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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.122_slideshow.ppt
April 01, 2006 - skills
Ability to act decisively on uncertain knowledge
Willingness to improvise when unexpected occurs
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psnet.ahrq.gov/sites/default/files/2024-06/spotlight_case_hemorrhagic_shock_slides_final.pptx
January 01, 2024 - If active resuscitation and transfusion are required, assessment of coagulation occurs in conjunction … Major vascular injury (e.g., left common iliac vein, inferior vena cava, or iliolumbar vein), occurs
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psnet.ahrq.gov/node/860050/psn-pdf
January 04, 2024 - AHT occurs from
direct impact to the head, shaking, or a combination of both, and can lead to serious … When this evaluation occurs overnight, it may not be feasible for many institutions to
have an attending
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psnet.ahrq.gov/node/61113/psn-pdf
January 01, 2021 - Do falls and other safety issues occur more often during
handovers when nurses are away from patients? Findings
from a retrospective study design.
November 11, 2020
Demaria J, Valent F, Danielis M, et al. Do falls and other safety issues occur more often during handovers
when nurses are away from patients? Finding…
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psnet.ahrq.gov/issue/medication-errors-occurring-use-bar-code-administration-technology
March 18, 2010 - Newspaper/Magazine Article
Medication errors occurring with the use of bar-code administration technology.
Citation Text:
Medication errors occurring with the use of bar-code administration technology. PA-PSRS Patient Saf Advis. December 2008;5:122-126.
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…
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psnet.ahrq.gov/issue/classification-adverse-events-occurring-surgical-intensive-care-unit
May 01, 2013 - Study
Classification of adverse events occurring in a surgical intensive care unit.
Citation Text:
Frankel H, Sperry J, Kaplan L, et al. Classification of adverse events occurring in a surgical intensive care unit. Am J Surg. 2007;194(3):328-32.
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Format:
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psnet.ahrq.gov/issue/systematic-evaluation-errors-occurring-during-preparation-intravenous-medication
October 07, 2015 - Study
Systematic evaluation of errors occurring during the preparation of intravenous medication.
Citation Text:
Parshuram CS, To T, Seto W, et al. Systematic evaluation of errors occurring during the preparation of intravenous medication. CMAJ. 2008;178(1):42-8. doi:10.1503/cmaj.06174…
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psnet.ahrq.gov/node/37533/psn-pdf
April 22, 2011 - Systematic evaluation of errors occurring during the
preparation of intravenous medication.
April 22, 2011
Parshuram CS, To T, Seto W, et al. Systematic evaluation of errors occurring during the preparation of
intravenous medication. CMAJ. 2008;178(1):42-8. doi:10.1503/cmaj.061743.
https://psnet.ahrq.gov/issue/sys…
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psnet.ahrq.gov/node/41989/psn-pdf
September 27, 2016 - Tapping front-line knowledge: identifying problems as
they occur helps enhance patient safety.
September 27, 2016
Luther K, Resar RK. Tapping front-line knowledge: identifying problems as they occur helps enhance
patient safety. Healthcare executive. 2013;28(1):84-7.
https://psnet.ahrq.gov/issue/tapping-front-line…
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psnet.ahrq.gov/node/838855/psn-pdf
October 27, 2022 - this symptom
usually resolves within several days.1 Post-bronchoscopy elevation in body temperature occurs … performed—which is often the reason for using navigational bronchoscopy, as in this case—pneumothorax
occurs
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psnet.ahrq.gov/perspective/cybersecurity-and-how-maintain-patient-safety
March 27, 2024 - full integration between all the departments. 8
How to Respond to a Cyberattack
When an attack occurs … keep everyone informed of potential or current patient safety issues. 11 When a patient-safety event occurs … However, many resources and tools can be developed in advance and ready to use when a cyberattack occurs … healthcare organization will definitely find out exactly what kind of culture exists when a cyberattack occurs
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psnet.ahrq.gov/perspective/conversation-withbarbara-pelletreau-and-john-riggi-about-cybersecurity
March 27, 2024 - However, many resources and tools can be developed in advance and ready to use when a cyberattack occurs … healthcare organization will definitely find out exactly what kind of culture exists when a cyberattack occurs … full integration between all the departments. 8
How to Respond to a Cyberattack
When an attack occurs … keep everyone informed of potential or current patient safety issues. 11 When a patient-safety event occurs
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psnet.ahrq.gov/node/34607/psn-pdf
June 12, 2018 - A clinician's guide to surgical fires: how they occur, how
to prevent them, how to put them out.
June 12, 2018
A clinician's guide to surgical fires. How they occur, how to prevent them, how to put them out. Health
Devices. 2003;32(1):5-24.
https://psnet.ahrq.gov/issue/clinicians-guide-surgical-fires-how-they-occu…
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psnet.ahrq.gov/node/60980/psn-pdf
January 01, 2022 - Analysis of risk factors for patient safety events occurring
in the emergency department.
October 7, 2020
Alsabri M, Boudi Z, Zoubeidi T, et al. Analysis of risk factors for patient safety events occurring in the
emergency department. J Patient Saf. 2022;18(1):e124-e135. doi:10.1097/pts.0000000000000715.
https://p…
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psnet.ahrq.gov/node/39252/psn-pdf
August 08, 2010 - Where errors occur in the preparation and administration
of intravenous medicines: a systematic review and
Bayesian analysis.
August 8, 2010
McDowell SE, Mt-Isa S, Ashby D, et al. Where errors occur in the preparation and administration of
intravenous medicines: a systematic review and Bayesian analysis. Qual Saf …
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psnet.ahrq.gov/node/35876/psn-pdf
June 18, 2013 - External Inquiry into the adverse incident that occurred at
Queen's Medical Centre, Nottingham, 4th January 2001.
June 18, 2013
Toft B. London, UK; Crown Copyright: 2001.
https://psnet.ahrq.gov/issue/external-inquiry-adverse-incident-occurred-queens-medical-centre-nottingham-
4th-january-2001
This UK Department o…
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psnet.ahrq.gov/node/42993/psn-pdf
March 19, 2014 - Baccalaureate nursing students' accounts of medical
mistakes occurring in the clinical setting: implications for
curricula.
March 19, 2014
Noland CM. Baccalaureate nursing students' accounts of medical mistakes occurring in the clinical setting:
implications for curricula. J Nurs Educ. 2014;53(3):S34-7. doi:10.392…
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psnet.ahrq.gov/node/37156/psn-pdf
October 06, 2011 - Preventable harm occurring to critically ill children.
October 6, 2011
Larsen G, Donaldson AE, Parker HB, et al. Preventable harm occurring to critically ill children. Pediatr Crit
Care Med. 2007;8(4):331-336.
https://psnet.ahrq.gov/issue/preventable-harm-occurring-critically-ill-children
This retrospective cohort…
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psnet.ahrq.gov/web-mm/defensive-medicine-glowing-pain
November 01, 2012 - 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/web-mm/late-anemia-following-rh-disease-newborn
June 17, 2010 - 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