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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/assessing-current-policies.html
January 01, 2013 - CANDOR
Family-Centered Rounds Toolkit
MATCH Toolkit
NICU Toolkit
Pressure Injury … analysis by:
Location and time of fall
Shift and day of week
Type of injury
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/fall-prevention/implementation-guide/get-ready.html
September 01, 2017 - CANDOR
Family-Centered Rounds Toolkit
MATCH Toolkit
NICU Toolkit
Pressure Injury … learn more about measurement, see the supplementary training webinar Measuring Fall and Fall-Related Injury
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/asp-pneumonitis-one-page.pdf
November 01, 2019 - Aspiration Pneumonitis/Pneumonia
Diagnosis
• Aspiration pneumonitis is an abrupt chemical injury
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-203-section-6-b-workgroup.pdf
September 18, 2014 - providers dedicated to skin care and HAPU prevention, e.g., an
institution-wide skin-care council led by wound … stakeholders including CCM, ENT, General Surgery, Plastic
Surgery, Dermatology, Transplant Surgery, Trauma … • Staging of Pressure ulcers would need to be done by a wound care expert vs. the PICU staff nurse … • Evaluation of potential pressure injury is labor intensive and subjective; data cannot be obtained … • Given the severity of illness/injury in PICU patients, 48 or 72 hours seems more reasonable to
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-200-section-6-b-expert-workgroup.pdf
September 18, 2014 - providers dedicated to skin care and HAPU prevention, e.g., an
institution-wide skin-care council led by wound … stakeholders including CCM, ENT, General Surgery, Plastic
Surgery, Dermatology, Transplant Surgery, Trauma … • Staging of Pressure ulcers would need to be done by a wound care expert vs. the PICU staff nurse … • Evaluation of potential pressure injury is labor intensive and subjective; data cannot be obtained … • Given the severity of illness/injury in PICU patients, 48 or 72 hours seems more reasonable to
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-199-section-6-b-pmcoe-picu-expert-workgroup.pdf
September 18, 2014 - providers dedicated to skin care and HAPU prevention, e.g., an
institution-wide skin-care council led by wound … stakeholders including CCM, ENT, General Surgery, Plastic
Surgery, Dermatology, Transplant Surgery, Trauma … • Staging of Pressure ulcers would need to be done by a wound care expert vs. the PICU staff nurse … • Evaluation of potential pressure injury is labor intensive and subjective; data cannot be obtained … • Given the severity of illness/injury in PICU patients, 48 or 72 hours seems more reasonable to
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Walsh_74.pdf
May 28, 2008 - This resulted in injury
in 2 of 90 patients and in excessive
pain that could have been ameliorated … A medication error causing injury to the patient (preventable adverse drug event).
2. … error without injury).
3. … Medication error with little potential for injury.
4. … Pediatric
acetaminophen overdose: risk factors associated with
hepatocellular injury.
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu3.html
October 01, 2014 - J Wound Ostomy Continence Nurs 2005;32:302-6.
Gray M, Bliss DZ, Doughty DB. … Determining the correct etiology of wounds: Many different types of lesions may occur on the skin and … The level and completeness of the spinal cord injury is critical in this determination. … Adv Skin Wound Care 2009;22(2):83-92.
Magan MA, Maklebust J. … Adv Skin Wound Care 2008;21(3):124-33.
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ce.effectivehealthcare.ahrq.gov/health-literacy/professional-training/lepguide/chapter1.html
September 01, 2020 - not be harmed by the care that is intended to help them, and they should remain free from accidental injury … Adverse event*:
Any injury caused by medical care. … include pneumothorax from central venous catheter placement, anaphylaxis to penicillin, postoperative wound … Similarly, postoperative wound infections count as adverse events even if the operation proceeded with … Near miss/close call * :
An event or situation that did not produce patient injury, but only because
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/pruhealing/puh-assessment.docx
April 08, 2016 - Granulation tissue is the growth of small blood vessels and connective tissue to fill in full thickness wounds … In partial thickness wounds it can occur throughout the wound bed as well as from the wound edges. … In full thickness wounds it occurs from the edges only. … <0.5 cm into wound bed
4= 25% to <50% wound covered
5= <25% wound covered … Stage 3
Stage 4
Unstageable
Suspected Deep Tissue Injury
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/scenarios/CombatCare.pdf
March 18, 2014 - They seem overwhelmed by the extent of the patient’s injuries. … the situational leader when the team becomes
temporarily immobilized by the sight of the patient’s injuries … has an actively
hemorrhaging 6-inch laceration on his right lower leg but no other obvious signs of injury … While the physician
is reviewing wound care instructions with the mother, the child complains of nausea
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-hcfd.pdf
November 01, 2023 - (e.g., units, rooms, equipment, logistics, and technologies) can improve patient outcomes, reduce injuries … nurse call
systems) on outcomes such as workplace satisfaction,
privacy, patient safety, and nurse injuries … Kent State
University
Kent, Ohio
R18 HS27261 [Grant]
Towards a Model of
Safety and Care for
Trauma … Design
2019-
2023
$2,445,076 Purpose: Investigate obstacles to improved patient
safety outcomes in trauma … design
guide model that serves as a primary source to direct the
design of the next generation of trauma
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/references.html
January 01, 2013 - CANDOR
Family-Centered Rounds Toolkit
MATCH Toolkit
NICU Toolkit
Pressure Injury … Preventing falls and eliminating injury at Ascension Health. … Reducing serious injury from falls in two veterans' hospital medical-surgical units.
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/report/apviia.html
June 01, 2010 - Effectiveness Reviews
Facilities
Home and Community Resources
Findings Report
Injuries … of State Directors of Developmental Disabilities Services, the National Associations of State Brain Injury … agencies, units on aging, agencies serving individuals with physical disabilities, traumatic brain injury … Medicaid-eligible individuals who are frail and elderly, have intellectual and developmental disabilities, head injuries … of State Directors of Developmental Disabilities Services, the National Associations of State Brain Injury
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ce.effectivehealthcare.ahrq.gov/research/findings/nhqrdr/2014chartbooks/hispanichealth/part2.html
May 01, 2018 - chemical dependency (measured by deaths due to cirrhosis); diabetes; homicide and accidents (unintentional injuries
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/report/index.html
June 01, 2010 - Effectiveness Reviews
Facilities
Home and Community Resources
Findings Report
Injuries
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module3/ebcommunication.pdf
August 20, 2013 - Deering, et al.,13 reported reduced rates of needle stick injuries and medication and
transfusion
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/roadmap.html
January 01, 2013 - CANDOR
Family-Centered Rounds Toolkit
MATCH Toolkit
NICU Toolkit
Pressure Injury … 5.1
Collect the right data to learn about falls, fall-related injuries, and their causes
Tool 5A,
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ce.effectivehealthcare.ahrq.gov/news/newsletters/e-newsletter/836.html
October 01, 2022 - Development and external validation of the KIIDS-TBI tool for managing children with mild traumatic brain injury … and intracranial injuries.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/c1_combo_prioritizationworksheet.pdf
June 29, 2016 - Rate on scale of 10 (agree/high) to 0 (disagree/low)
PSI 14 Postoperative
Wound … Dehiscence
PSI 15 Accidental
Puncture or Laceration
PSI 17 Birth Trauma-
Injury to Neonate
PSI … 18 Obstetric Trauma-
Vaginal Delivery With
Instrument
PSI 19 Obstetric Trauma-
Vaginal Delivery … 09 Postoperative
Respiratory Failure Rate
PDI 10 Postoperative
Sepsis Rate
PDI 11 Postoperative
Wound