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6361. AHRQ Safety Program for Perinatal Care: Experiences from the Frontline (pdf file)
      www.talkingquality.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_lowvision.pdf
      May 01, 2017 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor

6362. AHRQ Safety Program for Perinatal Care: Experiences from the Frontline (pdf file)
      www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_fullcolor.pdf
      May 01, 2017 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor

6363. AHRQ Safety Program for Perinatal Care: Experiences from the Frontline (pdf file)
      www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_lowvision.pdf
      May 01, 2017 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor

6364. AHRQ Safety Program for Perinatal Care: Experiences from the Frontline (pdf file)
      preventiveservices.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_lowvision.pdf
      May 01, 2017 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor

6365. AHRQ Safety Program for Perinatal Care: Experiences from the Frontline (pdf file)
      preventiveservices.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_fullcolor.pdf
      May 01, 2017 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor

6366. AHRQ Safety Program for Perinatal Care: Experiences from the Frontline (pdf file)
      ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_fullcolor.pdf
      May 01, 2017 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor

6367. AHRQ Safety Program for Perinatal Care: Experiences from the Frontline (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_lowvision.pdf
      May 01, 2017 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor

6368. AHRQ Safety Program for Perinatal Care: Experiences from the Frontline (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_fullcolor.pdf
      May 01, 2017 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor

6369. Anticipatory Guidance for Prevention of Stroke in Children with Sickle Cell Disease (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-225-fullreport.pdf
      June 01, 2019 - experience a stroke by 20 years of age; approximately 13 percent show evidence of silent infarcts, that is, injuries … Risk factors for stroke include a history of TIA, elevated systolic blood pressure, elevated steady‐state … These lesions are evidence of brain injury and should prompt evaluation of the child for learning and

6370. Assessing Harms when Comparing Medical Interventions | Effective Health Care (EHC) Program
      effectivehealthcare-admin.ahrq.gov/products/methods-guidance-harms/methods
      May 01, 2020 - Pressure to keep dropouts low in trials may result in rates that do not reflect real-world practice. … Hyperbaric oxygen therapy for traumatic brain injury: a systematic review of the evidence. … method based on the conclusions of international consensus meetings: application to drug-induced liver injuries

6371. Patient Safety Learning Pilot: Narratives from the Frontlines (pdf file)
      ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Kellie_30.pdf
      April 21, 2008 - As Tucker has noted, production pressure may cause health care professionals to participate in “first-order … improving patient safety: “We have been analyzing and creating reports of falls with and without injuries

6372. Best Practices in Public Reporting No. 2: Maximizing Consumer Understanding of Public Comparative Quality Reports: Effective Use of Explanatory Information | Agency for Healthcare Research and Quality
      www.ahrq.gov/ncepcr/tools/public-reporting/guide2.html
      June 01, 2017 - medical errors and does not cause harm," which would include measures such as surgical infection rates or injuries … Explanation of Its Purpose and Value The five goals for living well with diabetes (D5): controlling blood pressure

6373. Patient Safety Learning Pilot: Narratives from the Frontlines (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Kellie_30.pdf
      April 21, 2008 - As Tucker has noted, production pressure may cause health care professionals to participate in “first-order … improving patient safety: “We have been analyzing and creating reports of falls with and without injuries

6374. Health Information Technology Center for Education and Research on Therapeutics (HIT-CERT) - Final Report (pdf file)
      digital.ahrq.gov/sites/default/files/docs/publication/u19hs021094-bates-final-report-2017.pdf
      January 01, 2017 - Safe—avoiding injuries to patients from the care that is intended to help them. 2. … including: serotonin syndrome (21.5%, n=34), cardiotoxicity (16.5%, n=26), or sharp falls in blood pressure

6375. Experiences From the Frontline: Case Studies (pdf file)
      www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/frontline-cases-studies.pdf
      May 01, 2015 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) revealed … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased by … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor to

6376. Experiences From the Frontline: Case Studies (pdf file)
      www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/frontline-cases-studies.pdf
      May 01, 2015 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) revealed … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased by … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor to

6377. Experiences From the Frontline: Case Studies (pdf file)
      ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/frontline-cases-studies.pdf
      May 01, 2015 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) revealed … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased by … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor to

6378. Experiences From the Frontline: Case Studies (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/frontline-cases-studies.pdf
      May 01, 2015 - Root cause analyses of adverse events and near-misses (events that did not produce patient injury) revealed … The AHRQ Patient Safety Indicator 18 (Obstetric Trauma–Vaginal Delivery with Instrument) decreased by … in-house neonatal death, uterine rupture during labor, unplanned maternal admission to ICU, birth trauma … processes at the point of care to include specific maternal parameters, including blood loss, blood pressure … They established a standard process for blood pressure measurement upon admission and during labor to

6379. Final Progress Report: Targeted Delivery of Multiparametric Telemetry Clinical Messages to Mitigate Alarm Fatigue - PERSEUS (pdf file)
      www.ahrq.gov/sites/default/files/2024-05/kobayashi-report.pdf
      January 01, 2024 - study site was Rhode Island Hospital, a 719-bed nonprofit tertiary care referral facility and Level-I trauma … settings, including EKG/heart rate (HR), respiratory rate (RR), pulse oximetry (SpO2), noninvasive blood pressure … of (de-identified) physiologic datastreams from thousands of live patients with varying illnesses, injuries

6380. Final Progress Report: National Trends in Outpatient Quality Indicators (pdf file)
      www.ahrq.gov/sites/default/files/2024-11/stafford-fortmann-report.pdf
      January 01, 2024 - (Thorndike 1998), screening electrocardiogram use, exercise stress testing (Cohen 1999), and blood pressure … as poor diet, physical inactivity, and tobacco or other substance use, unsafe sex, unintentional injury