Results

Total Results: 4,281 records

Showing results for "occurred".

261. Development and Validation of the Medication Administration Error Reporting Survey (pdf file)
     www.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.

262. AHRQ Safety Program for MRSA Prevention
     www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/002-cusp-learning-defects.pptx
     October 01, 2024 - What actions occurred? What were people thinking and feeling? … What else was happening at the time the defect occurred?

263. Introduction | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/reports/issue-briefs/dxsafety-reimagining-healthcare-teams-1.html
     July 01, 2023 - Some of the most significant healthcare AI/ML advancements have occurred in diagnostics.

264. Introduction | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-reimagining-healthcare-teams-1.html
     July 01, 2023 - Some of the most significant healthcare AI/ML advancements have occurred in diagnostics.

265. 2023 National Healthcare Quality and Disparities Report (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2023-nhqdr-es.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

266. 2023 National Healthcare Quality and Disparities Report (pdf file)
     www.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

267. Appendix F. Hospital Practice Insights: Challenges and Solutions | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/implementation-guide/appendix-f.html
     September 01, 2017 - The team identified where breakdowns, workarounds, duplication, or variation occurred at each step and … contributed to policy development, training for nurses and therapists, and monitoring of falls that occurred … Scripting was rolled out to evening and night shifts, since most falls occurred during those times. … system to announce post-fall huddles using a specific code and noting the specific unit where the fall occurred … Forty percent of the falls occurred with staff in attendance, which may have prevented falls with injury

268. 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)
     www.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

269. Final Progress Report: Quality of bag mask ventilation in critically ill children (pdf file)
     www.ahrq.gov/sites/default/files/2024-05/nishisaki-report.pdf
     January 01, 2024 - Desaturation (SpO2<80%) or adverse TIAEs occurred in 5/20 (25%) of children with high-quality breath … Desaturation (SpO2<80%) or adverse TIAEs occurred in 5/20 (25%) of children with high-quality breath

270. Federal Interagency Workgroup: Improving Diagnostic Safety and Quality in Healthcare (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/topics/public-notes-meeting-summary-111921.pdf
     March 11, 2022 - Workgroup Summary: The latest Workgroup meeting occurred virtually on November 19, 2021, from 1 p.m.

271. Federal Interagency Workgroup: Improving Diagnostic Safety and Quality in Healthcare (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/topics/diagnostic-safety-workgroup-march-2022-meeting-notes.pdf
     January 01, 2022 - Workgroup Summary: The latest Workgroup meeting occurred virtually on March 11, 2022, from 11 a.m.

272. Health Care Consulting Group Uses AHRQ Research to Develop Cardiovascular Care Models for Women | Agency for Healthcare Research and Quality
     www.ahrq.gov/news/newsroom/case-studies/coe0606.html
     October 01, 2014 - "When a study came out about a certain drug or device, it never even occurred to me to ask how many men

273. Project Report - Lean Sigma (ppt file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/contentcalls/twomorees-slides/Two-More-Es-and-How-to-Spread-Dec-13-2011-508.ppt
     January 01, 2011 - Continued feedback of infection data that the team perceived as valid Improvements in safety culture that occurred

274. Facility Action Plan Template | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/tools/implement/action-plan.html
     March 01, 2017 - has done to communicate and share survey results with staff, and an understanding of what benefits occurred

275. Module 4: Teamwork and Communication: Material Use Guide | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module4/guide.html
     March 01, 2017 - facility leaders and administrators to share information with residents/families when an event has occurred

276. Antibiotic-Patient-Safety-Facilitator-Guide (doc file)
     www.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

277. Adverse Drug Events Occurring in U.S. Hospitals | Agency for Healthcare Research and Quality
     www.ahrq.gov/data/infographics/adverse-drug-events.html
     August 01, 2018 - Adverse Drug Events Occurring in U.S. Hospitals Adverse Drug Events Occurring in U.S. Hospitals (PDF, 1.5 MB) Source:   HCUP Statistical Brief #164: Characteristics of Adverse Drug Events Originating During the Hospital Stay, 2011

278. Final Progress Report: A Novel Debriefing Strategy for Interprofessional Simulation-Based Team Training (pdf file)
     www.ahrq.gov/sites/default/files/2024-01/vanschaik-report.pdf
     January 01, 2024 - On the rare occasions that interprofessional co-facilitation occurred prior to implementation of the … When this occurred, the discussion was brief and limited to generic statements about the importance … Discussions about medical management were less physician focused and more frequently occurred in the … Perspective taking was uncommon, and mostly occurred in the context of physician participants explaining … If so, why do you think they occurred?

279. Special Considerations for Measurement of Diagnostic Safety (continued) | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/reports/issue-briefs/state-of-science-2b.html
     June 01, 2020 - events so they can review the medical record to determine if an actual or potential adverse event has occurred … Process breakdown taxonomy, 97 both of which help to identify where in the diagnostic process a problem occurred

280. CAHPS Adult Hospital Survey | Agency for Healthcare Research and Quality
     www.ahrq.gov/cahps/surveys-guidance/hospital/about/adult_hp_survey.html
     January 01, 2025 - CMS implemented the HCAHPS survey in October 2006, and the first public reporting of HCAHPS results occurred