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  1. www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/CDI-facilitator-guide.pdf
    November 01, 2019 - Slide Factors Contributing to CDI SAY: Colonization of the intestinal tract with C. difficile occurs
  2. www.ahrq.gov/sites/default/files/2024-01/lipsitz-report.pdf
    January 01, 2024 - Final Progress Report: Improving Safety of Transitions to Skilled Nursing Care Using Video Conferencing 1. Title Page Title: Improving Safety of Transitions to Skilled Nursing Care Using Video Conferencing PI: Lewis Lipsitz, MD Team Members: Amber Moore, MD, MPHa,b; Julie C. Lima, MPH, PhDc; Sweta Patel, BD…
  3. www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/communication-facilitator-guide.docx
    June 01, 2021 - Aggressiveness, whether active or passive, occurs when someone attacks or ignores others' opinions in
  4. www.ahrq.gov/sites/default/files/publications/files/ltcmodule3.pdf
    June 01, 2012 - Often, when a change occurs that might signal illness in a resident, that change has nothing to do with … If a fall occurs, after taking care of the resident, assessing the resident again for risk factors is
  5. www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/prevhosp/impguide.html
    July 01, 2017 - were hospitalized is different from identifying changes in risk and intervening before hospitalization occurs
  6. www.ahrq.gov/research/findings/final-reports/stpra/stpra3.html
    April 01, 2018 - For example, assuming that the top event SSI occurs, the criticality of basic event A is the probability
  7. www.ahrq.gov/hai/tools/clabsi-cauti-icu/implement/playbook.html
    February 01, 2025 - Playbook for Preventing CLABSI and CAUTI in the ICU Setting The playbook helps your intensive care unit (ICU) understand how to integrate the Comprehensive Unit-based Safety Program (CUSP) and the tiered interventions introduced in the central line-associated bloodstream infection (CLABSI) and catheter-associat…
  8. www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/changing-system-slides.pptx
    June 01, 2021 - PowerPoint Presentation Changing the System To Improve Patient Safety Long-Term Care AHRQ Safety Program for Improving Antibiotic Use AHRQ Pub. No. 17(21)-0029 June 2021 Changing the System 1 Objectives Use barriers as opportunities to improve systems and prevent problems from recurring. List factors that may comp…
  9. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/nurse-role-dxsafety-apa.html
    September 01, 2022 - Reinforcing the Value and Roles of Nurses in Diagnostic Safety: Pragmatic Recommendations for Nurse Leaders and Educators Appendix A. SIDM Competencies To Improve Diagnosis and Suggested Questions for Debriefing Case Studies Previous Page   Table of Contents Reinforcing the Value and Roles of Nurse…
  10. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Stalhandske_71.pdf
    February 23, 2008 - Department of Veterans Affairs (VA), an emergency airway management event occurs outside of the operating … Specifics of the VA Policy The VA national policy addresses emergent and urgent airway management that occurs
  11. www.ahrq.gov/patient-safety/patients-families/consumer-exp/reporting/chapter4.html
    August 01, 2022 - Designing Consumer Reporting Systems for Patient Safety Events Chapter 4. Results and Key Findings Previous Page Next Page Table of Contents Designing Consumer Reporting Systems for Patient Safety Events Executive Summary Chapter 1. Background Chapter 2. Conceptual Framework and Design Chapt…
  12. www.ahrq.gov/hai/cauti-tools/phys-championsgd/section2.html
    October 01, 2015 - Resident Physicians as Champions in Preventing Device-Associated Infections Epidemiology of Invasive Devices and Complications Previous Page Next Page Table of Contents Resident Physicians as Champions in Preventing Device-Associated Infections Preamble and Summary Epidemiology of Invasive Devic…
  13. www.ahrq.gov/research/publications/search.html?page=17
    October 01, 2011 - Search Publications The Agency for Healthcare Research and Quality (AHRQ)'s publications offer practical information to help a variety of health care organizations, providers, and others make care safer in all health care settings. 171 - 180 of 191 Publications displayed Find Publications by Keyword or To…
  14. www.ahrq.gov/sites/default/files/wysiwyg/data/infographics/double-mastectomy.pdf
    February 01, 2016 - AHRQ Mastectomy SB Infographic v15 As this infographic shows, the rate of double mastectomies per 100,000 women more than tripled between 2005 and 2013. Mastectomies overall – both single and double mastectomies – increased 36 percent during that period. The rise in mastectomies occurred despite breast cancer…
  15. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/overview-cuspmvp-facguide.docx
    January 01, 2017 - Facilitator Guide: Build Your SSI Prevention Bundle Slide Title and Commentary Slide Number and Slide Title Slide Overview of the Comprehensive Unit-based Safety Program for Application to Mechanically Ventilated Patients SAY: Today, we will be giving you an overview of the Comprehensive Unit-based Safety Program…
  16. www.ahrq.gov/hai/tools/mvp/modules/cusp/overview-cusp-mvp-facguide.html
    February 01, 2017 - Overview of the Comprehensive Unit-based Safety Program for Application to Mechanically Ventilated Patients: Facilitator Guide AHRQ Safety Program for Mechanically Ventilated Patients Slide 1: Overview of the Comprehensive Unit-based Safety Program for Application to Mechanically Ventilated Patients Say: …
  17. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/implementation/training-tools/pf-engagement/pf-engagement-facnotes.docx
    May 01, 2017 - If an adverse outcome occurs, take the following immediate steps: 1. … SAY: When an incident occurs, it will be investigated and analyzed (e.g., a root cause analysis may
  18. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Drews_15.pdf
    February 26, 2008 - Error Producing Conditions in the Intensive Care Unit Error Producing Conditions in the Intensive Care Unit Frank A. Drews, PhD; Adrian Musters, BS; Matthew H. Samore, MD Abstract Up to 98,000 patients die because of human error in U.S. hospitals each year. Among the areas where errors occur frequently is t…
  19. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/fallsprev/ontimefallpxoverview-ig.pdf
    June 02, 2025 - It also asks which staff members are invited, who leads the meeting, and how often it occurs.
  20. www.ahrq.gov/sites/default/files/2025-04/elder-report.pdf
    January 01, 2025 - post-analytical office-based actions into a series of steps that form the testing process: • Ordering occurs … We found two themes, safety awareness (a leadership focus and communication that occurs around quality

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