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healthcare411.ahrq.gov/patient-safety/settings/hospital/candor/modules/facguide3/apc.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
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healthcare411.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide4/apd.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
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healthcare411.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes7.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 … Potential future injuries that may result from the adverse event.
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healthcare411.ahrq.gov/data/infographics/hac-rates_2019.html
July 01, 2020 - Description: National efforts to reduce hospital-acquired conditions such as adverse drug events and injuries … Pressure ulcers: 6% increase. Surgical site infections: 8% increase.
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/teamstepps/diagnosis-improvement/module5-situation-monitoring.pptx
January 10, 2022 - It also ensures staff are supported in times of stress or production pressures or when the day is just … allows individuals and teams to take steps to interrupt or correct an action or event before harm or injury … risk or unfolding error
An opportunity to interrupt or correct an action or event before harm or injury … Are the blood pressure cuffs, otoscope, ophthalmoscopes, and other equipment working properly? … Are things being left undone because of time pressure?
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/fallprevention-training/module1/module1_fall-prevention.docx
March 01, 2013 - In one study, a fall with serious injury added 6.3 days to the hospital stay. … The average operational cost for a fall with injury is about $14,000. … 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
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healthcare411.ahrq.gov/patient-safety/settings/hospital/fall-prevention/workshop/module-3/slides.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 … number of medications that could cause sedation, confusion, impaired balance, or orthostatic blood pressure … Carefully assess patients for any injuries in a systematic way.
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/grandrounds/mod01-grand-rounds-slides.pdf
April 01, 2016 - Say:
Today’s Presentation Goals are to:
■ Highlight the gap between optimal response to medical injury … the CANDOR process and how this toolkit will help organizations
improve their response to medical injury … nursing
staff in the room had Michelle connected to a monitor and monitored her heart
rate, blood pressure … of ergonomics; as we work more at desks and computers, these areas
are redesigned to help prevent injuries … Slide 35
Say:
In addition to the organization Medically Induced Trauma Support Services (or
MITSS)
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healthcare411.ahrq.gov/patient-safety/settings/hospital/fall-prevention/workshop/module-3/guide.html
September 01, 2017 - Injury
Preventing Pressure Ulcers in Hospitals
Re-Engineered Discharge Toolkit
QI … Post-Fall Huddles: Reducing Preventable Falls and Fall-Related Injuries —AHRQ Fall Prevention Program … The patient should be carefully and systematically assessed for injuries. … The post-fall clinical review focuses on immediate risk of injury or complications. … RCA is often used for a fall with injury.
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module1/grand-rounds-presentation-slides.pptx
January 01, 2014 - Video: Do Less Harm
2
Presentation Goals
Highlight the gap between optimal response to medical injury … Resolution) process and how this toolkit will help organizations improve their response to medical injury … The nursing staff in the room had Michelle connected to a monitor and monitored her heart rate, blood pressure … field of ergonomics; as we work more at desks and computers, these areas are redesigned to help prevent injuries … helps them care for their patients.
36
Module 1
In addition to the organization Medically Induced Trauma
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/chartbooks/healthyliving/qdr2015-chartbook-healthyliving.pdf
January 01, 2020 - , and
■ Birth trauma not elsewhere classified.24
Many of these injuries to neonates may be preventable … .25
Birth trauma—injury to neonate per 1,000 live births, 2004-2013
0.0
0.5
1.0
1.5
2.0
2.5 … Birth trauma—injury to neonate per 1,000 live births, 2004-2013
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5 … Trends:
■ Birth trauma-neonatal injury rates fell from 2.6 per 1,000 live births in 2004 to … Birth Trauma Rate—Injury to Neonate: Technical Specifications.
-
healthcare411.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide5.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
-
healthcare411.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/scenarios/CombatCare.pdf
March 18, 2014 - The right leg is continuing to bleed and now has pressure dressings
applied. … They seem overwhelmed by the extent of the patient’s injuries. … Seeing the blood pressure, the nurse asks, “Do you want a code cart in here?” … has an actively
hemorrhaging 6-inch laceration on his right lower leg but no other obvious signs of injury … While the physician
is reviewing wound care instructions with the mother, the child complains of nausea
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healthcare411.ahrq.gov/patient-safety/settings/hospital/candor/modules/facguide3/notes.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 … An adverse event is "any injury caused by medical care" and doesn't imply "error," "negligence," or poor
-
healthcare411.ahrq.gov/patient-safety/settings/hospital/candor/modules/facguide3.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
-
healthcare411.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide6.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 … For additional support in the planning process, Medically Induced Trauma Support Services (MITSS) resources
-
healthcare411.ahrq.gov/sites/default/files/wysiwyg/research/findings/ta/topicrefinement/obesity_topic-refinement.pdf
May 22, 2014 - Adverse effects of interventions
● Activity-related injury
● Adverse effects of medication ( diarrhea … Respiratory disease (i.e., asthma, COPD)
● Sleep apnea
o BMI
o Adverse effects
● Activity-related injuries … Question
1b
CMS Intermediate
outcomes
We are excluding all intermediate
outcomes (adherence, blood pressure … outcomes
CMS Intermediate
outcomes
We are excluding all intermediate
outcomes (adherence, blood pressure … skinfold thickness and waist
circumference; excluding all intermediate outcomes (adherence, blood pressure
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healthcare411.ahrq.gov/patient-safety/settings/hospital/red/toolkit/index.html
April 01, 2023 - Resources
CANDOR
Family-Centered Rounds Toolkit
MATCH Toolkit
NICU Toolkit
Pressure … Injury
Preventing Pressure Ulcers in Hospitals
Re-Engineered Discharge Toolkit
QI
-
healthcare411.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes1.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
-
healthcare411.ahrq.gov/patient-safety/settings/hospital/fall-prevention/workshop/module-4/slides.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