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Showing results for "occurred".
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www.ahrq.gov/sites/default/files/wysiwyg/research/findings/final-reports/16774-Bundy-draft-1.pdfSeptember 29, 2009 - Categories E through H errors not only occurred and reached the patient but also caused harm. … In one study of nationally representative US data, extra vaccination occurred in 21% of young children … Harmful errors occurred with all cardiovascular drug classes. … However, because over half the errors occurred at the administering stage of medication processing, … Not surprisingly, a large majority of reported pediatric antidepressant medication errors occurred
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module6/module6-care-for-caregiver.pptxMay 01, 2011 - , but they feared that an error may have occurred. … /organization recognizing event occurred. … This stage is characterized by either the second-victim realizing that an event has occurred, or the … organization recognizing that an event has occurred. … The event might produce feelings of internal inadequacy, either because the event occurred or because
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Morningbriefing (doc file)
pbrn.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/morningbriefing.docAugust 07, 2012 - : This tool provides a structured approach to help physicians and nurses identify the problems that occurred … If an adverse event occurred, you should also use the Learn From Defects Form. II. -
Morningbriefing (doc file)
pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/morningbriefing.docAugust 07, 2012 - : This tool provides a structured approach to help physicians and nurses identify the problems that occurred … If an adverse event occurred, you should also use the Learn From Defects Form. II. -
Morningbriefing (doc file)
healthcare411.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/morningbriefing.docAugust 07, 2012 - : This tool provides a structured approach to help physicians and nurses identify the problems that occurred … If an adverse event occurred, you should also use the Learn From Defects Form. II. -
Morningbriefing (doc file)
cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/morningbriefing.docAugust 07, 2012 - : This tool provides a structured approach to help physicians and nurses identify the problems that occurred … If an adverse event occurred, you should also use the Learn From Defects Form. II. -
Morningbriefing (doc file)
monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/morningbriefing.docAugust 07, 2012 - : This tool provides a structured approach to help physicians and nurses identify the problems that occurred … If an adverse event occurred, you should also use the Learn From Defects Form. II. -
Morningbriefing (doc file)
talkingquality.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/morningbriefing.docAugust 07, 2012 - : This tool provides a structured approach to help physicians and nurses identify the problems that occurred … If an adverse event occurred, you should also use the Learn From Defects Form. II. -
digital.ahrq.gov/sites/default/files/docs/library/NEJMsa1102519.htmlJune 16, 2021 - An error occurred while setting your user cookie.
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digital.ahrq.gov/sites/default/files/docs/library/NEJMsa1102519_0.htmlJune 16, 2021 - An error occurred while setting your user cookie.
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digital.ahrq.gov/sites/default/files/docs/library/NEJMsb1103659.htmlJune 16, 2021 - An error occurred while setting your user cookie.
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Blackbox: A Multidisciplinary Team-Based Framework for HIT Error Pattern Detection - Final Report (pdf file)
digital.ahrq.gov/sites/default/files/docs/citation/r21hs024755-hettinger-final-report-2019.pdfJanuary 01, 2019 - This allowed the team to standardize their approach in coding if an error occurred and what the evidence … , if a pause in workflow occurred and other elements. … After some investigation and changes within the EHR, the corrupted video files occurred infrequently … The team investigated evidence of diagnostic imaging studies that occurred on one side of the body … The remaining errors occurred during the modification of either order sets or the use of favorites -
www.ahrq.gov/sites/default/files/wysiwyg/research/findings/final-reports/14253-Carayon-draft-1.pdfDecember 01, 2006 - The pump observations occurred 1 month before Smart IV pump implementation and 5 months 4 after … Forty-six hours of meeting time occurred over 4.5 months, representing 600 person-hours of time. … The second round of usability testing occurred with what was ultimately the final pump. … There were nine different units and the emergency department on which the observations occurred. … Staff were unaware and surprised that an UNDER- infusion most likely occurred in these cases.
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www.ahrq.gov/patient-safety/settings/hospital/candor/modules/checklist5.htmlAugust 01, 2022 - after the CANDOR event is identified, advise the patient and/or family that an adverse event may have occurred … Explain what is known about why the adverse event occurred; do not speculate.
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www.ahrq.gov/sites/default/files/2024-09/ratwani-report.pdfJanuary 01, 2024 - tasks physicians were engaged in on a second-by-second basis and to document the when interruptions occurred … • The location of where the interruption occurred was recorded as being at the workstation, in the … Consequently, we could not observe any interruptions that occurred in patient rooms. … Rejecting interruptions occurred only 1.3% of the time (n = 6 occurrences). … source of the interruptions and the primary tasks that were being performed when the interruptions occurred
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www.ahrq.gov/sites/default/files/2024-02/herwaldt-report.pdfJanuary 01, 2024 - Identification Errors 4/21/04 – 2/07/05 (Pilot Period) Prevented Errors Count Step/ Occurred Step … Skipped steps occurred when the nurse or phlebotomist failed to scan -10- the patient’s barcoded … Skipped steps often occurred because personnel within the Critical Care Laboratory failed to complete … Skipped steps during administration occurred when the transfusionist failed to complete all three scans … This occurred at night in an intensive care unit shortly after the system was activated.
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psnet.ahrq.gov/issue/woman-who-died-alta-bates-may-be-victim-medical-error-not-medication-mistakeMarch 23, 2011 - This newspaper article reports how a medical error, which occurred during a nursing strike, resulted
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www.ahrq.gov/sites/default/files/2024-07/morse-merryweather-report.pdfJanuary 01, 2024 - The majority of FREs occurred in the Stand and Gait phases (n = 45 and 33, respectively). … Twenty-eight FREs occurred in Stand Preparation through the Stand Phase, FREr; 18 FREs occurred during … The shortest duration occurred in the Gait Initiation Subphase: 1.32 (0.58) seconds. … The majority of FREs occurred during rising. … The majority of the 61 FREs occurred during rising.
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Spotlight Case [MONTH] 2003 (ppt file)
psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.64_slideshow.pptJune 01, 2004 - dopt=Abstract&list_uids=12477944 Disclosure: What Patients Want Jargon-free statement that error occurred … discussing such issues Physician may choose words carefully to avoid explicitly stating that an error occurred … malpractice claims Others argue that the reason few injured patients sue is because they are unaware error occurred … should be disclosed to patients Error disclosure should include an explicit statement that an error occurred -
Aspiration Pneumonitis/Pneumonia (pdf file)
ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/asp-pneumonitis-one-page.pdfNovember 01, 2019 - regimens for community-acquired pneumonia (CAP) (e.g., ampicillin- sulbactam, ceftriaxone) if the event occurred … regimens for hospital-acquired pneumonia (HAP) (e.g., cefepime, piperacillin- tazobactam) if the event occurred
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