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Showing results for "occurred".

41. Simon SR et al. 2006 "Computerized prescribing alerts and group academic detailing to reduce the use of potentially inappropriate medications in older people." | Digital Healthcare Research
    digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/simon-sr-et-al-2006
    January 01, 2006 - INTERVENTION: The computerized age-specific alerts occurred at the time of prescribing a targeted potentially … The alerts were programmed to 'pop up' only when both of the following circumstances occurred: 1. … Approximately 14 (82%) alerts per clinician occurred while ordering these medications for patients younger … January to June 2004), [they received] approximately four alerts per clinician, all of which, by design, occurred

42. Evaluation of Medications Removed from Automated Dispensing Machines Using the Override Function Leading to Multiple System Changes (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Miller_93.pdf
    March 12, 2008 - The authors explained that these problems occurred when the pharmacy was closed and when all medications … Of the 59 instances of override, 17 (28.8 percent) occurred during a first shift (7:00 am to 3:30 pm … ); 31 (52.5 percent) occurred during a second shift (3:00 pm to 11:30 pm); and 11 (18.6 percent) occurred … Forty-five overrides (76.3 percent) occurred on weekdays. … The largest number of overrides occurred during the second shift, which was also when the majority of

43. Objective Outcomes Data Collection Tool | Agency for Healthcare Research and Quality
    www.ahrq.gov/hai/tools/mvp/modules/vae/objective-outcome-tool.html
    January 01, 2017 - Total number of episodes of mechanical ventilation How many episodes of mechanical ventilation have occurred … Total number of deaths How many deaths have occurred in the patients who have been or were mechanically

44. Statistical Brief #147: Emergency Department Visits and Hospital Inpatient Stays for Seasonal and 2009 H1N1 Influenza, 2008-2009 (pdf file)
    hcup-us.ahrq.gov/reports/statbriefs/sb147.pdf
    March 01, 2012 - ■ ED visits for influenza occurred at a rate of 417.5 per 100,000 population in 2009 compared to … Hospitalizations for influenza occurred at a rate of 53.1 per 100,000 population in 2009 compared to … In 2008, peak activity occurred in February (79.9 ED visits per 100,000 population). … In 2009, peak activity occurred in October (125.2 ED visits per 100,000 population). … During the second wave of the 2009 H1N1 pandemic, which occurred in the 2009–2010 influenza season

45. Relationships between medications used in a mental health hospital and types of medication errors: a cross-sectional study over an 8-year period. | PSNet
    psnet.ahrq.gov/issue/relationships-between-medications-used-mental-health-hospital-and-types-medication-errors
    November 29, 2023 - This study used 8 years of medication records to identify when in the medication process the error occurred … Nearly one-third of errors were wrong dose and occurred in the prescribing stage.

46. Electronic Communications Across Provider Settings | Digital Healthcare Research
    digital.ahrq.gov/ahrq-funded-projects/electronic-communications-across-provider-settings
    January 01, 2023 - Project planning occurred in two rural settings. … Planning also occurred among six rural community health centers throughout New Hampshire.

47. Comprehensive Diabetes Care: Blood Pressure Control (<140/90 mm Hg) (pdf file)
    integrationacademy.ahrq.gov/sites/default/files/2020-07/Comprehensive_Diabetes_Care_Blood_Pressure.pdf
    January 01, 2020 - Diagnosis may occur at any time in the member’s history, but must have occurred by the end of the measurement … Diagnosis may occur during the measurement year or the year prior to the measurement year, but must have occurred

48. Facilitator Guide: Build Your SSI Prevention Bundle (doc file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/vae/objective-outcome-tool.docx
    January 01, 2017 - Total number of episodes of mechanical ventilation How many episodes of mechanical ventilation have occurred … Total number of deaths How many deaths have occurred in the patients who have been or were mechanically

49. Final Progress Report: Effects of Extended Work Hours on ICU Patient Safety (pdf file)
    www.ahrq.gov/sites/default/files/2024-09/czeisler-report.pdf
    January 01, 2024 - The intervention schedule had no extended work shifts, and 96 percent of work hours occurred within … the 16 hours scheduled, in contrast to the traditional schedule, in which 58 percent of work hours occurred … Intercepted serious intern errors occurred 27.9% more frequently on the traditional schedule than on … No adverse events occurred. … A total of 61 observed sessions occurred over the 12-month period, during which 183 simulations occurred

50. Psn-Pdf (pdf file)
    psnet.ahrq.gov/node/37446/psn-pdf
    January 06, 2017 - Investigators discovered that inpatient warfarin- related errors occurred most frequently during transcription … /documentation and administration, while outpatient errors occurred most frequently during prescribing

51. Omission of high-alert medications: a hidden danger. | PSNet
    psnet.ahrq.gov/issue/omission-high-alert-medications-hidden-danger
    January 11, 2017 - The investigation found that more than half of errors occurred during the administration process, and … September 27, 2016 External Inquiry into the adverse incident that occurred at Queen's

52. What Happens After a Patient Safety Event? Medical Expenditures and Outcomes in Medicare (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Encinosa.pdf
    January 01, 2003 - period the IOM report was released), we examine potentially preventable adverse medical events that occurred … The unit of observation was any major surgery admission (identified as the “index” surgery) that occurred … The surgeries occurred at 1,725 hospitals nationwide. … potentially preventable adverse medical events only cases in which the evidence that such an event occurred … Thus, there may have been many more preventable safety events (as well as close calls) that occurred

53. AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/fallspx/reports.html
    November 01, 2017 - within the facility’s electronic medical record, such as nurse assessments, and represent changes that occurred … the facility’s electronic medical record as determined by the facility and may represent changes that occurred … Fall Risk Factors Report provides information regarding the number and percentage of falls that have occurred … For each month, it displays the number of falls that occurred and the risk factors   associated with … Shift during which the fall occurred. Time at which the fall occurred.

54. Saving Lives and Saving Money: Hospital-Acquired Conditions Update - Interim Data From National Efforts To Make Care Safer, 2010-2014 (pdf file)
    www.ahrq.gov/sites/default/files/publications2/files/interimhacrate2014_cx.pdf
    November 19, 2015 - patients over the 4 years (2011, 2012, 2013, and 2014) relative to the number of HACs that would have occurred … precise causes of the decline in patient harm are not fully understood, the increase in safety has occurred … the reduction in the rate of HACs, we estimate that approximately 790,000 fewer incidents of harm occurred … in 2014 than would have occurred if the rate of HACs had remained steady at the 2010 level (Exhibit … Cumulatively, approximately 2.1 million fewer incidents of harm occurred in 2011, 2012, 2013, and 2014

55. Interim Update on 2013 Annual Hospital-Acquired Condition Rate (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/2014finalhacreport-cx.pdf
    December 01, 2016 - patients over the 4 years (2011, 2012, 2013, and 2014) relative to the number of HACs that would have occurred … precise causes of the decline in patient harm are not fully understood, the increase in safety has occurred … the reduction in the rate of HACs, we estimate that approximately 798,000 fewer incidents of harm occurred … in 2014 than would have occurred if the rate of HACs had remained steady at the 2010 level (Exhibit … Cumulatively, approximately 2.1 million fewer incidents of harm occurred in 2011, 2012, 2013, and 2014

56. Final Data From National Efforts To Make Care Safer, 2010-2014 (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/2014FinalHACreport4Web-13Dec2016.pdf
    December 01, 2016 - patients over the 4 years (2011, 2012, 2013, and 2014) relative to the number of HACs that would have occurred … precise causes of the decline in patient harm are not fully understood, the increase in safety has occurred … the reduction in the rate of HACs, we estimate that approximately 798,000 fewer incidents of harm occurred … in 2014 than would have occurred if the rate of HACs had remained steady at the 2010 level (Exhibit … Cumulatively, approximately 2.1 million fewer incidents of harm occurred in 2011, 2012, 2013, and 2014

57. Psn-Pdf (pdf file)
    psnet.ahrq.gov/node/41522/psn-pdf
    December 02, 2014 - resulted in patient harm in the outpatient setting, and this study found that more than 250 such errors occurred … Although pharmacists intercepted nearly half the errors, more than one-third occurred at the time of

58. Psn-Pdf (pdf file)
    psnet.ahrq.gov/node/39402/psn-pdf
    August 08, 2010 - A fatal vincristine error that occurred in the United Kingdom was the subject of a detailed investigation … preventing-vincristine-administration-errors https://psnet.ahrq.gov/issue/external-inquiry-adverse-incident-occurred-queens-medical-centre-nottingham

59. Psn-Pdf (pdf file)
    psnet.ahrq.gov/node/36200/psn-pdf
    February 15, 2011 - Prior research revealed that patients wanted the physicians to apologize for the error, explain how it occurred … Approximately half of respondents declined to explain how the error occurred or discuss specific plans

60. Event Investigation and Analysis Guide: Appendix E | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide4/ape.html
    August 01, 2022 - Confirmation and Consensus Meeting Announcement Template As you may know, a patient care incident occurred