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141. Technical Interventions To Prevent CAUTI | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cauti-tools/guides/implguide-pt3.html
     October 01, 2015 - ulcers or similarly severe wounds that cannot be kept clear of urinary incontinence despite wound care … require strict prolonged immobilization following specific types of trauma or surgery. … Examples include instability in the thoracic or lumbar spine, multiple traumatic injuries such as pelvic … Intermittent catheterization is most often used in patients with neurogenic bladder or spinal cord injury … despite wound care and other urinary management strategies, if ISC is adequate to manage the type of

142. Fact Sheet on Patient Safety Indicators (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a1b_combo_psifactsheet.pdf
     October 01, 2015 - Year PSI 02 Death Rate in Low-Mortality Diagnosis- Related Groups (DRGs) 0.32 0347 2012 PSI 03 Pressure … Thrombosis Rate 4.99 0450 2012 PSI 13 Postoperative Sepsis Rate 9.61 PSI 14 Postoperative Wound … Laceration Rate X 1.89 0345 2012 PSI 16 Transfusion Reaction Count X N/A* 0349 2012 PSI 17 Birth Trauma … Rate – Injury to Neonate 1.89 PSI 18 Obstetric Trauma Rate – vaginal delivery with instrument … 133.19 PSI 19 Obstetric Trauma Rate – vaginal delivery without instrument 20.97 PSI 90

143. Declines in Hospital-Acquired Conditions (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/data/infographics/hac-rates-2019-updated.pdf
     January 01, 2019 - Conditions National efforts to reduce hospital-acquired conditions such as adverse drug events and injuries … CLABSI+ -6% Clostridioides difficile Infections -37% Falls -5% Obstetric Adverse Events -3% Pressure

144. Declines in Hospital-Acquired Conditions (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/data/infographics/hac_rates_2019.pdf
     January 01, 2019 - Conditions National efforts to reduce hospital-acquired conditions such as adverse drug events and injuries … Clostridioides difficile Infections -37% Falls -5% Obstetric Adverse Events -5% Pressure

145. Results | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/pfp/haccost2017-results.html
     November 01, 2017 - literature on excess mortality may be due to the difficulty in finding reliable sources of data on injuries … One study used national representative data (HCUP-NIS) for obstetrical trauma (defined based on AHRQ … only. 54 Further, this study found no increase in mortality for obstetrical trauma. … studies included amniotic fluid embolisms and anesthesia complications; two studies included intracranial injuries … and internal injuries of thorax, abdomen, and pelvis; one study included iatrogenic events.

146. Chartbook on Healthy Living: Slide Presentation | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/nhqrdr/chartbooks/healthyliving/healthyliving-slides.html
     April 01, 2018 - Patient Safety: Birth trauma—injury to neonates. … Birth trauma not elsewhere classified. 24 Many of these injuries to neonates may be preventable … . 25 Slide 42 Birth trauma—injury to neonate per 1,000 live births, 2004-2013 Image: Chart … Overall Rate: In 2013, the birth trauma-neonatal injury rate was 1.9 per 1,000 live births. … Birth Trauma Rate—Injury to Neonate: Technical Specifications.

147. Declines in Hospital-Acquired Conditions | Agency for Healthcare Research and Quality
     www.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.

148. Table 17A: National HCBS Population | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab17.html
     February 01, 2023 - 9,215 6,184 Composite: ACSC Overall 22,374 14,832 21,534 17,751 23,720 16,492 Pressure … 316 271 324 280 375 250 Outcome Indicator Prevalence of High Blood Pressure … 7,298 7,429 9,114 6,570 Composite: ACSC Overall 19,447 18,724 23,221 17,538 Pressure

149. From Quality Measures to Quality Care: Examples of Quality Improvement at Work | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/quality-measures/21st-century/challenges.html
     June 01, 2018 - Reducing the Incidence of Pressure Ulcers For the hospitalized and home care patient, pressure ulcers … Patients in critical care, with hip fractures or with spinal injuries, are at particular risk. … The VA viewed pressure ulcer development as an ideal indicator because they are common, required the … The rate of pressure ulcer development dropped from 11.5 percent to zero. … voluntarily report unexpected events or errors that lead to death, or serious physical or psychological injury

150. Puh-Implementation-Handouts (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/pruhealing/puh-implementation-handouts.pdf
     July 01, 2016 - We record onset day, stage, and surface area of each pressure ulcer during wound rounds. … ulcer healing and you will be able to identify wounds suspected of infection. … Pressure Injury Alliance’s Prevention and Treatment of Pressure Ulcers Guidelines c.  Wound, Ostomy … X X X X Wound rounds Multidisciplinary team weekly review of residents with pressure ulcers. … Rounds Report and Pressure Ulcers at Risk for Delayed Healing with wound rounds.

151. Puh-Implementation-Handouts (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/pruhealing/puh-implementation-handouts.docx
     July 01, 2016 - We record onset day, stage, and surface area of each pressure ulcer during wound rounds. … ulcer healing and you will be able to identify wounds suspected of infection. … Injury Alliance’s Prevention and Treatment of Pressure Ulcers Guidelines c. … Wound, Ostomy, and Continence Nurses Society (WOCN) Pressure Ulcer Guidelines d. … Ulcer Report Pressure Ulcers At Risk for Delayed Healing Weekly Wound Rounds Report Weekly Pressure

152. 2013 Annual Hospital-Acquired Condition Rate and Estimates of Cost Savings and Deaths Averted From 2010 to 2013 | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/pfp/hacrate2013.html
     January 01, 2018 - 2 In 2010 an HHS Office of the Inspector General (OIG) team identified the rate of harm—that is, injuries … The estimate for deaths associated with pressure ulcers was based primarily on the paper by Zhan and … Zhan and Miller estimated that excess mortality due to pressure ulcers was 72 deaths per 1,000 pressure … This estimate is based on analysis of data from HCUP identifying injuries in 7.45 million hospital discharge … For example, pressure ulcers had a high baseline prevalence, and excess mortality attributed to pressure

153. Methods To Estimate the Baseline 2010 PFP National Hospital-Acquired Condition Rate | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/pfp/methods.html
     December 01, 2017 - Catheters Falls MPSMS In-Hospital Patient Falls Obstetric Adverse Events PSI OB Trauma … Pressure Ulcers Surgical Site Infections NHSN SSIs combined for 17 procedures based on CDC … The national number of adverse events captured by PSIs 18 and 19 on obstetric injury , and the national … Ulcers Hospital-Acquired Pressure Ulcers 53.03 62.45 0.85 VAP Ventilator-Associated … In-Hospital Patient Falls 262,317 32,750,000 8.010 Obstetric Adverse Events PSI OB Trauma

154. SOPS Nursing Home Survey: What You Need To Know - Nicholas Castle, Ph.D., M.H.A., FGSA (pdf file)
     www.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

155. Efforts To Improve Patient Safety Result in 1.3 Million Fewer Patient Harms | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/pfp/interimhacrate2013.html
     November 01, 2015 - 2 In 2010 an HHS Office of the Inspector General (OIG) team identified the rate of harm—that is, injuries … The estimate for deaths associated with pressure ulcers was based primarily on the paper by Zhan and … Zhan and Miller estimated that excess mortality due to pressure ulcers was 72 deaths per 1,000 pressure … This estimate is based on analysis of data from HCUP identifying injuries in 7.45 million hospital discharge … For example, pressure ulcers had a high baseline prevalence, and excess mortality attributed to pressure

156. Puh-Erepguide (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/pruhealing/puh-erepguide.pdf
     February 10, 2014 - Healing  Weekly Wound Rounds Report  Weekly Pressure Ulcer Treatment Summary Report  Pressure … home chains, and wound centers. … Injury Alliance. … The wound nurse, wound physician, and other disciplines attending wound rounds can see quickly which … Treatments  Wound Cleanser.

157. Table 10: Outcome Indicators by Selected Home and Community-Based Services 1915(c) Waiver Services Offered, 2005 | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab10.html
     February 01, 2023 - Composite: ACSC Overall Yes 22,422 20,395 25,160 No 18,138 19,018 17,666 Pressure … 7,607 Composite: ACSC Overall 20,384 19,444 14,877 19,094 19,184 20,443 Pressure

158. Data Infographics | Agency for Healthcare Research and Quality
     www.ahrq.gov/data/infographics/index.html
     February 01, 2025 - Antidepressant Prescriptions Potentially Preventable Pediatric Hospital Stays Most Common Cause of Injuries … 2017 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 Inpatient … Anemia in Hemodialysis Patients Worse Among Blacks HRSA's Health Center Program Making Progress on Blood Pressure

159. Table 9: Outcome Indicators by Selected Home and Community-Based Services Medicaid State Plan Services Offered, 2005 | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab9.html
     February 01, 2023 - Overall Yes 18,922 20,115 18,052 19,228 No 28,131 18,583 22,752 19,363 Pressure … Composite: ACSC Overall 19,083 19,110 16,427 19,636 23,560 27,103 21,664 20,810 Pressure

160. Appendix B. Detailed Research Domain Framework Definitions and Classification Rules | Agency for Healthcare Research and Quality
     www.ahrq.gov/healthsystemsresearch/hspc-research-study/appendix-b.html
     June 01, 2020 - Examples of intermediate outcomes include clinical health measures (e.g., adequate control of blood pressure … Intermediate outcomes include measures related to the incidence of chronic conditions—such as high blood pressure … This category includes studies of population health, injury occurrence, and disease progression. … Examples of intermediate outcomes of care are blood pressure, asthma, and glycemic control.  … that primarily examine how to treat injuries or disease (even if the injury or disease is preventable