Results

Total Results: 4,038 records

Showing results for "occurs".

301. Code Status Confusion | PSNet
     psnet.ahrq.gov/web-mm/code-status-confusion
     September 01, 2006 - If this occurs, hospital-based physicians must discuss treatment decisions with a surrogate decision-maker … If a cardiopulmonary arrest occurs, there is no opportunity to ask the patient whether she wants cardiopulmonary

302. The Wrongful Resuscitation | PSNet
     psnet.ahrq.gov/web-mm/wrongful-resuscitation
     October 12, 2012 - Too often, the timing of discussions to clarify patient preferences only occurs in the last days of life … Rather, the more common error occurs when the physician has not written a DNR order because the patient's

303. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49798/psn-pdf
     July 01, 2017 - ACPO typically occurs in hospitalized or institutionalized patients after surgery or in association … ischemia is present.(1) Even when pharmacologic or endoscopic therapy for ACPO is successful, relapse occurs

304. Mechanical Prosthetic Valve Thrombosis with Thromboembolism. | PSNet
     psnet.ahrq.gov/web-mm/mechanical-prosthetic-valve-thrombosis-thromboembolism
     August 21, 2005 - Although this complication occurs more commonly on a mechanical mitral valve than on a mechanical aortic … recommended, in part because intravenous heparin therapy can be rapidly reversed with protamine if bleeding occurs

305. Treatment Challenges After Discharge | PSNet
     psnet.ahrq.gov/web-mm/treatment-challenges-after-discharge
     January 03, 2017 - Sadly, though, direct communication between physicians occurs only 3%–20% of the time, and the discharge … One such opportunity for harm occurs when test results are pending at the time of a care transition.

306. Spotlight Case [MONTH] 2003 (ppt file)
     psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.227_slideshow.ppt
     November 01, 2010 - Lack of direct or indirect communication between discharging and receiving team Direct communication occurs

307. In response to "Failure to Report" (March 2007) | PSNet
     psnet.ahrq.gov/perspective/response-failure-report-march-2007
     June 01, 2007 - When an error occurs in a situation where nurses may be manipulating a medication in a non-emergency

308. Spotlight Case July 2008 (ppt file)
     psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.254_slideshow.ppt
     November 01, 2011 - Misses (2) Near misses may also be identified through active clinical monitoring Active monitoring occurs

309. Spotlight
     psnet.ahrq.gov/sites/default/files/2024-09/final_spotlight_case_open_wound_of_the_elbow_slides_09.19.2024.pptx
     January 01, 2024 - Medical error occurs when a clinician neglects to identify and remove foreign matter associated with … Patient harm occurs when retained foreign matter leads to avoidable infection, discomfort, delayed healing … Ideally, processes should exist to ensure that follow up occurs within a defined period with a specific

310. A clinician's guide to surgical fires: how they occur, how to prevent them, how to put them out. | PSNet
     psnet.ahrq.gov/issue/clinicians-guide-surgical-fires-how-they-occur-how-prevent-them-how-put-them-out
     March 12, 2025 - Commentary A clinician's guide to surgical fires: how they occur, how to prevent them, how to put them out. Citation Text: 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. Copy Citation Format: …

311. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/867357/psn-pdf
     December 18, 2024 - Inadvertent esophageal intubation occurs more often when it was necessary to apply pressure to the front … P stands for pneumothorax, which typically occurs in trauma patients with rib fractures or patients

312. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33586/psn-pdf
     December 15, 2024 - This phenomenon occurs because of the sheer number of alerts, and it is compounded by the fact that

313. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33603/psn-pdf
     September 15, 2024 - NHSN) defines a surgical site infection (SSI) as an infection related to an operative procedure that occurs

314. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/837958/psn-pdf
     December 01, 2021 - until the patient is transferred to hospital emergency department care.”1, 2 Operationally, wall time occurs … with an ambulance patient and provide ongoing care until an appropriate transition of care to the ED occurs … do so, they do have an ethical obligation to continue providing care until an appropriate handoff occurs

315. External Inquiry into the adverse incident that occurred at Queen's Medical Centre, Nottingham, 4th January 2001. | PSNet
     psnet.ahrq.gov/issue/external-inquiry-adverse-incident-occurred-queens-medical-centre-nottingham-4th-january-2001
     September 10, 2014 - Book/Report External Inquiry into the adverse incident that occurred at Queen's Medical Centre, Nottingham, 4th January 2001. Citation Text: External Inquiry into the adverse incident that occurred at Queen's Medical Centre, Nottingham, 4th January 2001. Toft B. London, UK; Crown C…

316. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/862601/psn-pdf
     February 14, 2024 - Why simulation matters: a systematic review on medical errors occurring during simulated health care. February 14, 2024 Bokka L, Ciuffo F, Clapper TC. Why simulation matters: a systematic review on medical errors occurring during simulated health care. J Patient Saf. 2024;20(2):110-118. doi:10.1097/pts.000000000000…

317. Medication errors occurring with the use of bar-code administration technology. | PSNet
     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. Copy Citation …

318. Systematic evaluation of errors occurring during the preparation of intravenous medication. | PSNet
     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…

319. Classification of adverse events occurring in a surgical intensive care unit. | PSNet
     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. Copy Citation Format: Goog…

320. Hemorrhagic Shock after Elective Spine Surgery: Failure to Rescue after Limited Response to Nursing Concerns. | PSNet
     psnet.ahrq.gov/web-mm/hemorrhagic-shock-after-elective-spine-surgery-failure-rescue-after-limited-response-nursing
     October 31, 2023 - 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