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psnet.ahrq.gov/issue/analysis-variation-between-diagnosis-admission-vs-discharge-and-clinical-outcomes-among
June 22, 2022 - February 22, 2023
Misdiagnosis of thoracic aortic emergencies occurs frequently among
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psnet.ahrq.gov/issue/association-use-mandatory-prescription-drug-monitoring-program-prescribing-practices-patients
March 01, 2023 - September 23, 2020
Type 1 diabetes defined by severe insulin deficiency occurs after
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psnet.ahrq.gov/issue/hospital-autopsy-endangered-or-extinct
November 21, 2021 - November 21, 2021
Type 1 diabetes defined by severe insulin deficiency occurs after 30
-
psnet.ahrq.gov/issue/medication-reconciliation-and-patient-safety-trauma-applicability-existing-strategies
September 23, 2020 - August 3, 2017
Misdiagnosis of thoracic aortic emergencies occurs frequently among transfers
-
psnet.ahrq.gov/issue/should-operations-be-regionalized-empirical-relation-between-surgical-volume-and-mortality
August 04, 2021 - August 23, 2023
Misdiagnosis of thoracic aortic emergencies occurs frequently among transfers
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psnet.ahrq.gov/issue/medication-sharing-storage-and-disposal-practices-opioid-medications-among-us-adults
March 30, 2022 - November 14, 2018
Type 1 diabetes defined by severe insulin deficiency occurs after 30
-
psnet.ahrq.gov/issue/automation-i-pass-tool-improve-transitions-care
August 04, 2021 - November 21, 2021
Type 1 diabetes defined by severe insulin deficiency occurs after 30
-
psnet.ahrq.gov/issue/vanishing-nonforensic-autopsy
February 09, 2011 - September 6, 2023
Misdiagnosis of thoracic aortic emergencies occurs frequently among
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psnet.ahrq.gov/issue/association-between-hospital-characteristics-and-rates-preventable-complications-and-adverse
April 17, 2009 - April 13, 2022
Misdiagnosis of thoracic aortic emergencies occurs frequently among transfers
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psnet.ahrq.gov/issue/nurses-perceptions-multidisciplinary-team-work-acute-health-care
January 06, 2017 - June 8, 2011
Type 1 diabetes defined by severe insulin deficiency occurs after 30 years
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psnet.ahrq.gov/node/73642/psn-pdf
August 25, 2021 - Patient death or serious injury associated
with intravascular air embolism that occurs while being cared … insufflation in children can be considered but has not been recommended.3,5,
15
If an adverse event occurs … Once a complication occurs, escalation of care requires three fundamental communication steps as
identified
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psnet.ahrq.gov/issue/preventable-harm-occurring-critically-ill-children
September 28, 2010 - Study
Preventable harm occurring to critically ill children.
Citation Text:
Larsen G, Donaldson AE, Parker HB, et al. Preventable harm occurring to critically ill children. Pediatr Crit Care Med. 2007;8(4):331-336.
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Format:
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psnet.ahrq.gov/node/33652/psn-pdf
June 01, 2007 - than as intended
Patient death or serious disability associated with intravascular air embolism that occurs … care facility
Patient death or serious disability associated with hypoglycemia, the onset of which occurs … significant injury of a patient or staff member resulting from a physical assault (i.e., battery)
that occurs
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psnet.ahrq.gov/issue/computerization-can-create-safety-hazards-bar-coding-near-miss
March 11, 2011 - April 24, 2018
Type 1 diabetes defined by severe insulin deficiency occurs after 30 years
-
psnet.ahrq.gov/issue/residents-reflections-quality-improvement-temporal-stability-and-associations-preventability
September 20, 2011 - December 21, 2014
Type 1 diabetes defined by severe insulin deficiency occurs after 30
-
psnet.ahrq.gov/issue/what-causes-prescribing-errors-children-scoping-review
September 09, 2015 - July 1, 2017
Type 1 diabetes defined by severe insulin deficiency occurs after 30 years
-
psnet.ahrq.gov/issue/are-med-school-grads-prepared-practice-medicine
April 04, 2012 - August 22, 2018
Type 1 diabetes defined by severe insulin deficiency occurs after 30
-
psnet.ahrq.gov/perspective/conversation-cheryl-jones-about-addressing-workplace-violence-and-creating-safer
October 31, 2023 - findings indicated that verbal violence from patients (e.g., insults, threats, screaming, cursing) occurs … I think the most concerning, at least in the immediate sense, is the violence that occurs from patients … leaders will act on reported information, they are more likely to report workplace violence when it occurs … if they’re trained on organizational procedures and policies to address workplace violence when it occurs … in hospitals were from patients and families toward healthcare workers. 8 Horizontal violence that occurs
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psnet.ahrq.gov/perspective/addressing-workplace-violence-and-creating-safer-workplace
October 31, 2023 - in hospitals were from patients and families toward healthcare workers. 8 Horizontal violence that occurs … findings indicated that verbal violence from patients (e.g., insults, threats, screaming, cursing) occurs … I think the most concerning, at least in the immediate sense, is the violence that occurs from patients … leaders will act on reported information, they are more likely to report workplace violence when it occurs … if they’re trained on organizational procedures and policies to address workplace violence when it occurs
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.314_slideshow.ppt
February 01, 2014 - difficult for providers to make mistakes
Permit the detection and correction of errors before harm occurs … e.g., prevent malfunctioning or unintentional operation by reverting back to a safe state if failure occurs