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psnet.ahrq.gov/perspective/conversation-david-juurlink-md-phd
May 22, 2017 - We do have some tools that will allow us to identify people who are at particularly high risk of being … Risk mitigation measures, such as urine toxicology screening, patient contracts, and risk assessment … tools, are also increasingly popular, although there is limited evidence regarding whether or how these … While there are no perfect risk assessment instruments, universal screening and triaging of chronic opioid … users with tools such as the Screening, Brief Intervention, and Referral to Treatment model also represent
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psnet.ahrq.gov/web-mm/risks-malpositioned-gastrostomy-tube-and-poor-communication
August 01, 2012 - location-related error , where the abnormality was outside the anatomic area of focus (i.e., runoff of oral … number of care teams performing gastrostomy procedures where possible, to standardize communication tools … Department of Health and Human Services. … Department of Health and Human Services. … May 25, 2016
A scoping review of communication tools applicable to patients and their
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psnet.ahrq.gov/periodic-issue/periodic-issue-287
April 28, 2021 - BMC Health Serv Res . 2021; 21(1) :114 . … Int J Qual Health Care . 2021; 33(1) . … She stopped taking insulin because she was not tolerating any oral intake. … diabetics, the use of a stepwise approach to diagnosing acid-based disorders, clinical decision support tools … was admitted for scheduled Cesarean delivery, before being tested according to a universal inpatient screening
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psnet.ahrq.gov/sites/default/files/2023-11/spotlight_case_the_risk_of_malpositioned.pdf
January 01, 2023 - location-related error, where the abnormality was outside the anatomic area of focus (i.e., runoff
of oral … – Current best practices include using checklists at hand-offs, implementing standardized hand-off tools … Health
care providers and care teams should be aware of basic strategies to recognize and handle PEG … number of care teams performing gastrostomy procedures where possible, to
standardize communication tools … Area of Focus: Improving Health Care Quality. 2006. Accessed
November 6, 2023.
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psnet.ahrq.gov/web-mm/medication-reconciliation-pitfalls
May 01, 2006 - Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … done in instances when the medication is hard to obtain (e.g., Revlimid [lenalidomide], a specialty oral … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/issue/risk-management-radiology-departments
January 03, 2007 - : lessons learned in pediatrics within a large academic health system. … January 25, 2023
Unintended consequences of patient online access to health records: … Systematic review, recommendations, and novel model for health IT collaboration. … March 24, 2010
Medication errors involving oral chemotherapy. … December 13, 2017
Focus On: Health Care Policy and Quality.
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psnet.ahrq.gov/perspective/conversation-withrichard-ricciardi-about-office-based-patient-safety
January 31, 2024 - During the meeting, attendees would talk about the TeamSTEPPS program, the tools and materials, and how … because there’s a physical trauma of needing to have repeated diagnostic or preventative testing and screening … Sarah Mossburg : I’m curious about any strategies or tools that providers working in office-based care … The mitigation strategy of incorporating individualized fall risk screening to identify patients most … However, building awareness of frequently misdiagnosed conditions in primary care and developing tools
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psnet.ahrq.gov/perspective/opioid-overdose-patient-safety-problem
May 01, 2017 - Such efforts must be accompanied by increased use of alternative pharmacologic and nonpharmacologic tools … Risk mitigation measures, such as urine toxicology screening, patient contracts, and risk assessment … tools, are also increasingly popular, although there is limited evidence regarding whether or how these … While there are no perfect risk assessment instruments, universal screening and triaging of chronic opioid … users with tools such as the Screening, Brief Intervention, and Referral to Treatment model also represent
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psnet.ahrq.gov/web-mm/sick-and-pregnant
August 25, 2021 - Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services … Some drugs, such as oral contraceptives, are classified as category X, when data show that they are not … J Womens Health (Larchmt). 2005;14:61-67. [go to PubMed] 2. … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/node/853774/psn-pdf
September 27, 2023 - heart rate 104 beats per minute,
respirations 16 per minute, oxygen saturation 97% on room air, and oral … Triage tools should be improved to better identify high-risk presentations, given anatomic and physiologic … including the Centers for Medicare & Medicaid Services
(CMS) and The Joint Commission (TJC), demand screening … of the nation’s mental health
crisis. … Geriatric screening, triage urgency, and 30-Day
mortality in older emergency department patients.
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psnet.ahrq.gov/periodic-issue/periodic-issue-330
February 23, 2022 - frequently missed tasks such as patient surveillance, comforting patients, skin care, ambulation, and oral … The COVID-19 pandemic disrupted many aspects of health care. … The usability of health information technology, such as electronic health records (EHR), continues to … associated with low back pain that should prompt expedited evaluation, the importance of lung cancer screening … The commentary discusses the challenges of screening for suicide risk and the importance of continuity
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psnet.ahrq.gov/issue/trauma-when-theres-no-time-count
April 20, 2016 - March 6, 2005
Association of display of patient photographs in the electronic health … January 20, 2021
Critical care nurses’ physical and mental health, worksite wellness … February 2, 2022
The impact of racism on child and adolescent health. … August 19, 2015
An observational study of direct oral anticoagulant awareness indicating … August 21, 2019
Estimating breast cancer overdiagnosis after screening mammography among
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psnet.ahrq.gov/node/857059/psn-pdf
November 29, 2023 - location-related error, where the abnormality was outside the anatomic area of focus (i.e., runoff of
oral … .38,42 Current best practices include
using checklists at hand-offs, implementing standardized hand-off tools … number of care teams performing gastrostomy procedures where possible, to
standardize communication tools … Department of Health and Human Services. … Department of Health and Human Services.
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psnet.ahrq.gov/issue/nurses-perspective-serious-adverse-drug-event
August 29, 2007 - Am J Health Syst Pharm. 1999;56(9):904-7. … Am J Health Syst Pharm . 1999; 56 (9) :904-7 . … Am J Health Syst Pharm. 1999;56(9):904-7. … October 15, 2008
An observational study of direct oral anticoagulant awareness indicating … May 1, 2019
Screening for adverse drug events: a randomized trial of automated calls
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psnet.ahrq.gov/periodic-issue/periodic-issue-286
April 28, 2021 - Health Care Anal . 2021; Epub Mar 22 . … Health Care Anal . 2021; Epub Mar 22 . … She stopped taking insulin because she was not tolerating any oral intake. … diabetics, the use of a stepwise approach to diagnosing acid-based disorders, clinical decision support tools … was admitted for scheduled Cesarean delivery, before being tested according to a universal inpatient screening
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psnet.ahrq.gov/periodic-issue/periodic-issue-276
January 29, 2021 - e.g., access to personal protective equipment, liability coverage), patient care (e.g., guidance for screening … Qual Manag Health Care . 2021; 30(1) :61-68 . … Fatigue among health care workers can increase risk of errors. … During rounds the next morning, the patient reported new oral pain (which had begun the previous day) … assessment in the hospital setting during cross-coverage and the value of structured, validated hand-off tools
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psnet.ahrq.gov/perspective/patient-safety-office-based-care-settings
January 31, 2024 - The mitigation strategy of incorporating individualized fall risk screening to identify patients most … However, building awareness of frequently misdiagnosed conditions in primary care and developing tools … practices and tools designed to increase the effectiveness of communication to improve patient safety … Team Strategies and Tools to Enhance Performance and Patient Safety at primary healthcare units: Effect … because there’s a physical trauma of needing to have repeated diagnostic or preventative testing and screening
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psnet.ahrq.gov/node/33806/psn-pdf
April 01, 2016 - We ultimately
https://psnet.ahrq.gov/issue/development-and-implementation-oral-sign-out-skills-curriculum … RW: How important were the IT tools? … There's certainly still
huge potential and room for improvement and ease in creating handoff tools. … see the value and importance of having these types of tools available. … techniques, huddles, or having a formal debrief to go through things were all
relatively poorly applied in health
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psnet.ahrq.gov/issue/how-does-law-recognize-and-deal-medical-errors
March 17, 2021 - September 12, 2018
Direct observation of depression screening: identifying diagnostic … August 26, 2020
Inappropriate dosing of direct oral anticoagulants in patients with atrial … August 27, 2014
Patient safety: this is public health. … August 21, 2019
Disruptive behavior affects hospital financial health. … Health Care Executives and Administrators
Legal and Policy Approaches
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psnet.ahrq.gov/web-mm/delayed-evaluation-abdominal-pain-elderly-patient
February 26, 2020 - heart rate 104 beats per minute, respirations 16 per minute, oxygen saturation 97% on room air, and oral … Triage tools should be improved to better identify high-risk presentations, given anatomic and physiologic … including the Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC), demand screening … of the nation’s mental health crisis. … Geriatric screening, triage urgency, and 30-Day mortality in older emergency department patients.