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  1. ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/match/chapter-6.html
    July 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit PressureInjury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI
  2. ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/match/chapter-4.html
    July 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit PressureInjury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI
  3. ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/candor/modules/facguide3/notes.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit PressureInjury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI … An adverse event is "any injury caused by medical care" and doesn't imply "error," "negligence," or poor
  4. ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/manage-resident-RTI-slides.pptx
    June 01, 2021 - Case 1: Diagnostic Evaluation Temp 99.2° Fahrenheit Heart rate 98 beats per minute Blood pressure … antibiotic therapy Clinical instability Unable to maintain oxygen saturation Hypotension (systolic blood pressure … Pneumonia Versus Pneumonitis8 21 Aspiration Pneumonitis Aspiration Pneumonia Pathophysiology Acute lung injury
  5. ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/prevhosp/2-preventablehospitalandedvisits-samplerpts_3.pdf
    November 30, 2013 - • Current clinical conditions contributing to transfer risk: use of oxygen, catheter or ostomy, any pressure … and skin, injury (fall related or not fall related), musculoskeletal, abnormal labs or anemia, fever … or skin issues • Fall-related injury • Non-fall-related injury • Abnormal labs • Fever/possible infection … disease • Asthma • Circulatory problems • Hypertension • Gastroenteritis • Angina pectoris • Falls/trauma … obstructive pulmonary disease, asthma, circulatory problems, hypertension, gastroenteritis, angina, falls/trauma
  6. ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-0232-fullreport.pdf
    February 01, 2020 - percentile (2) documentation of diastolic blood pressure percentile, (3) classification of blood pressure … Markers of vascular injury can be detected in very young children, demonstrating that the path to cardiovascular … , systolic blood pressure value, diastolic blood pressure value, and both height and weight (necessary … blood pressure, diastolic blood pressure, height, and weight) was 100 percent, with a Kappa statistic … Systolic or diastolic blood pressure values. 30 7.
  7. ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/candor/modules/facguide3.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit PressureInjury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI
  8. ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/resource/nicu/packet/apd.html
    December 01, 2013 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit PressureInjury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI
  9. ce.effectivehealthcare.ahrq.gov/research/findings/studies/index.html?page=475
    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) Injuriesand 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
  10. ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/resource/guide/web1.html
    December 01, 2017 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit PressureInjury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI
  11. ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/red/toolkit/redtool-other.html
    March 01, 2013 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit PressureInjury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI
  12. ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/red/toolkit/ptoutcome-mail.html
    March 01, 2013 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit PressureInjury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI
  13. ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/safety/changes-slides.pptx
    November 01, 2019 - associated with biliary duct obstruction from a gallstone Temperature of 101° F, pulse of 100, and blood pressure … Acute kidney injury and unnecessary lab tests and imaging could have been avoided 3 Piperacillin/tazobactam … Care Learning From Antibiotic-Associated Adverse Events Adverse event: Patient develops acute kidney injury
  14. ce.effectivehealthcare.ahrq.gov/sites/default/files/publications/files/resphys-champions_2.pdf
    September 01, 2015 - Assistance with healing of perineal and sacral wounds in incontinent patients. … Required immobilization for trauma or surgery. … Examples include an unstable thoracic or lumbar spine, multiple traumatic injuries such as pelvic fractures … For example, wound care nurses and physical therapists would discourage UC use to reduce the risk for … Many clinical sites (sputum, urine, wounds, or ulcers) are not sterile.
  15. ce.effectivehealthcare.ahrq.gov/sites/default/files/publications/files/resphys-champions.pdf
    September 01, 2015 - Assistance with healing of perineal and sacral wounds in incontinent patients. … Required immobilization for trauma or surgery. … Examples include an unstable thoracic or lumbar spine, multiple traumatic injuries such as pelvic fractures … For example, wound care nurses and physical therapists would discourage UC use to reduce the risk for … Many clinical sites (sputum, urine, wounds, or ulcers) are not sterile.
  16. ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Duthie.pdf
    January 01, 2004 - mandatory error reporting programs gather data on errors associated with fatal outcomes or serious injuries … of administration were trapped prior to completion.10 The population above age 65 sustained more injuries … The most significant potential for injury occurred in the transition of a patient across and between … Inaccurate or incomplete data about medication regimens, when undetected, caused patient injuries. … Time pressures—due to limited CT scanner availability; the critical nature of the patient’s condition
  17. ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-194-fullreport.pdf
    April 01, 2019 - These complications include compromised airway, hypoxia leading to central nervous system injury, and … • Signs or symptoms of increased intracranial pressure. … • Trauma. o Suspected child abuse. o Concussion. … These risks include dental trauma; airway edema (swelling of the windpipe); vocal cord spasm or injury … ; regurgitation of stomach contents with subsequent aspiration (inhalation) pneumonia; injury to arteries
  18. ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide6.html
    August 01, 2022 - Resources CANDOR Family-Centered Rounds Toolkit MATCH Toolkit NICU Toolkit PressureInjury Preventing Pressure Ulcers in Hospitals Re-Engineered Discharge Toolkit QI … For additional support in the planning process, Medically Induced Trauma Support Services (MITSS) resources
  19. ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Donaldson_87.pdf
    April 23, 2008 - Patient Falls Project aimed to reduce the incidence of patient falls and the severity of fall-related injury … Throughout this phase, coaches sought to understand site priorities (goals/ strategic plans) and pressures … • Implement individualized interventions to prevent falls/reduce injury. … improvements Monitor organizational change over time; analyze falls risk assessment, incidence, and injury … Changes may be explained by the “pressure” of the intervention (continuous reminders; ongoing scheduled
  20. ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/hycr-tools-resources-guide.pdf
    April 28, 2023 - (aerobic and strength) and that all accidental injuries would be virtually assessed by the physiologist … Alert staff if you have any: Chest pain, pressure, aching, or indigestion. … (aerobic and strength) and that all accidental injuries would be virtually assessed by the physiologist … Try to place the majority of the pressure on your foot, on your big toe. 2. … Assess the patient, instruct patient to check blood pressure and heartrate on home blood pressure device

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