Results

Total Results: 2,566 records

Showing results for "occurred".

121. Introduction | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-pediatric-safety-1.html
     August 01, 2023 - focus of pediatric research, particularly in tertiary children’s hospitals. 6-11 Less exploration has occurred

122. Tool: I-PASS | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/teamstepps-program/curriculum/communication/tools/ipass.html
     July 01, 2023 - to support a patient are prepared for situations they might not have considered before the handoff occurred

123. 2023 National Healthcare Quality and Disparities Report (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2023-nhqdr-es-rev.pdf
     January 01, 2023 - ■ The change in racial and ethnic diversity has occurred largely in younger age groups. … The slowdown occurred after passage of several federal COVID-19-related bills, which included temporary … This was due, in part, to the emergence of more transmissible variants of the virus, which occurred … • Most COVID-19 deaths occurred among adults age 65 and over. … But large numbers of deaths also occurred among adults ages 50-64 and 18-49, especially during surges

124. Development and Validation of the Medication Administration Error Reporting Survey (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Wakefield2.pdf
     January 01, 2003 - First, by definition, recognition that an error has occurred means that the error happened some time … Because of this, recognition that an error has occurred is very difficult.20 Second, even if an error … activities leading to patients receiving medication, they are often “blamed” for errors that may have occurred … When errors occur, they are likely to be viewed as failures of character (i.e., the error occurred … • Nurses do not recognize an error occurred. • Medication error is not clearly defined.

125. Event Investigation and Analysis Guide: Appendix C | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide4/apc.html
     August 01, 2022 - This format helps to utilize the information found in the investigation to understand why the event occurred

126. Conclusion | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-patients-source-understanding-dx-error-vol2-5.html
     June 01, 2023 - situations that pose the greatest challenges for patients and families to reliably assess what has occurred

127. Intravenous Infusion Safety Initiative: Collaboration, Evidence-Based Best Practices, and “Smart” Technology Help Avert High-Risk Adverse Drug Events and Improve Patient Outcomes (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Maddox_38.pdf
     March 26, 2008 - devices were used with critical care patient types, 52 percent of the highest risk-averted overdoses occurred … 11, 12, 13, 14 Leape, et al., showed that 38 percent of medication errors causing preventable ADEs occurred … Of the nonintercepted potential ADEs and preventable ADEs, 51 percent occurred during the administration … modules were used with critical care patient types, 52 percent of highest risk averted overdoses occurred … drug overdose, these overdoses would have been associated with 6-month costs of $1,968,000, had they occurred

128. Antibiotic-Patient-Safety-Facilitator-Guide (doc file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/antibiotic-patient-safety-facilitator-guide.docx
     June 01, 2021 - We’re only going to focus on those that occurred in the long-term care facility. … SAY: A second problem occurred when the daytime health care practitioner prescribed antibiotics. … Science of Safety SAY: Let’s apply the three basic principles of safe design to the problems that occurred

129. Pocket Cards_4 Moments (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/four-moments/poster-three-options.pdf
     November 01, 2019 - Pocket Cards_4 Moments Th e Fo ur M om en ts o f A nt ib io tic D ec isi on M ak in g AHRQ Pub. No. 17(20)-0028-EF November 2019 Moment 1 occurs at the time that initiation of antibiotic therapy is being considered. Ask, “Does my patient have an infection that requires antibiotics?” Mome…

130. Silence A Commentary | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/patient-safety/reports/liability/silence.html
     August 01, 2017 - There are four things patients and families want after medical harm has occurred: tell us what happened … after medical harm. 5 I believe there is a fifth desire for some patients and families after harm has occurred

131. Chapter 3. Development of the Data Infrastructure | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/practiceimprovement/delivery-initiative/ihs/chapter3.html
     December 01, 2017 - The identified differences were minimal and were primarily due to registration updates that occurred … Admissions that occurred within 30 days of a previous inpatient discharge were identified as readmissions … Diabetes education visits are visits that occurred in diabetes education clinics and are not counted

132. Implementation Planning | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/teamstepps-program/curriculum/implement/activity/plan.html
     February 01, 2024 - Measure before and after you implement TeamSTEPPS to see whether the desired changes occurred.

133. Federal Interagency Workgroup: Improving Diagnostic Safety and Quality in Healthcare (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/topics/dagnostic-safety-workgroupmeeting-notes-july2022.pdf
     November 03, 2022 - Workgroup Summary: The latest workgroup meeting occurred virtually on July 25, 2022, and was attended

134. Federal Interagency Workgroup on Improving Diagnostic Safety and Quality in Health Care March Meeting Summary (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/topics/meeting-summary-031720.pdf
     July 23, 2020 - Workgroup Summary: The latest workgroup meeting occurred virtually on March 17, 2020, from 10 a.m.

135. Section 8: The Care Management Evidence Base (continued) | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm8a.html
     October 01, 2014 - quality of life improved significantly at 6 months, whereas at 12 months, no significant improvement occurred … symptoms were reduced significantly, but at 12 months, no significant change in asthma symptoms had occurred … Similarly, the same study found that after 2 weeks, no differences occurred in asthma planning visits … same study found that after two weeks, no differences in asthma planning visits or acute care visits occurred

136. The New York Model: Root Cause Analysis Driving Patient Safety Initiative to Ensure Correct Surgical and Invasive Procedures (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Faltz_56.pdf
     March 27, 2008 - These errors occurred in a wide variety of locations (Table 3). Table 3. … Of the latter, two of the four cases occurred when the vendor representative handed the wrong component … Presentations included a detailed description of a recent wrong-sided surgical sentinel event that occurred … Of these, two-thirds occurred in settings other than the operating room.

137. Adverse Drug Events Occurring in U.S. Hospitals | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/data/infographics/adverse-drug-events.html
     August 01, 2018 - Skip to main content An official website of the Department of Health and Human Services Careers Contact Us Español FAQs Search all AHRQ sites Search small Search Menu …

138. Leading Teams (Instructor Guide) (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/teamstepps/longtermcare/module4/ts2-0ltc_module4_ig_lead.pdf
     May 10, 2017 - When emergencies have occurred at these events in the past, many people come running and there is … include: • Accurate recounting and documentation of key events; • Analysis of why the event occurred … • Recap the situation, background, and key events that occurred. … • Accurate recounting and documentation of key events; • Analysis of why the event occurred, what worked

139. Engage Patients and Families for Perinatal Safety (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/engage/pf-engagement-facilitator-guide.pdf
     May 01, 2017 - Generally, only findings that are reasonably certain to have occurred and unlikely to change should … investigate and analyze it (e.g., a root cause analysis may be conducted) to determine whether patient harm occurred

140. Introduction | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/diagnostic-safety/resources/issue-briefs/education-dx-outcomes-1.html
     March 01, 2022 - amount, content, and quality within and across professions. 10 - 12 Much learning about diagnosis has occurred