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psnet.ahrq.gov/perspective/health-care-worker-presenteeism-challenge-patient-safety
November 03, 2015 - and norovirus.( 6 )
Despite how risky health care worker presenteeism is for patients, it commonly occurs … and Knowledge
Like many threats to patient safety, the reasons why health care worker presenteeism occurs
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psnet.ahrq.gov/web-mm/nonsustained-ventricular-tachycardia-after-acute-coronary-syndromes-recognizing-high-risk
September 20, 2011 - is not associated with increased risk of sudden death or all-cause mortality, particularly when it occurs … In the case of new-onset NSVT, NSVT that is increasing in frequency or duration, or NSVT that occurs
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psnet.ahrq.gov/web-mm/making-do
September 05, 2018 - When this sort of improvisation occurs, the surgeon must ensure that the system provides the same level … Even though infection is possible, sepsis rarely occurs after operative hysteroscopy.
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psnet.ahrq.gov/node/33825/psn-pdf
January 01, 2017 - some
state regulatory agencies mandate RCAs after sentinel events and when significant patient harm occurs … Hindsight bias occurs
when people investigating a situation already know the outcome.
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psnet.ahrq.gov/node/49748/psn-pdf
December 01, 2015 - The vasodilatation that occurs in the splanchnic
bed leads to a lowering of mean arterial pressure and … If a patient develops a
large fall in blood pressure, as occasionally occurs, I would give vasopressor
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psnet.ahrq.gov/node/49739/psn-pdf
August 21, 2015 - Tracheo-esophageal fistula (TEF) occurs in approximately 1 in 1250 patients following tracheostomy.(1 … Finally, laryngotracheal stenosis occurs in approximately 1.7% of patients following tracheostomy, though
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psnet.ahrq.gov/node/49599/psn-pdf
February 23, 2010 - into two distinct entities: positive and
negative.(5) Positive defensive medicine, as in this case, occurs … Negative defensive medicine occurs when
physicians curtail services to avoid high-risk patients or procedures
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psnet.ahrq.gov/node/49704/psn-pdf
March 01, 2014 - Decreased excretion of bilirubin in newborns occurs because it takes time to increase the activity of … Thus, the late anemia occurs due to ongoing hemolysis of the
remaining Rh+ cells and because the transfused
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psnet.ahrq.gov/node/33653/psn-pdf
June 01, 2007 - When an error occurs in a situation where nurses may be manipulating a medication in a non-emergency
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psnet.ahrq.gov/node/33604/psn-pdf
December 15, 2024 - Correct medication use occurs when the "five rights" are followed, meaning the
right dose of the right
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psnet.ahrq.gov/node/72614/psn-pdf
March 01, 2021 - Relatively rare, but still affecting thousands: Birth trauma occurs in approximately 7.4 out of
every … shoulder dystocia (when the baby's
shoulders cannot move past the mother's pelvis during delivery), which occurs … reported in an average of less than 1 percent of births; for example, maternal
cerebrovascular accident occurs
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psnet.ahrq.gov/innovation/rehearsing-team-care-relatively-rare-obstetric-emergencies-leads-improved-outcomes
July 23, 2024 - Relatively rare, but still affecting thousands: Birth trauma occurs in approximately 7.4 out of every … shoulder dystocia (when the baby's shoulders cannot move past the mother's pelvis during delivery), which occurs … reported in an average of less than 1 percent of births; for example, maternal cerebrovascular accident occurs
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psnet.ahrq.gov/primer/rapid-response-systems
July 18, 2024 - standard cardiac arrest or "code blue" teams, which are summoned only after cardiopulmonary arrest occurs
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psnet.ahrq.gov/web-mm/importance-following-safe-practices-infant-feeding-and-handling-expressed-breast-milk
January 31, 2024 - Processes for Infant Feeding Expressed breast milk being given to the wrong baby is a mistake that occurs … After an error occurs, healthcare teams should have an open discussion with the patient and family as … Healthcare team members should also be provided support after an error occurs.
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psnet.ahrq.gov/node/851971/psn-pdf
July 31, 2023 - eats indiscriminately whatever it finds.1 Pica is often associated with iron deficiency and therefore
occurs … Intentional foreign body ingestion occurs most often in children under three years of age. … In adults,
repeated intentional ingestion of metal objects usually occurs in patients with borderline
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psnet.ahrq.gov/web-mm/unintentional-ketamine-overdose-operating-room-mixing-ampules
March 25, 2020 - Commentary
By Christian Bohringer MD
This incident describes a common type of adverse drug event that occurs … resuspended in different concentrations when they are drawn up from the ampule. 1,2 This type of event occurs
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psnet.ahrq.gov/node/50389/psn-pdf
September 25, 2019 - medical practice—rely on both of these processes, although the vast majority of our
decision-making occurs … Diagnosis often occurs as a coproductive activity between persons in specific ecosystems, and
the interactions
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psnet.ahrq.gov/web-mm/breathe-easy-safe-tracheostomy-management
June 07, 2023 - Tracheo-esophageal fistula (TEF) occurs in approximately 1 in 1250 patients following tracheostomy.( … Finally, laryngotracheal stenosis occurs in approximately 1.7% of patients following tracheostomy, though
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psnet.ahrq.gov/web-mm/dropped-no
October 30, 2019 - However, on dictation, the first word "No" was obscured by the dictation system click that occurs when … The primary error in this case was that the word "no" was obscured by the dictation system click that occurs
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psnet.ahrq.gov/web-mm/hard-swallow
April 26, 2023 - This delay occurs primarily because medical records are voluminous and often organized in ways that promote … the electronic medical record (EMR) create safety mechanisms to assure that important communication occurs