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www.ahrq.gov/hai/tools/mvp/modules/vae/monitoring-fac-guide.html
February 01, 2017 - Monitoring Ventilator-Associated Events: Facilitator Guide
AHRQ Safety Program for Mechanically Ventilated Patients
Slide 1: Monitoring Ventilator-Associated Events
Say:
Today, we will discuss monitoring ventilator-associated events.
Slide 2: Learning Objectives
Say:
After this session, you will…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/sat-sbt-factsheet.docx
January 01, 2017 - Facilitator Guide: Build Your SSI Prevention Bundle
Did You Know?
· Spontaneous awakening trials (SAT) and spontaneous breathing trials (SBT) reduce the length of mechanical ventilation, thereby reducing the risk for developing ventilator-associated pneumonia (VAP).
· In 2012, Luetz’s review article focusing on 14 stu…
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www.ahrq.gov/hai/tools/mvp/modules/technical/ltvv-fac-guide.html
October 01, 2020 - Measure Descriptions for Low Tidal Volume Ventilation: Facilitator Guide
AHRQ Safety Program for Mechanically Ventilated Patients
Slide 1: Measure Descriptions for Low Tidal Volume Ventilation
Say:
In this module, you will learn about the data measures and definitions you will use to evaluate low tidal …
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www.ahrq.gov/hai/tools/mvp/modules/technical/early-mobility-tool.html
January 01, 2017 - Daily Early Mobility Data Collection Tool
AHRQ Safety Program for Mechanically Ventilated Patients
Hospital ID# ___________ Unit ID# ___________ Date (mm/dd/yyyy) ___________
Fill out for all beds
Fill out if patient is intubated or has tracheostomy (trached) and is mechanically v…
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psnet.ahrq.gov/node/866817/psn-pdf
January 01, 2025 - Longitudinal study of the manifestations and mechanisms
of technology-related prescribing errors in pediatrics.
September 25, 2024
Raban MZ, Fitzpatrick E, Merchant A, et al. Longitudinal study of the manifestations and mechanisms of
technology-related prescribing errors in pediatrics. J Am Med Inform Assoc. 2025;3…
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psnet.ahrq.gov/node/867087/psn-pdf
January 01, 2025 - The impact of surgical complications on obstetricians'
and gynecologists' wellbeing and coping mechanisms as
second victims.
November 6, 2024
Collings R, Potter C, Gebski V, et al. The impact of surgical complications on obstetricians’ and
gynecologists’ well-being and coping mechanisms as second victims. Am J Obs…
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psnet.ahrq.gov/node/855433/psn-pdf
November 15, 2023 - Room for resilience: a qualitative study about
accountability mechanisms in the relation between work-
as-done (WAD) and work-as-imagined (WAI) in hospitals.
November 15, 2023
Weenink J-W, Tresfon J, van de Voort I, et al. Room for resilience: a qualitative study about accountability
mechanisms in the relation bet…
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psnet.ahrq.gov/node/838312/psn-pdf
October 12, 2022 - Causes of adverse events in home mechanical
ventilation: a nursing perspective.
October 12, 2022
Lipprandt M, Liedtke W, Langanke M, et al. Causes of adverse events in home mechanical ventilation: a
nursing perspective. BMC Nurs. 2022;21(1):264. doi:10.1186/s12912-022-01038-2.
https://psnet.ahrq.gov/issue/causes-a…
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psnet.ahrq.gov/node/840175/psn-pdf
November 16, 2022 - Mechanical Prosthetic Valve Thrombosis with
Thromboembolism.
November 16, 2022
Hedayati N, White RO. Mechanical Prosthetic Valve Thrombosis with Thromboembolism. PSNet [internet].
2022.
https://psnet.ahrq.gov/web-mm/mechanical-prosthetic-valve-thrombosis-thromboembolism
The Case
A 61-year-old woman presented to …
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psnet.ahrq.gov/node/867701/psn-pdf
August 01, 2017 - Toolkit To Improve Safety for Mechanically Ventilated
Patients.
August 1, 2017
Agency for Healthcare Research and Quality . Toolkit To Improve Safety for Mechanically Ventilated
Patients. August 2017.
https://psnet.ahrq.gov/issue/toolkit-improve-safety-mechanically-ventilated-patients
Patients requiring mechanica…
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psnet.ahrq.gov/node/39409/psn-pdf
March 31, 2010 - Learning mechanisms to limit medication administration
errors.
March 31, 2010
Drach-Zahavy A, Pud D. Learning mechanisms to limit medication administration errors. J Adv Nurs.
2010;66(4). doi:10.1111/j.1365-2648.2010.05294.x.
https://psnet.ahrq.gov/issue/learning-mechanisms-limit-medication-administration-errors
…
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psnet.ahrq.gov/node/35660/psn-pdf
June 25, 2010 - Increased catheter-related bloodstream infection rates
after the introduction of a new mechanical valve
intravenous access port.
June 25, 2010
Maragakis LL, Bradley KL, Song X, et al. Increased catheter-related bloodstream infection rates after the
introduction of a new mechanical valve intravenous access port. In…
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psnet.ahrq.gov/node/43620/psn-pdf
October 29, 2014 - Error in intensive care: psychological repercussions and
defense mechanisms among health professionals.
October 29, 2014
Laurent A, Aubert L, Chahraoui K, et al. Error in intensive care: psychological repercussions and defense
mechanisms among health professionals. Crit Care Med. 2014;42(11):2370-8.
doi:10.1097/CC…
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psnet.ahrq.gov/node/42536/psn-pdf
August 13, 2014 - Levels of reflective thinking and patient safety: an
investigation of the mechanisms that impact on student
learning in a single cohort over a 5 year curriculum.
August 13, 2014
Ambrose LJ, Ker J. Levels of reflective thinking and patient safety: an investigation of the mechanisms that
impact on student learning i…
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psnet.ahrq.gov/node/44507/psn-pdf
July 18, 2016 - Six habits to enhance MET performance under stress: a
discussion paper reviewing team mechanisms for
improved patient outcomes.
July 18, 2016
Fein EC, Mackie B, Chernyak-Hai L, et al. Six habits to enhance MET performance under stress: A
discussion paper reviewing team mechanisms for improved patient outcomes. Aus…
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND_0030_06-19-2008.pdf
January 01, 2008 - Effective Health Care
Topic Number(s): 0090
Document Completion Date: 6-29-09
1
Results of Topic Selection Process & Next Steps
Mechanical thrombectomy devices in acute coronary syndromes will go forward for refinement as a
comparative effectiveness or effectiveness review. The scope of thi…
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/vte-prophyalaxis_research-protocol.pdf
March 01, 2011 - not reviewed the report, except as given the opportunity to do so through the
peer or public review mechanism … and have not reviewed
the report, except as given the opportunity to do so through the public review mechanism … professional conflicts of interest may submit comments on draft reports through the public comment
mechanism
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psnet.ahrq.gov/node/38767/psn-pdf
April 18, 2011 - Failed spinal anaesthesia: mechanisms, management,
and prevention.
April 18, 2011
Fettes PDW, Jansson J-R, Wildsmith JAW. Failed spinal anaesthesia: mechanisms, management, and
prevention. Br J Anaesth. 2009;102(6):739-48. doi:10.1093/bja/aep096.
https://psnet.ahrq.gov/issue/failed-spinal-anaesthesia-mechanisms-ma…
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/blood-clots-hip-knee-surgery_executive.pdf
March 01, 2012 - Given the
mechanism of action for these devices, bleeding should not
result from their use, so benefits
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psnet.ahrq.gov/node/42342/psn-pdf
December 31, 2014 - The safety of electronic prescribing: manifestations,
mechanisms, and rates of system-related errors
associated with two commercial systems in hospitals.
December 31, 2014
Westbrook JI, Baysari M, Li L, et al. The safety of electronic prescribing: manifestations, mechanisms, and
rates of system-related errors asso…