-
psnet.ahrq.gov/node/73468/psn-pdf
July 07, 2021 - implementation-communication-didactics-obgyn-residents-disclosure-adverse-
perioperative
Medical residents are frequently involved
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psnet.ahrq.gov/node/844785/psn-pdf
September 11, 2019 - a
high potential for information loss due to the rapidity of handoffs and the multiple disciplines involved
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psnet.ahrq.gov/node/73325/psn-pdf
May 26, 2021 - emergency medical services (EMS) employees in Germany found
nearly three-quarters of respondents had been involved
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psnet.ahrq.gov/node/72813/psn-pdf
March 10, 2021 - This article discusses inequities in maternal health outcomes and provision of care, factors involved
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psnet.ahrq.gov/node/837777/psn-pdf
August 03, 2020 - suggests improvements in current
approaches to avoid the use of prosecutorial methods to hold those involved
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psnet.ahrq.gov/node/837070/psn-pdf
May 11, 2022 - Falls represented 1% of
all safety reports between 2014 and 2020 and most commonly involved falls from
-
psnet.ahrq.gov/node/847053/psn-pdf
April 05, 2023 - This article provides an overview of the regulatory bodies in Norway that are involved in investigating
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psnet.ahrq.gov/node/47771/psn-pdf
April 24, 2019 - second victim effect has been used to describe the emotional impact that providers may experience
when involved
-
psnet.ahrq.gov/node/73568/psn-pdf
August 04, 2021 - coping-strategies-health-care-providers-second-victims-systematic-review
https://psnet.ahrq.gov/primer/second-victims-support-clinicians-involved-errors-and-adverse-events
-
psnet.ahrq.gov/node/74135/psn-pdf
December 01, 2021 - powerful emotions, rapid change
and progression, family involvement, multiple patients and providers involved
-
psnet.ahrq.gov/node/48102/psn-pdf
August 07, 2019 - duration-second-victim-symptoms-aftermath-patient-safety-incident-and-association-level
https://psnet.ahrq.gov/primer/second-victims-support-clinicians-involved-errors-and-adverse-events
-
psnet.ahrq.gov/node/72638/psn-pdf
January 13, 2021 - Manipulations most commonly
involved oral liquids and intravenous orders and occurred most often in
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.296_slideshow.ppt
April 01, 2013 - 22301322
*
Making PN Use Safer
Ideally the processes should be standardized and experts should be involved … Institutions should manage an adequate volume of PN patients to maintain expertise
Caregivers involved … 222. http://www.ncbi.nlm.nih.gov/pubmed/23112276
*
Pharmacists and PN
Pharmacists may not be involved … do not dedicate pharmacist time to review or clarify PN orders
When knowledgeable pharmacists are involved … guidelines and best practices documents
To enhance safety and reduce PN-related errors, providers should be involved
-
psnet.ahrq.gov/node/35146/psn-pdf
November 04, 2015 - This article uses examples from several hospitals to illustrate the behavioral and financial issues involved
-
psnet.ahrq.gov/node/50841/psn-pdf
January 29, 2020 - Differentiate the human and technologic roles involved in delivering the correct blood to the correct … Infrastructure
The pathway of blood delivery is inherently complex because multiple patient care areas are involved … Interview staff involved to determine what aspects of the system failed and why.
3. … review may include re-educating the staff on the current SOP, evaluating
other samples processed by the involved … Re-addressing the six core elements of competency of the staff members involved, per CLIA, is required
-
psnet.ahrq.gov/node/39080/psn-pdf
November 04, 2009 - discusses an instance of mistakenly implanted embryos and the impact of the error on the two
families involved
-
psnet.ahrq.gov/innovation/handshake-antimicrobial-stewardship-model-recognize-and-prevent-diagnostic-errors
September 08, 2021 - The Safer Dx Instrument is designed to retrospectively determine whether a clinical scenario involved … the “Good Catch” cases and there was 80% agreement between the two reviewers as to whether the case involved
-
psnet.ahrq.gov/primer/reporting-patient-safety-events
March 30, 2022 - used as a general term for all voluntary patient safety event reporting systems, which rely on those involved … Initial reports often come from the frontline personnel directly involved in an event or the actions … Because event reports usually are submitted by personnel involved in the events themselves, these caregivers
-
psnet.ahrq.gov/node/844547/psn-pdf
February 15, 2023 - evidence-and-consensus-based-definition-second-victim-strategic-topic-healthcare-quality
https://psnet.ahrq.gov/primer/second-victims-support-clinicians-involved-errors-and-adverse-events
-
psnet.ahrq.gov/node/847531/psn-pdf
April 12, 2023 - identified, including meaningful acknowledgment of harm and opportunities for patients and families to
be involved