Results

Total Results: over 10,000 records

Showing results for "occurred".

4801. Risk factors for hospital admissions associated with adverse drug events. | PSNet
      psnet.ahrq.gov/issue/risk-factors-hospital-admissions-associated-adverse-drug-events
      October 18, 2018 - Study Risk factors for hospital admissions associated with adverse drug events. Citation Text: Kongkaew C, Hann M, Mandal J, et al. Risk factors for hospital admissions associated with adverse drug events. Pharmacotherapy. 2013;33(8):827-37. doi:10.1002/phar.1287. Copy Citation Fo…

4802. A systems approach to identify factors influencing adverse drug events in nursing homes. | PSNet
      psnet.ahrq.gov/issue/systems-approach-identify-factors-influencing-adverse-drug-events-nursing-homes
      March 18, 2020 - Study A systems approach to identify factors influencing adverse drug events in nursing homes. Citation Text: Al-Jumaili AA, Doucette WR. A Systems Approach to Identify Factors Influencing Adverse Drug Events in Nursing Homes. J Am Geriatr Soc. 2018;66(7):1420-1427. doi:10.1111/jgs.15389…

4803. Adverse drug event nonrecognition in emergency departments: an exploratory study on factors related to patients and drugs. | PSNet
      psnet.ahrq.gov/issue/adverse-drug-event-nonrecognition-emergency-departments-exploratory-study-factors-related
      April 12, 2011 - Study Adverse drug event nonrecognition in emergency departments: an exploratory study on factors related to patients and drugs. Citation Text: Roulet L, Ballereau F, Hardouin J-B, et al. Adverse drug event nonrecognition in emergency departments: an exploratory study on factors related …

4804. Unintended discontinuation of medication following hospitalisation: a retrospective cohort study. | PSNet
      psnet.ahrq.gov/issue/unintended-discontinuation-medication-following-hospitalisation-retrospective-cohort-study
      September 05, 2018 - Study Unintended discontinuation of medication following hospitalisation: a retrospective cohort study. Citation Text: Redmond P, McDowell R, Grimes TC, et al. Unintended discontinuation of medication following hospitalisation: a retrospective cohort study. BMJ Open. 2019;9(6):e024747. d…

4805. Impact of nighttime rapid response team activation on outcomes of hospitalized patients with acute deterioration. | PSNet
      psnet.ahrq.gov/issue/impact-nighttime-rapid-response-team-activation-outcomes-hospitalized-patients-acute
      April 06, 2022 - Study Impact of nighttime rapid response team activation on outcomes of hospitalized patients with acute deterioration. Citation Text: Fernando SM, Reardon PM, Bagshaw SM, et al. Impact of nighttime Rapid Response Team activation on outcomes of hospitalized patients with acute deteriorat…

4806. Shape matters: a neglected feature of medication safety: why regulating the shape of medication containers can improve medication safety. | PSNet
      psnet.ahrq.gov/issue/shape-matters-neglected-feature-medication-safety-why-regulating-shape-medication-containers
      December 09, 2020 - Commentary Shape matters: a neglected feature of medication safety: why regulating the shape of medication containers can improve medication safety. Citation Text: Bitan Y, Nunnally M. Shape matters: a neglected feature of medication safety: why regulating the shape of medication contain…

4807. Race differences in reported harmful patient safety events in healthcare system high reliability organizations. | PSNet
      psnet.ahrq.gov/issue/race-differences-reported-harmful-patient-safety-events-healthcare-system-high-reliability
      March 01, 2023 - Study Race differences in reported harmful patient safety events in healthcare system high reliability organizations. Citation Text: Thomas AD, Pandit C, Krevat SA. Race Differences in Reported Harmful Patient Safety Events in Healthcare System High Reliability Organizations. J Patient S…

4808. Evolving quality improvement support strategies to improve Plan–Do–Study–Act cycle fidelity: a retrospective mixed-methods study. | PSNet
      psnet.ahrq.gov/issue/evolving-quality-improvement-support-strategies-improve-plan-do-study-act-cycle-fidelity
      March 17, 2014 - Study Emerging Classic Evolving quality improvement support strategies to improve Plan–Do–Study–Act cycle fidelity: a retrospective mixed-methods study. Citation Text: McNicholas C, Lennox L, Woodcock T, et al. Evolving quality improvement support strategies to …

4809. Workplace training for senior trainees: a systematic review and narrative synthesis of current approaches to promote patient safety. | PSNet
      psnet.ahrq.gov/issue/workplace-training-senior-trainees-systematic-review-and-narrative-synthesis-current
      February 07, 2024 - Review Workplace training for senior trainees: a systematic review and narrative synthesis of current approaches to promote patient safety. Citation Text: Walton M, Harrison R, Burgess A, et al. Workplace training for senior trainees: a systematic review and narrative synthesis of curren…

4810. Emergency intubation of children outside of the operating room. | PSNet
      psnet.ahrq.gov/issue/emergency-intubation-children-outside-operating-room
      May 27, 2011 - Study Emergency intubation of children outside of the operating room. Citation Text: Long E, Barrett MJ, Peters C, et al. Emergency intubation of children outside of the operating room. Paediatr Anaesth. 2020;30(3):319-330. doi:10.1111/pan.13784. Copy Citation Format: DOI G…

4811. Empowering frontline nurses: a structured intervention enables nurses to improve medication administration accuracy. | PSNet
      psnet.ahrq.gov/issue/empowering-frontline-nurses-structured-intervention-enables-nurses-improve-medication
      March 13, 2012 - Study Empowering frontline nurses: a structured intervention enables nurses to improve medication administration accuracy. Citation Text: Kliger J, Blegen MA, Gootee D, et al. Empowering frontline nurses: a structured intervention enables nurses to improve medication administration accur…

4812. A new category of "never events"-ending harmful hospital policies. | PSNet
      psnet.ahrq.gov/issue/new-category-never-events-ending-harmful-hospital-policies
      September 07, 2022 - Commentary A new category of "never events"-ending harmful hospital policies. Citation Text: Chokshi DA, Beckman AL. A new category of "never events"-ending harmful hospital policies. JAMA Health Forum. 2022;3(10):e224703. doi:10.1001/jamahealthforum.2022.4703. Copy Citation Format…

4813. Patient safety in external beam radiotherapy—guidelines on risk assessment and analysis of adverse error-events and near misses: introducing the ACCIRAD project. | PSNet
      psnet.ahrq.gov/issue/patient-safety-external-beam-radiotherapy-guidelines-risk-assessment-and-analysis-adverse
      March 15, 2017 - Study Patient safety in external beam radiotherapy—guidelines on risk assessment and analysis of adverse error-events and near misses: introducing the ACCIRAD project. Citation Text: Malicki J, Bly R, Bulot M, et al. Patient safety in external beam radiotherapy - guidelines on risk asses…

4814. Effects of patient-, environment- and medication-related factors on high-alert medication incidents. | PSNet
      psnet.ahrq.gov/issue/effects-patient-environment-and-medication-related-factors-high-alert-medication-incidents
      January 22, 2016 - Study Effects of patient-, environment- and medication-related factors on high-alert medication incidents. Citation Text: Manias E, Williams A, Liew D, et al. Effects of patient-, environment- and medication-related factors on high-alert medication incidents. Int J Qual Health Care. 2014…

4815. Assessment of emergency department antibiotic discharge prescription dosing errors for pediatric patients in a community hospital health system. | PSNet
      psnet.ahrq.gov/issue/assessment-emergency-department-antibiotic-discharge-prescription-dosing-errors-pediatric
      March 01, 2011 - Study Assessment of emergency department antibiotic discharge prescription dosing errors for pediatric patients in a community hospital health system. Citation Text: Barstow L, Herman E, Phillips H, et al. Assessment of Emergency Department Antibiotic Discharge Prescription Dosing Errors…

4816. Misleading one detail: a preventable mode of diagnostic error? | PSNet
      psnet.ahrq.gov/issue/misleading-one-detail-preventable-mode-diagnostic-error
      February 10, 2016 - Study Misleading one detail: a preventable mode of diagnostic error? Citation Text: Arzy S, Brezis M, Khoury S, et al. Misleading one detail: a preventable mode of diagnostic error? J Eval Clin Pract. 2009;15(5):804-6. doi:10.1111/j.1365-2753.2008.01098.x. Copy Citation Format: …

4817. Automation of the I-PASS tool to improve transitions of care. | PSNet
      psnet.ahrq.gov/issue/automation-i-pass-tool-improve-transitions-care
      August 04, 2021 - Study Automation of the I-PASS tool to improve transitions of care. Citation Text: Skaret MM, Weaver TD, Humes RJ, et al. Automation of the I-PASS Tool to Improve Transitions of Care. J Healthc Qual. 2019;41(5):274-280. doi:10.1097/JHQ.0000000000000174. Copy Citation Format: …

4818. Residents' numeric inputting error in computerized physician order entry prescription. | PSNet
      psnet.ahrq.gov/issue/residents-numeric-inputting-error-computerized-physician-order-entry-prescription
      March 24, 2019 - Study Residents' numeric inputting error in computerized physician order entry prescription. Citation Text: Wu X, Wu C, Zhang K, et al. Residents' numeric inputting error in computerized physician order entry prescription. Int J Med Inform. 2016;88:25-33. doi:10.1016/j.ijmedinf.2016.01.0…

4819. BONE break: a hot debrief tool to reduce second victim syndrome for nurses. | PSNet
      psnet.ahrq.gov/issue/bone-break-hot-debrief-tool-reduce-second-victim-syndrome-nurses
      August 02, 2015 - Study BONE break: a hot debrief tool to reduce second victim syndrome for nurses. Citation Text: Hess A, Flicek T, Watral AT, et al. BONE break: a hot debrief tool to reduce second victim syndrome for nurses. Jt Comm J Qual Patient Saf. 2024;50(9):673-677. doi:10.1016/j.jcjq.2024.05.005.…

4820. Final Progress Report: Demonstration Project To Refine, Automate and Test a Novel Emergency Department Trigger Tool (pdf file)
      www.ahrq.gov/sites/default/files/2025-02/griffey-report.pdf
      January 01, 2025 - We detected a total of 1,181 AEs, 722 of which were POA and 459 occurred in the ED. … for the taxonomy was that, for MERP E-I events, categorizations should describe the actual harm that occurred