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www.ahrq.gov/sites/default/files/wysiwyg/research/findings/making-healthcare-safer/mhs3/opioids-1.pdf
March 01, 2020 - Safety Practices
Given the importance of harms due to opioids, we identified potential patient safety … Safety Practices
Harms Due to Opioids 10-28
Author,
Year
Description of
Patient Safety
Practice … Safety Practices
Harms Due to Opioids 10-29
Author,
Year
Description of
Patient Safety
Practice … Safety Practices
Harms Due to Opioids 10-30
Author,
Year
Description of
Patient Safety
Practice … Safety Practices
Harms Due to Opioids 10-32
Author,
Year
Description of
Patient Safety
Practice
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psnet.ahrq.gov/web-mm/misconnection-leading-arterial-thrombosis
January 29, 2021 - The radial artery, in particular, follows a variable course in different patients. … Approaches to Improving Patient Safety Avoid injecting drugs and air bubbles into arterial lines All … Christian Bohringer, MBBS Consulting Editor, AHRQ, Patient Safety Network (PSNet) Professor of Clinical … Safety Authority. … Tubing Misconnections: Making the Connection to Patient Safety.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/130-ss-swiss-cheese-fg.docx
April 01, 2025 - As a refresher, the Science of Safety focuses on safe system design. … Patient safety and quality is a property of the system rather than the actions of individual caregivers … Provide patients a handout with clear written instructions and assign a provider to review them in detail … for several teaching sessions; afterwards, the mentor could observe her initial teaching session with patients … As a result, the defects persist and eventually, patients can suffer harm.
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psnet.ahrq.gov/node/836976/psn-pdf
April 27, 2022 - Intraosseous Line Extravasation in a Pediatric Trauma Patient. PSNet [internet]. 2022. … Compartment syndrome is a clinical diagnosis and patients’ reported symptoms are the earliest indicators … Approach to Improving Patient Safety
Overall, this case demonstrates how an unstable pediatric patient … Ideally, two large bore peripheral IV lines should be placed in unstable patients. … The “3 As” is a useful to assess for compartment
syndrome in pediatric patients.
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.257_slideshow.ppt
December 01, 2011 - devices among clinicians and their common health care uses
Describe the benefits of mobile technology to safety … *
*
Case: Multitasking Mishap (2)
The patient underwent successful PEG tube replacement on hospital … rounding with the attending, the resident was able to enter orders in real time as team members evaluated patients … Improving ambulatory prescribing safety with a handheld decision support system: a randomized controlled … enhance communication, access to literature, and connectivity to clinical systems, enhancing quality, safety
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hcup-us.ahrq.gov/reports/methods/2007_01.pdf
January 01, 2007 - However, patients 2, 7, and 9 are each
V1 V2V1V1V3V2V1 V3 V1 V2
Patient
1
Hospital 2 Hospital … 1
Level 1
Visits
Level 2
Patients
Level 3
Hospitals
Patient
2
Patient
3
Patient
4 … Sources of Variation
Consider a simple two-level hierarchy of patients within hospitals for patient … Are diagnosis specific outcome indicators based on administrative
data useful in assessing quality of … Quality and Safety in Healthcare, 13: 32-39,
2004.
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psnet.ahrq.gov/node/33873/psn-pdf
February 01, 2019 - that movement, but it's also coming from the disappointment that many
of us have about the overall indicators … It's not just how we're doing in patient safety
and quality, but what's missing that's not helping us … They don't understand quality and safety and how to work in teams. … safety project area. … safety and the health care systems.
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/head-neck-cancer_surveillance.pdf
August 01, 2012 - for Updating Systematic Reviews for the EHC Program
CER # 20:
Comparative effectiveness and safety … Comparative effectiveness and safety of
radiotherapy treatments for head and neck
cancer. … A
dosimetric correlation of radiation dose and
early grade 3 dysphagia in oropharyngeal
cancer patients … A
matched cohort comparison of head and
neck squamous cell carcinoma patients
treated with intensity … Multivariate analysis of quality of life
outcome for nasopharyngeal carcinoma
patients after treatment
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psnet.ahrq.gov/web-mm/missed-pneumonia
June 01, 2005 - The patient had taken a 2-hour plane ride the day before onset of symptoms. … The patient quickly improved on antibiotics and was discharged 2 days later. … Does this patient have community-acquired pneumonia? … April 12, 2023
Development of patient safety measures to identify inappropriate diagnosis … Perspective
The Role of Bar Coding and Smart Pumps in Safety
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digital.ahrq.gov/sites/default/files/docs/page/buildinghealthitresearchcapacity.pdf
December 01, 2012 - intended to promote and build research
capacity in the use of health IT to improve health
care quality, safety … funding disserta-
tion research projects focused in one of three research
areas: 1) the quality and safety … Most patient
portals give patients access
to a summary of their
health data and permit
two-way electronic … However, the
benefit of patient portals is contingent on patients’
ability to navigate the technology … now a Senior Consultant at Bates White
Economic Consulting, provides government agen-
cies and other clients
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/depression-postpartum-screening_disposition-comments.pdf
May 01, 2013 - Disposition of Comments for Efficacy and Safety of Screening for Postpartum Depression
Comparative … Effectiveness Research Review Disposition of Comments Report
Research Review Title: Efficacy and Safety … Efficacy
and Safety of Screening for Postpartum Depression. Comparative Effectiveness Review 106. … What are community patients? … It can be considered unethical to screen
women without a safety net and protocol in place.
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psnet.ahrq.gov/web-mm/check-anesthesia-machine
August 01, 2006 - Safety: A Personal Story
August 1, 2006
WebM&M Cases … safety, teamwork, safety leadership, and simulation to healthcare leaders and managers. … August 31, 2011
Optimizing Pediatric Patient Safety in the Emergency Care Setting. … Safety Research
December 1, 2003
Critical role of the surgeon–anesthesiologist … relationship for patient safety.
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/type-2-diabetes-medications-update_executive.pdf
March 01, 2011 - In addition to having an increased number of
medication choices, patients with type 2 diabetes often … organized these deficiencies and
recommendations using the PICOTS format for
specifying research questions: patient … Populations
Studies often employed narrow inclusion criteria,
enrolling patients at lowest risk for … complications, and
they commonly used run-in periods to avoid enrolling
patients with adverse effects … We identified the following research gaps
related to target patient populations:
1.
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www.ahrq.gov/sites/default/files/wysiwyg/chsp/compendium/2018-Compendium-TechDoc-update.pdf
January 01, 2018 - Safety net systems. The list provides three indicators related to safety net systems. … The DSH patient percentage is
defined as: DSH Patient Percent = (Medicare SSI Days/Total Medicare Days … The list also includes three indicators of teaching intensity. … percentage
The DSH patient percentage is defined as: DSH Patient Percentage = (Medicare
SSI days … How did safety-net hospitals cope in the 1990s?
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www.ahrq.gov/sites/default/files/2024-07/ellenbecker-boylan-report.pdf
January 01, 2024 - On average, nurses are most satisfied with
their relationships with patients and peers and with the … component of the SEM was specified with the eight subscales of
the HHNJS (described above) as observed indicators … 0.51 12.67
Stress & Workload 0.44 11.33
Relationship with
Physicians 0.31 7.14
Relationship with Patients … ”
Percent (%) of
Agencies Reporting
“yes”
Offer competitive benefits 97 78
Enhanced workplace safety … Comparison
between two wards for the care of severely demented patients.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/clinicians-providers/ahrq-works/impact-burnout.pdf
July 01, 2017 - safety,
and care quality. … Burnout can also threaten patient
safety and care quality when depersonalization leads to
poor interactions … with patients and when burned-out
physicians suffer from impaired attention, memory, and
executive … send
faxes to give doctors more face-to-face time with
patients. … Conclusion
Burnout takes a toll on physicians, their patients, and their
practices.
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psnet.ahrq.gov/node/867672/psn-pdf
February 26, 2025 - with severe abdominal pain and in patients with peritoneal
tenderness. … Case Analysis
This case involved a patient presenting with high-risk abdominal pain. … Safety
Imaging in High-Risk Abdominal Pain
Patients presenting to the ED with abdominal pain of uncertain … Safety Network (PSNet)
Professor
Department of Surgery, Division of Trauma, Acute Care Surgery, and … Barnes, MD, FACEP
Consulting Editor, AHRQ’s Patient Safety Network (PSNet)
https://psnet.ahrq.gov//
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digital.ahrq.gov/sites/default/files/docs/page/2006Welebob_051711comp.pdf
June 06, 2006 - 2006 Page 1
Connecting to Health:
Public – Private Sector Health Information
Exchange Efforts
Patient … Safety and Health IT Conference
Agency for Healthcare Research and Quality
June 6, 2006
Emily Welebob … 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Provider
inefficiencies
due to lack of
data to
support
patient … • Advancements in functionality to support
improvements in quality and safety are evident. … Accurately linking patient data- 80% of
respondents indicated that accurately
linking patient data
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www.uspreventiveservicestaskforce.org/uspstf/document/evidence-summary/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing
August 20, 2019 - Prevalence of BRCA1 and BRCA2 gene mutations in patients with early-onset breast cancer. … Patients' resistance to risk information in genetic counseling for BRCA1 /2. … Psychological support needs for women at high genetic risk of breast cancer: some preliminary indicators … Impact of panel gene testing for hereditary breast and ovarian cancer on patients. … Short-term surgical outcome and safety of risk reducing salpingo-oophorectomy in BRCA1 /2 mutation carriers
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psnet.ahrq.gov/web-mm/one-dose-fifty-pills
January 13, 2021 - Unfortunately, pride and shame can take precedence over patient safety. … Second, system-based interventions can preserve patient safety and educate housestaff while hopefully … The answer to this seeming conflict of autonomy versus patient safety is in creating a culture where … Creation of a Medical Procedure Service to Improve Patient Safety
March 1, 2008 … May 12, 2021
Establishing a multi-institutional quality and patient safety consortium