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Showing results for "pressure injury".
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221. AHRQ Safety Program for Improving Surgical Care and Recovery. | PSNet
     psnet.ahrq.gov/issue/ahrq-safety-program-improving-surgical-care-and-recovery
     December 24, 2008 - January 31, 2018 Pressure Injury Prevention in Hospitals Training Program.

222. Drill down with root cause analysis. | PSNet
     psnet.ahrq.gov/issue/drill-down-root-cause-analysis
     June 15, 2016 - Related Resources From the Same Author(s) A case of transfusion error in a trauma … May 25, 2022 Root cause analysis for hospital-acquired pressure injury.

223. Exposure to incivility does not hinder speaking up: a randomised controlled high-fidelity simulation-based study. | PSNet
     psnet.ahrq.gov/issue/exposure-incivility-does-not-hinder-speaking-randomised-controlled-high-fidelity-simulation
     August 24, 2022 - March 30, 2022 Communication failures contributing to patient injury in anaesthesia malpractice … Related Resources Barriers and facilitators to reporting medical device-related pressure … Health care workers' experiences of workplace incidents that posed a risk of patient and worker injury

224. The Hidden Danger of Unseen Intravenous Catheters | PSNet
     psnet.ahrq.gov/web-mm/hidden-danger-unseen-intravenous-catheters
     October 04, 2023 - efflux of solutions from a vessel into the surrounding tissue during an infusion” and may cause grave injury … Outcomes and management of peripheral intravenous infiltration injuries. Hand (NY) . … Vascular access, fluid resuscitation, and blood transfusion in pediatric trauma. … June 2, 2015 Implementation of the World Health Organization Trauma Care Checklist Program … WebM&M Cases Intraosseous Line Extravasation in a Pediatric Trauma

225. Preeminent hospitals penalized over rates of patients’ injuries. | PSNet
     psnet.ahrq.gov/issue/preeminent-hospitals-penalized-over-rates-patients-injuries
     January 17, 2018 - Newspaper/Magazine Article Preeminent hospitals penalized over rates of patients’ injuries … Citation Text: Preeminent hospitals penalized over rates of patients’ injuries. Rau J. … Citation Citation Text: Preeminent hospitals penalized over rates of patients’ injuries … February 16, 2022 More than 750 hospitals face Medicare crackdown on patient injuries

226. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/846169/psn-pdf
     March 15, 2023 - young patients because their strong chest wall muscles can create much higher negative intrathoracic pressures … Succinylcholine is contraindicated in patients with stroke, spinal cord injury, burns, or myotonic dystrophy … inadequate resources such as the broken drug refrigerator otherwise could have led to irreversible injury … Risk of respiratory complications and wound infection in patients undergoing ambulatory surgery: smokers … Negative-pressure pulmonary edema. Chest. 2016;150(4):927-933. [Available at] 14.

227. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/840141/psn-pdf
     November 16, 2022 - reporting and improvements in safety culture, as well as decreases in adverse events such as falls, pressure … injuries and healthcare-acquired infections.

228. Algorithm-Based Decision Support System Guides Trauma Staff During Initial Treatment, Leading to Fewer Medical Errors | PSNet
     psnet.ahrq.gov/innovation/algorithm-based-decision-support-system-guides-trauma-staff-during-initial-treatment
     May 31, 2023 - High risk of errors, preventable death : Multidisciplinary trauma teams face tremendous time pressures … , and specialty situations (neurotrauma, burns, spinal cord injury, and orthopedic trauma). … For example, prompts might remind staff working with a patient with abnormally low blood pressure to … The program had a particularly large impact on the use of pressure dressings to control hemorrhage (p … Missed injuries in a level I trauma center. J Trauma. 2002 Apr;52(4):715-9. 

229. Getting rid of "never events" in hospitals. | PSNet
     psnet.ahrq.gov/issue/getting-rid-never-events-hospitals
     April 25, 2016 - Never events are devastating and preventable, and health care organizations are under increasing pressure … September 21, 2005 "Near injury" alters procedures at Virginia Mason.

230. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/72811/psn-pdf
     September 01, 2022 - High risk of errors, preventable death: Multidisciplinary trauma teams face tremendous time pressures … , and specialty situations (neurotrauma, burns, spinal cord injury, and orthopedic trauma). … For example, prompts might remind staff working with a patient with abnormally low blood pressure to … The program had a particularly large impact on the use of pressure dressings to control hemorrhage ( … Missed injuries in a level I trauma center. J Trauma. 2002 Apr;52(4):715-9.  2.

231. Periodic Issue | PSNet
     psnet.ahrq.gov/periodic-issue/periodic-issue-294
     June 30, 2021 - Study Learning during crisis: the impact of COVID-19 on hospital-acquired pressure injury … injuries. … injuries between March and July 2020. … The authors discuss how prior organizational efforts to reduce hospital-acquired pressure injuries allowed … complaining of intermittent left shoulder pain for several years was diagnosed with a rotator cuff injury

232. Safety climate associated with adverse events in nursing homes: a national VA study. | PSNet
     psnet.ahrq.gov/issue/safety-climate-associated-adverse-events-nursing-homes-national-va-study
     September 08, 2021 - The survey found that supervisor commitment to safety was associated with lower rates of major injuries … from falls and catheter use, and that environmental safety was associated with lower rates of pressure … ulcers, major injuries from falls, and catheter use.

233. Rates of adverse events in hospitalized patients after summer-time resident changeover in the United States: is there a July effect? | PSNet
     psnet.ahrq.gov/issue/rates-adverse-events-hospitalized-patients-after-summer-time-resident-changeover-united
     June 22, 2022 - room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure … March 23, 2012 Injury and death associated with incidents reported to the Patient Safety … Hospitals Medicine Medication Errors/Preventable Adverse Drug Events Nosocomial Infections Pressure

234. An Easily Forgotten Tube | PSNet
     psnet.ahrq.gov/web-mm/easily-forgotten-tube
     June 01, 2016 - national guidelines, including those from the American College of Gastroenterology ( 7 ), the Welsh Wound … the past year; sensitivity or allergies to any of the materials used in the device; rectal or anal injury … An FMS device should not be used for a mobile patient as movement may lead to pressure on the tubing, … An FMS is unsuitable for spinal cord injury patients due to the high risk of autonomic dysreflexia that … Wounds UK. 2005;1:3:110-114. [Available at] 7.

235. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/73642/psn-pdf
     August 25, 2021 - The required insufflation leads to an increase in peak inspiratory pressures, and this increase is more … pronounced during dilation as the balloon pressure increases tracheal stress. … Patient death or serious injury associated with intravascular air embolism that occurs while being cared … vessel may be exposed due to underlying disease (e.g., ulcers, mucosal inflammation), scope-induced injury … Technical steps like using appropriate monitoring, minimizing insufflation and dilation pressures to

236. Supporting perioperative safety during a disaster through clinical crisis education. | PSNet
     psnet.ahrq.gov/issue/supporting-perioperative-safety-during-disaster-through-clinical-crisis-education
     July 05, 2017 - August 12, 2020 Learning during crisis: the impact of COVID-19 on hospital-acquired pressure … injury incidence. … January 15, 2025 Identifying resilience: a system safety review of trauma and orthopaedic

237. Obstetric Quality and Safety. | PSNet
     psnet.ahrq.gov/issue/obstetric-quality-and-safety
     February 25, 2009 - November 15, 2017 Learning during crisis: the impact of COVID-19 on hospital-acquired pressure … injury incidence.

238. Contributing factors for pediatric ambulatory diagnostic process errors: Project RedDE. | PSNet
     psnet.ahrq.gov/issue/contributing-factors-pediatric-ambulatory-diagnostic-process-errors-project-redde
     November 30, 2022 - Diagnostic errors, including missed diagnoses of adolescent depression, elevated blood pressure, and … included failure to screen for adolescent depression, failure to recognize and act on abnormal blood pressure … August 9, 2011 Delayed or missed diagnosis of cervical spine injuries.

239. Care home safety incidents and safeguarding reports relating to hospital to care home transitions: a retrospective content analysis. | PSNet
     psnet.ahrq.gov/issue/care-home-safety-incidents-and-safeguarding-reports-relating-hospital-care-home-transitions
     July 17, 2024 - Common incidents included pressure injuries, medication errors , and premature discharge. … Long-Term Care Geriatrics Discontinuities, Gaps, and Hand-Off Problems Medical Complications Pressure

240. HSJ Patient Safety Congress. | PSNet
     psnet.ahrq.gov/issue/hsj-patient-safety-virtual-congress
     April 17, 2024 - September 29, 2021 Learning during crisis: the impact of COVID-19 on hospital-acquired pressure … injury incidence.