a systematic review. | PSNet
    psnet.ahrq.gov/issue/are-interventions-reduce-interruptions-and-errors-during-medication-administration-effective
    August 28, 2024 - These efforts included sterile cockpit approaches derived from the aviation industry.

45. AHRQ Safety Program for Intensive Care Units: Preventing CLABSI and CAUTI: Final Report. | PSNet
    psnet.ahrq.gov/issue/ahrq-safety-program-intensive-care-units-preventing-clabsi-and-cauti-final-report
    April 06, 2022 - Recommendations for collaborative implementation success are included.

46. Identification of adverse events in ground transport emergency medical services. | PSNet
    psnet.ahrq.gov/issue/identification-adverse-events-ground-transport-emergency-medical-services
    August 26, 2020 - The guiding principles included a focus on events that were potentially preventable during the continuum

47. Impact of leadership walkarounds on operational, cultural and clinical outcomes: a systematic review. | PSNet
    psnet.ahrq.gov/issue/impact-leadership-walkarounds-operational-cultural-and-clinical-outcomes-systematic-review
    October 12, 2022 - Organizational outcomes included staff perception of safety culture , near miss reports, teamwork,

48. Sleep deprivation and medication administration errors in registered nurses- a scoping review. | PSNet
    psnet.ahrq.gov/issue/sleep-deprivation-and-medication-administration-errors-registered-nurses-scoping-review
    September 23, 2020 - Based on 18 included studies, the authors conclude that insufficient experimental or observational evidence

49. Nurses' perceived causes of medication administration errors: a qualitative systematic review. | PSNet
    psnet.ahrq.gov/issue/nurses-perceived-causes-medication-administration-errors-qualitative-systematic-review
    September 16, 2020 - Perceived causes included lack of medication knowledge, fatigue , complacency, heavy workloads, and

50. Residency training in handoffs: a survey of program directors in psychiatry. | PSNet
    psnet.ahrq.gov/issue/residency-training-handoffs-survey-program-directors-psychiatry
    January 01, 2019 - Barriers to developing such training included difficulty attaining buy-in from clinicians and standardizing

51. The influence of bullying on nursing practice errors: a systematic review. | PSNet
    psnet.ahrq.gov/issue/influence-bullying-nursing-practice-errors-systematic-review
    January 30, 2019 - Fourteen articles were included in the review and four themes were identified: the influence of work

52. Clinical clerkship students' perceptions of (un)safe transitions for every patient. | PSNet
    psnet.ahrq.gov/issue/clinical-clerkship-students-perceptions-unsafe-transitions-every-patient
    October 19, 2022 - The most common cause of frustration among students was poor communication, which included unclear discussion

53. Evaluating iatrogenic prescribing: development of an oncology-focused trigger tool. | PSNet
    psnet.ahrq.gov/issue/evaluating-iatrogenic-prescribing-development-oncology-focused-trigger-tool
    December 23, 2020 - The final tool included 22 triggers and achieved high interrater reproducibility, but had only a modest

54. A safety evaluation of the impact of maternity-orientated human factors training on safety culture in a tertiary maternity unit. | PSNet
    psnet.ahrq.gov/issue/safety-evaluation-impact-maternity-orientated-human-factors-training-safety-culture-tertiary
    October 19, 2022 - describes a multidisciplinary human factors training intervention for labor and delivery care that included

55. Learning from Bristol: The Report of the Public Inquiry into Children's Heart Surgery at the Bristol Royal Infirmary 1984--1995. | PSNet
    psnet.ahrq.gov/issue/learning-bristol-report-public-inquiry-childrens-heart-surgery-bristol-royal-infirmary-1984
    October 20, 2021 - Their objectives included understanding what happened in Bristol, assessing the quality of care and system

56. 2022 Updated Results for the AHRQ Surveys on Patient Safety Culture (SOPS) Diagnostic Safety Supplemental Items. | PSNet
    psnet.ahrq.gov/issue/2022-updated-results-ahrq-surveys-patient-safety-culture-sops-diagnostic-safety-supplemental
    April 06, 2022 - Identified weaknesses included lack of discussions about misdiagnoses when they occurred.

57. Clinical criteria to screen for inpatient diagnostic errors: a scoping review. | PSNet
    psnet.ahrq.gov/issue/clinical-criteria-screen-inpatient-diagnostic-errors-scoping-review
    December 12, 2018 - These included triggers that are already in use for detecting adverse events (such as cardiopulmonary

58. Unveiling the hidden struggle of healthcare students as second victims through a systematic review. | PSNet
    psnet.ahrq.gov/issue/unveiling-hidden-struggle-healthcare-students-second-victims-through-systematic-review
    September 06, 2023 - The authors suggest that instruction about second victims could be included in curriculum on identifying

59. Opportunities to improve diagnosis in emergency transfers to the pediatric intensive care unit. | PSNet
    psnet.ahrq.gov/issue/opportunities-improve-diagnosis-emergency-transfers-pediatric-intensive-care-unit
    June 28, 2023 - This retrospective study included 129 pediatric emergency transfer cases and examined the relationship

60. Multiple Failures in Test Results Follow-up for a Patient Diagnosed with Prostate Cancer at the Hampton VA Medical Center in Virginia. | PSNet
    psnet.ahrq.gov/issue/multiple-failures-test-results-follow-patient-diagnosed-prostate-cancer-hampton-va-medical
    July 26, 2023 - Seven recommendations are included for improving abnormal test result communication and error management