-
www.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide4/apb.html
August 01, 2022 - Event Investigation and Analysis Guide: Appendix B
Detailed Review Timeline
Event Type:
Individuals Interviewed:
NAME
TITLE/ROLE
Nurse #1
Charge nurse
Nurse #2
RN
CNA X
Nursing tech
Manager MS
Manager
Pertinent Interview Findings
There was only one certifi…
-
www.ahrq.gov/cahps/surveys-guidance/helpful-resources/analysis/index.html
July 01, 2025 - Analyzing CAHPS Survey Data
Users of CAHPS surveys may take a few different approaches to analyzing their data to generate results that can be reported to healthcare providers, administrators, and consumers. The CAHPS team supports users in conducting their analyses of the closed-ended surveys by developing and…
-
www.ahrq.gov/patient-safety/news-events/psaw-2021/index.html
July 01, 2022 - Patient Safety Awareness Week
AHRQ and colleagues from the U.S. Department of Health and Human Services, the Health Resources and Services Administration, the Institute for Healthcare Improvement, and the entire patient safety community are collaborating to observe Patient Safety Awareness Week. While AHRQ's …
-
psnet.ahrq.gov/issue/swift-new-tool-identifying-prospective-hazards
February 03, 2021 - Commentary
Beyond FMEA: the structured what-if technique (SWIFT).
Citation Text:
Card AJ, Ward JR, Clarkson PJ. Beyond FMEA: The structured what-if technique (SWIFT). J Healthc Risk Manag. 2012;31(4):23-29. doi:10.1002/jhrm.20101.
Copy Citation
Format:
DOI Google Scholar Bi…
-
psnet.ahrq.gov/issue/patient-safety-and-quality-evidence-based-handbook-nurses
May 29, 2024 - Book/Report
Patient Safety and Quality: An Evidence-Based Handbook for Nurses.
Citation Text:
Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Hughes RG, ed. Rockville, MD: Agency for Healthcare Research and Quality; 2008. AHRQ Publication No. 08-0043.
Copy Ci…
-
digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/dansky-kh-et-al-1999
January 01, 1999 - Dansky KH et al. 1999 "Electronic medical records: are physicians ready?"
Reference
Dansky KH, Gamm LD, Vasey JJ, et al. Electronic medical records: are physicians ready? Practitioner application. J Healthc Manag 1999;44(6):440.
Abstract
"The use of electronic medical records [EMR] in healthc…
-
digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/chen-c-et-al-2009
January 01, 2009 - Chen C et al. 2009 "The Kaiser Permanente Electronic Health Record: transforming and streamlining modalities of care."
Reference
Chen C, Garrido T, Chock D, et al. The Kaiser Permanente electronic health record: transforming and streamlining modalities of care. Health Aff 2009;28(2):323-333.
Abs…
-
psnet.ahrq.gov/issue/pharmacy-nursing-intervention-improve-accuracy-and-completeness-medication-histories
May 29, 2014 - Commentary
Pharmacy–nursing intervention to improve accuracy and completeness of medication histories.
Citation Text:
Tessier EG, Henneman EA, Nathanson BH, et al. Pharmacy–nursing intervention to improve accuracy and completeness of medication histories. American Journal of Health-Sys…
-
www.ahrq.gov/sites/default/files/wysiwyg/research/publications/pubcomguide/Talent-Release-fillable-form.pdf
April 01, 2024 - Talent Release Form
Talent Release Form
Instructions
This Talent Release Form must be completed by nongovernment people hired as
narrators, actors, extras, or models for a scripted video, audio recording, or photo
session. This includes paid and unpaid talent – anyone who will be recognizable in the
fina…
-
psnet.ahrq.gov/issue/nurse-driven-system-improving-patient-quality-outcomes
October 12, 2011 - Commentary
A nurse-driven system for improving patient quality outcomes.
Citation Text:
Johnson K, Hallsey D, Meredith RL, et al. A nurse-driven system for improving patient quality outcomes. J Nurs Care Qual. 2006;21(2):168-175.
Copy Citation
Format:
Google Scholar PubMe…
-
integrationacademy.ahrq.gov/sites/default/files/2020-07/Update_Geriatric_Depression_Scale-15.pdf
January 01, 2020 - Geriatric Depression Scale-15 (short version)
Geriatric Depression Scale (Short Form)
Patient’s Name: Date:
Instructions: Choose the best answer for how you felt over the pas…
-
digital.ahrq.gov/ahrq-funded-projects/intervention-inc-interactive-family-centered-mhealth-tool-reduce-obesity-risk
January 01, 2023 - Intervention INC: An Interactive Family-Centered mHealth Tool to Reduce Obesity Risk in Urban Minority Preadolescents
Project Description
Events
A family-centered multi-component digital tool with an innovative communication approach may reduce childhood obesity risk, as …
-
psnet.ahrq.gov/issue/preventing-errors-when-preparing-and-administering-medications-enteral-feeding-tubes
November 30, 2016 - Newspaper/Magazine Article
Preventing errors when preparing and administering medications via enteral feeding tubes.
Citation Text:
Preventing errors when preparing and administering medications via enteral feeding tubes. ISMP Medication Safety Alert! Acute care edition. November 17, 202…
-
psnet.ahrq.gov/issue/survey-results-pharmacists-provide-support-enhance-organizational-response-codes
November 02, 2022 - Newspaper/Magazine Article
Survey results from pharmacists provide support to enhance the organizational response to codes.
Citation Text:
Survey results from pharmacists provide support to enhance the organizational response to codes. ISMP Medication Safety Alert! Acute care edition. Oc…
-
psnet.ahrq.gov/issue/healthgrades-sixth-annual-patient-safety-american-hospitals-study
October 25, 2013 - Book/Report
HealthGrades Sixth Annual Patient Safety in American Hospitals Study.
Citation Text:
HealthGrades Sixth Annual Patient Safety in American Hospitals Study. Golden, CO: HealthGrades, Inc.; April 2009.
Copy Citation
Save
Save to your library
…
-
psnet.ahrq.gov/issue/vanishing-nonforensic-autopsy
February 09, 2011 - Commentary
The vanishing nonforensic autopsy.
Citation Text:
Shojania KG, Burton EC. The vanishing nonforensic autopsy. N Engl J Med. 2008;358(9):873-5. doi:10.1056/NEJMp0707996.
Copy Citation
Format:
DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote …
-
psnet.ahrq.gov/issue/improve-health-care-focus-fixing-systems-not-people
September 08, 2021 - Newspaper/Magazine Article
To improve health care, focus on fixing systems — not people.
Citation Text:
Mate KS, Clark J, Salvon-Harman J. To improve health care, focus on fixing systems — not people. Harvard Business Review. July 12, 2024;
Copy Citation
Format:
Google Scho…
-
psnet.ahrq.gov/issue/pharmacy-led-medication-reconciliation-best-practice
September 30, 2020 - Newspaper/Magazine Article
Pharmacy-led medication reconciliation is best practice.
Citation Text:
Pharmacy-led medication reconciliation is best practice. Tanski MC. Pharmacy Times Health Systems edition. September 2023;12(5):34-35.
Copy Citation
Save
Save to y…
-
psnet.ahrq.gov/issue/government-and-industry-fail-protect-public-when-they-suggest-carefully-following
February 24, 2016 - Newspaper/Magazine Article
Government and industry fail to protect the public when they suggest "carefully following instructions" is enough to prevent vaccine errors.
Citation Text:
Government and industry fail to protect the public when they suggest "carefully following instructions" i…
-
psnet.ahrq.gov/issue/administration-concentrated-potassium-chloride-injection-during-code-still-deadly
May 02, 2018 - Newspaper/Magazine Article
Administration of concentrated potassium chloride for injection during a code: still deadly!
Citation Text:
Administration of concentrated potassium chloride for injection during a code: still deadly! ISMP Medication Safety Alert! Acute care edition. June …