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psnet.ahrq.gov/node/73102/psn-pdf
July 01, 2022 - effective than relying on a list of prescriptions provided by a pharmacy or dictated from
memory by a patient … Effectiveness of opioid prescriptions and alternate options
Review with client:? … If there are alerts of potential medication-related problems, the care manager
follows up with the patient … The positive experience
resulting from this nurse-pharmacist collaboration prompted working with Vanderbilt … Aging to further develop HomeMeds, in
which these highly skilled community health coaches, adept at patient
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psnet.ahrq.gov/perspective/what-makes-good-checklist
October 01, 2010 - field differs from the aviation field in this area, as there can be more variability in surgical team experience … It's about putting the patient first. … care or the doctor and nurse when they're treating patients. … I think patients deserve better than that. … We are so quick to say, patients are dying, we must go do something.
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psnet.ahrq.gov/node/836939/psn-pdf
April 27, 2022 - the doubling of use of intensive care unit (ICU) beds,
as well as high patient acuity, scarcity of … communication amongst providers and with patients and their friends
and family. … of acutely ill patients. … volume, centered patient safety, and reduced staff burnout. … by reducing patient visits from clinical staff.
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psnet.ahrq.gov/web-mm/ems-perils-hospital-overcrowding
November 25, 2020 - When the patient arrived at 19:40, the ED was severely impacted with a high volume of patients in the … waiting room and multiple boarding patients awaiting inpatient beds. … to an ED unless the patient refuses care at the scene. 10 Although most ambulance patients require … safety, patient experience, and the morale of hospital staff. … Some Patients Can’t Wait: Improving Timeliness of Emergency Department Care.
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psnet.ahrq.gov/perspective/evidence-based-physical-examination-patient-safety-practice
November 01, 2012 - And, to arrive in America was to have this wonderful experience of actually using all the technology … we as physicians make contact with patients. … important event in the patient–physician encounter. … The patient in the bed can seem almost as an icon for the "real" patient who's in the computer—who I … AV : I think clinicians still enjoy their time with patients.
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psnet.ahrq.gov/innovation/risk-mitigation-using-anesthesia-risk-alert-program-applying-proactive-approach-data
February 26, 2025 - Safety Organization, the NAPA Anesthesia Patient Safety Institute (NAPSI), which monitors patients for … The resulting five high-risk clinical scenarios focus on patients with (1) known or suspected difficult … airways in patients undergoing general endotracheal anesthesia, (2) a high body mass index (greater … Because this patient information is not gathered and documented on all patients, the NAPSI team could … Specifically, the team observed the number of adverse events in all patients with a body mass index at
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psnet.ahrq.gov/web-mm/obstructed-view
August 07, 2019 - The patient had never had a colonoscopy. … The nasogastric tube is really just for patient comfort and may be omitted if the patient is not retching … A patient who is getting sicker needs urgent surgical evaluation." … Obstructions in patients without a history of abdominal surgery are uncommon and warrant early surgical … January 10, 2024
Patients' perspectives on quality and patient safety failures: lessons
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psnet.ahrq.gov/perspective/aviation-safety-methods-quickly-adopted-questions-remain
January 01, 2006 - lifesaving task of evacuating more than 300 panicking individuals faster than I could ever evacuate 30 patients … also may result in reporting systems that are more responsive and relevant to the local providers, patients … Beforehand, they just went along and processed their patients, with no open communication about how to … Association of open communication and the emotional and behavioural impact of medical error on patients … March 12, 2025
Long-term impacts faced by patients and families after harmful healthcare
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psnet.ahrq.gov/sites/default/files/2024-09/final_spotlight_case_open_wound_of_the_elbow_slides_09.19.2024.pptx
January 01, 2024 - foreign body is in superficial (as opposed to deep) tissue and is highly dependent on operator skill and experience … antibiotic treatment (termed “prophylactic” by the authors) for patients with non-bite wounds. … For some patients, probably including the one in this case, even delayed closure is not feasible or may … Alternatively, patients should be instructed to return to the index ED for re-evaluation.
49
49 … Take Home Points
50
Take-Home Points (1)
51
Evaluate all patients for their risk of wound infection
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psnet.ahrq.gov/node/33618/psn-pdf
September 01, 2005 - Playing Well with Others: "Translocational Research" in
Patient Safety
September 1, 2005
Wachter R … Playing Well with Others: "Translocational Research" in Patient Safety. PSNet [internet]. 2005. … https://psnet.ahrq.gov/perspective/playing-well-others-translocational-research-patient-safety
Perspective … Hospital nurse staffing and patient mortality,
nurse burnout, and job dissatisfaction. … In: Making Health Care Safer:
A Critical Analysis of Patient Safety Practices.
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psnet.ahrq.gov/perspective/conversation-remle-p-crowe-phd
May 16, 2022 - The things that we asked about was whether or not there were problems during the transfer of patients … safety, that not all parts of the healthcare continuum experience this the same but we're able to compare … We don't just proactively intubate all our patients because they might have some breathing difficulty … The project is huge, not just for patients, but for providers, as well as the communities. … A recent systematic review identified a median rate of 5.9 incidents per 100 records/transports/patients
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psnet.ahrq.gov/perspective/identifying-safety-events-prehospital-setting
May 16, 2022 - A recent systematic review identified a median rate of 5.9 incidents per 100 records/transports/patients … The things that we asked about was whether or not there were problems during the transfer of patients … safety, that not all parts of the healthcare continuum experience this the same but we're able to compare … We don't just proactively intubate all our patients because they might have some breathing difficulty … The project is huge, not just for patients, but for providers, as well as the communities.
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psnet.ahrq.gov/node/33686/psn-pdf
August 01, 2009 - When they really dug into the data, they found that of about 1750
patients seen in 2003, about 40 patients … Of
those patients, 19 died. … The medication is not here and the patient needs
it." … The patient needs it. … Now from what our experience has been in the industry, organizations that identify the problem, investigate
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psnet.ahrq.gov/web-mm/are-you-mrs-issue-identification-over-telephone
January 01, 2016 - Provide clear protocols for identifying patients who lack identification (i.e., patients carrying no … Educate patients on the importance and relevance of correct patient identification. … Encourage patients to participate in the identification process. … and asked 25 providers to place test orders.( 10 ) The researchers intentionally gave patients similar … None of the providers looked at the second identifier when selecting patients from a pick list, even
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psnet.ahrq.gov/node/60044/psn-pdf
March 16, 2020 - impact of culture on patient safety and
factors that contribute to a culture of patient
safety. … Engage patients and families in QIPS efforts. … q=/issue/patient-safety-morning-report-innovation-teaching-core-patient-safety-principles-third-year … multifaceted programs that incorporate several different learning
approaches and authentic experiences with patients … Engaging with patients and families to share information, disclose errors and improve care.
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psnet.ahrq.gov/perspective/medication-safety-nursing-homes-whats-wrong-and-how-fix-it
August 01, 2012 - is called the Minimum Data Set or the MDS, which gives a lot of information about the residents (patients … experience, are now publicly reported on the Web. … Multicomponent pharmacist intervention did not reduce clinically important medication errors for ambulatory patients … Safety in Frail Older Patients
November 26, 2019
Adverse events in long-term … December 15, 2010
Addressing delays in medication administration for patients transferred
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psnet.ahrq.gov/web-mm/discharge-instructions-pacu-who-remembers
August 05, 2009 - The patient pushed herself to bear weight several weeks after the surgery. … For verbal communication with patients, it is important to limit the quantity of information that patients … a critically important aspect of patient care, which has significant implications for patient outcomes … Interventions to improve care for patients with limited health literacy. … patients aware of when they do not understand?
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psnet.ahrq.gov/node/49459/psn-pdf
September 01, 2004 - emergency physician, administration of intravenous crystalloid and empiric broad-spectrum antibiotics,
the patient … telephone the pharmacy for clarification, a physician demanding her immediate
assistance with another patient … Several minutes later, when she re-entered the room of the
leukemia patient, she forgot what she had … The patient experienced no adverse effects—presumably he received none of the Diprivan, given the air … The Commentary
Interruptions, Distractions, and Multitasking: Ubiquitous Threats to Patient Safety
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psnet.ahrq.gov/perspective/conversation-withpeter-j-pronovost-md-phd-0
October 01, 2010 - It's about putting the patient first. … care or the doctor and nurse when they're treating patients. … I think patients deserve better than that. … We are so quick to say, patients are dying, we must go do something. … field differs from the aviation field in this area, as there can be more variability in surgical team experience
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psnet.ahrq.gov/perspective/conversation-david-blumenthal-md-mpp-0
March 27, 2024 - In the work that we are doing at the Commonwealth Fund on the optimal management of high-cost patients … The engagement of patients has enormous potential. … One thing I've concluded from the experience of who naturally and proactively adopted records and who … It is filtered and shows him maybe 20 patients. … It kept my patients from going to Chelsea, Massachusetts at 4:00 on Saturday morning to find a spot in