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41. Selected Best Practices and Suggestions for Improvement (pdf file)
    www.talkingquality.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4u_combo_pdi09-postoprespfailure-bestpractices.pdf
    May 17, 2016 - o Decreased central nervous system input (head injury, ingestion of central nervous system depressant … o Peripheral nerve/neuromuscular junction (spinal cord injury, organophosphate/carbamate poisoning, … expansion exercises with children, such as incentive spirometry, deep breathing, intermittent positive-pressure … breathing, and continuous positive airway pressure. … Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review

42. Module 1: Preventing Falls in Hospitals—Training Guide | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/fall-prevention/workshop/module-1/guide.html
    September 01, 2017 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit Pressure … Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI … Between 30 and 51 percent of falls in hospitals result in an injury ranging from bruises to severe wounds … The cost of serious fall-related injuries at three Midwestern hospitals. … Thus, the CAUTI, SSI, and Pressure Injury committees used the AHRQ assessment tools, and a speak-up campaign

43. Fall Prevention Toolkit (doc file)
    www.talkingquality.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/fallprevention-training/module1/module1_tools.docx
    March 01, 2013 - bodies have definitions (e.g., the NQF defines a fall as “an unplanned descent to the floor without injury … study by van Gaal and colleagues evaluated a program that targeted three patient safety practices (pressure … and found an overall positive effect on the development of any adverse event, a composite measure of pressure … out specific fall assessments or interventions, and investigations such as lying and standing blood pressure … Violence and Injury Prevention: Falls. 2012.

44. Hospitals and Health Systems | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/resource/index.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit Pressure … Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI … Patients with Limited English Proficiency NICU Toolkit Preventing Falls in Hospitals Preventing Pressure

45. Fall TIPS: A Patient-Centered Fall Prevention Toolkit | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/fall-tips/index.html
    February 01, 2021 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit Pressure … Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI … Background Falls are the most common cause of preventable injury.

46. AHRQ Quality Indicators Prioritization Worksheet Example (pdf file)
    www.talkingquality.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/c2_combo_prioritizationworksheetexample.pdf
    June 29, 2016 - Postoperative Sepsis 12.7 11.7 15 $49,215 $ 738,225 N 9 7 3 Y Y Y Y Y PSI 14 Postoperative Wound … - Injury to Neonate 0.0 0.1 0 $88,000 $ - N 2 3 9 Y Y Y Y Y PSI 18 Obstetric … Trauma-Vaginal Delivery With Instrument 134.8 135.1 17 $90,000 $ 1,530,000 N 2 3 8 Y Y … Y Y Y PSI 19 Obstetric Trauma-Vaginal Delivery Without Instrument 17.0 17.9 5 $96,000 $ … Rate 0.0 16.2 0 $117,815 $ - N 9 10 10 Y Y Y Y Y PDI 11 Postoperative Wound

47. Data Infographics | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/data/infographics/index.html
    March 01, 2024 - Antidepressant Prescriptions Potentially Preventable Pediatric Hospital Stays Most Common Cause of Injuries … People Who Spent the Most for Healthcare in 2017 Causes of Hospital Stays for Traumatic Brain Injury … in 2017 High Healthcare Spending in 2017 Sports-Related Traumatic Brain Injuries Among Children … Hemodialysis Patients Worse Among Blacks HRSA's Health Center Program Making Progress on Blood Pressure

48. SOPS Nursing Home Survey: What You Need To Know - Nicholas Castle, Ph.D., M.H.A., FGSA (pdf file)
    www.talkingquality.ahrq.gov/sites/default/files/wysiwyg/sops/events/webinar/03-nh_webcast-castle.pdf
    January 01, 2006 - Hospitals ►Moving, Transferring, or Lifting Residents ►Medication errors ►Falls ►Pressure ulcers ►Sanitation … Patient Safety Culture in Nursing Homes • Safety culture influences staff as well as residents ► Overall injury

49. Case Scenarios: Handling Challenging Communications | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide5/scenarios.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit Pressure … Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI … Eventually the team is able to re-establish Mary's normal heart rate, blood pressure, and adequate blood … During the resuscitation efforts, information obtained from the devices monitoring Mary's EKG, blood pressure … Over the next few days, it is clear that he has suffered a significant brain injury due to the lack of

50. Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/research/findings/studies/index.html?page=484
    January 01, 2024 - (132) Blood Thinners (79) Brain Injury (64) Breast Feeding (18) Burnout (64) Cancer … (255) Imaging (245) Implementation (191) Infectious Diseases (260) Influenza (41) Injuries … and Wounds (207) Inpatient Care (221) Intensive Care Unit (ICU) (267) Kidney Disease and … Tools & Toolkits (49) Training (143) Transitions of Care (192) Transplantation (141) Trauma … Adv Skin Wound Care 2013 Feb;26(2):83-92; quiz p.93-4. doi: 10.1097/01.ASW.0000426718.59326.bb. .

51. B3A Combo Chartsforpresentations (xls file)
    www.talkingquality.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/b3a_combo_chartsforpresentations.xlsx
    January 01, 2006 - 0.1493487343 PSI 12 Statistically Lower 0 PSI 13 Postoperative sepsis 17.433 0 PSI 14 Postoperative wound … 0.0683602771 PSI 15 Statistically Lower 0 PSI 16 Transfusion reaction 0.000004 0 PSI 17 Birth trauma … - injury to neonate 2.188 0 PSI 18 Obstetric trauma - vaginal with instrument 0.139241 0.062898 … 0.215583 133.928 -99.8960329431 0.0570030165 0.0570022699 PSI 18 Statistically Lower 0 PSI 19 Obstetric trauma … 0.01989 -100 -100 117.3881347411 PDI 10 No Statistically Significant Difference 0 PDI 11 Postoperative Wound

52. Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/research/findings/studies/index.html?page=485
    January 01, 2024 - Autism (31) Back Health and Pain (58) Behavioral Health (699) Blood Clots (62) Blood Pressure … (132) Blood Thinners (79) Brain Injury (64) Breast Feeding (18) Burnout (64) Cancer … (255) Imaging (245) Implementation (191) Infectious Diseases (260) Influenza (41) Injuries … and Wounds (207) Inpatient Care (221) Intensive Care Unit (ICU) (267) Kidney Disease and … Tools & Toolkits (49) Training (143) Transitions of Care (192) Transplantation (141) Trauma

53. Appropriate Disclosure to a Patient: Video | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/candor/videos/app-disclosure.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit Pressure … Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI

54. Accountability—Peer to Peer Coaching: Video | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/candor/videos/accountability.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit Pressure … Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI

55. Communication and Optimal Resolution (CANDOR): Grand Rounds Presentation Video | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/candor/videos/grpresentation.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit Pressure … Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI

56. Planning for Meetings with Family: Video | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/candor/videos/meeting.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit Pressure … Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI

57. Event Investigation and Analysis Guide: Appendix B | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide4/apb.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit Pressure … Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI … However, she felt pressure from senior leaders to comply with the request and did not speak up. … 0945) The CNA reports back to RN#1 the following: "Your new patient’s blood sugar was 149, the blood pressure … 0947) The CNA reports back to RN#2 the following: "Your new patient’s blood sugar was 525, the blood pressure

58. Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/research/findings/studies/index.html?page=480
    January 01, 2024 - Autism (31) Back Health and Pain (58) Behavioral Health (699) Blood Clots (62) Blood Pressure … (132) Blood Thinners (79) Brain Injury (64) Breast Feeding (18) Burnout (63) Cancer … and Wounds (207) Inpatient Care (220) Intensive Care Unit (ICU) (264) Kidney Disease and … Tools & Toolkits (49) Training (143) Transitions of Care (192) Transplantation (141) Trauma … Keywords: Elderly, Medication, Medication: Safety, Nursing Homes, Long-Term Care, Injuries and Wounds

59. Home Mechanical Ventilators: Protocol Appendix A (pdf file)
    www.talkingquality.ahrq.gov/sites/default/files/wysiwyg/research/findings/ta/topicrefinement/hmv-protocol-appendixa.pdf
    October 11, 2017 - or NPPV or "Positive Airway Pressure*" or "positive end- expiratory pressure*").ti. 25411 3 1 or … 5811 14 *Obesity/ 256788 15 *Respiratory Insufficiency/ 25610 16 *Scoliosis/ 20526 17 *Spinal Cord Injuries … ventilation" or "non-invasive positive pressure ventilation" or NPPV or "Positive Airway Pressure*" … ventilation" or "non-invasive positive pressure ventilation" or NPPV or "Positive Airway Pressure*" … ventilation" or "non-invasive positive pressure ventilation" or NPPV or "Positive Airway Pressure*"

60. Toolkit for Using the AHRQ Quality Indicators | Agency for Healthcare Research and Quality
    www.talkingquality.ahrq.gov/patient-safety/settings/hospital/resource/qitool/index.html
    March 01, 2017 - Injury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI … detailed information on best practices for selected indicators Introduction PDF [248.26 KB] PSI03 Pressure … Pulmonary Embolism or DVT PDF [136.84 KB] PSI13 Postoperative Sepsis PDF [78.65 KB] PSI14 Postoperative Wound … Dehiscence PDF [137.17 KB] PSI15 Accidental Puncture or Laceration PDF [115.46 KB] PSI18-19 Obstetric Trauma … Respiratory Failure PDF [270.5 KB] PDI10 Postoperative Sepsis PDF [286.81 KB] PDI11 Postoperative Wound