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1121. The National Action Alliance to Advance Patient Safety Summer Webinar Series - PowerPoint Presentation (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/public-action-alliance-slides-040323_LOCKED.pdf
      May 25, 2023 - factors focus areas • Workplace Change Collaborative – National Framework on Burnout and Moral Injury … “By and large, the U.S. does not account for medical care injuries and deaths in our vital statistics … Where it should say 'medical care harm/injuries', it's blank. … as surge … our new normal *Healthcare Acquired Infections, Early Elective Deliveries, Falls with Injury … , Healthcare Acquired Pressure Injuries, NTSV C-Section patients to get to WHO Goal, Sepsis Mortality

1122. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/843150/psn-pdf
      December 05, 2022 - In these cases, easily managed health needs like high blood pressure or diabetes can progress to acute … People may go to a provider because they have an injury or concern, and providers can only focus on … There is also that trauma of accessing care and feeling that bias and stigma, which can prevent patients … I am trans, but I also have high blood pressure and high cholesterol. … We just want to be seen as humans, so that we can get our blood pressure managed on a regular basis.

1123. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49522/psn-pdf
      November 01, 2006 - Mostly in response to increasing pressure from the hospital's administration to improve compliance with … Intramuscular injection site injuries masquerading as pressure ulcers. Wounds. 2003;15:302-312.

1124. TREAT ECARDS: Translating Evidence into Action: Electronic Clinical Decision Support in ARDS – Final Report (pdf file)
      digital.ahrq.gov/sites/default/files/docs/citation/r18hs026188-gong-final-report-2022.pdf
      January 01, 2022 - frequent re-admissions, and high costs in the hospital.4 Because ARDS develops after some initial injury … is a major contributor and driver to the mortality reported by better recognized conditions such as trauma … hospital floor, ICU); 3) because ARDS develops acutely and co-exists with other serious conditions like trauma … of mechanical ventilation, Page 10 of 21 Phase 2 involved prevention of complications and lung injury … Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury

1125. Archived: Gestational Diabetes: Screening | United States Preventive Services Taskforce
      www.uspreventiveservicestaskforce.org/uspstf/recommendation/gestational-diabetes-screening-2008
      May 15, 2008 - evidence for benefits of screening in the following health outcomes: perinatal mortality, brachial plexus injury … , the generally accepted primary outcomes (for example, stillbirth, neonatal death, brachial plexus injury … the treatment group had a 30% percent lower risk for pregnancy-induced hypertension (defined as blood pressure … of participants to permit evaluation of important health outcomes such as mortality, brachial plexus injury … are limited because most babies with macrosomia are born to mothers without GDM, and most cases of injuries

1126. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/846170/psn-pdf
      March 15, 2023 - confusion, the patient ran out of his medication and his daughter and home health nurse noted poor blood pressure … This lapse resulted in poor blood pressure control, but fortunately no harmful outcomes. … errors have the potential to be serious and may result in adverse drug events (ADE), which are patient injuries … What changes you will make to your blood pressure medications?”

1127. Missed Diagnosis of Addison’s Disease in Adolescent Presenting with Fatigue. | PSNet
      psnet.ahrq.gov/web-mm/missed-diagnosis-addisons-disease-adolescent-presenting-fatigue
      October 28, 2020 - order of 1 in 10,000 individuals 2-4 – and can be related to autoimmune destruction, infiltration/injury … (hemorrhage, trauma, infection), underlying genetic or metabolic disorders, or medication effects. … Forms of AI that affect mineralocorticoid production can cause low blood pressure or orthostatic hypotension … including gastrointestinal illness as well as any infection, medical/dental procedure, or physical trauma … life-threatening and can occur in patients with AI due to any physiologic stress, including viral illness or injury

1128. Inadequate Anesthesia Preparation Leading to Difficult Intubation and Severe Hypoxemia | PSNet
      psnet.ahrq.gov/web-mm/inadequate-anesthesia-preparation-leading-difficult-intubation-and-severe-hypoxemia
      January 29, 2021 - managing the difficult airway. 8 The combination of these devices can also help to prevent airway trauma … this high-risk scenario was, in retrospect, not the most prudent course of action due to the airway trauma … neuromuscular blockade with high dose sugammadex was an essential step that prevented hypoxic brain injury … reversal of neuromuscular blockade made surgical cricothyroidotomy unnecessary, preventing hypoxic brain injury … abdominal contents displacing the diaphragm in a cephalad direction with the positive end expiratory pressure

1129. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50931/psn-pdf
      February 26, 2020 -  re-evaluation of the available information to refine the list of possible diagnoses.5  Systematic pressures … Even in the absence of a history suggestive of esophageal perforation (instrumentation, injury, vomiting … Utter, MD MSc  Professor of Surgery  Division of Trauma, Acute Care Surgery, and Surgical Critical

1130. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/73103/psn-pdf
      March 31, 2021 - On arrival, she was in septic shock with systolic blood pressure in the 80’s. … Common examples include pneumonia, Clostridium difficile infection, pressure injuries, delirium, and … diarrhea in an incontinent patient with skin breakdown on the “backside” should have raised an alarm, as wound … The use of a video visit for wound care is possible as skin and wound tissue can be adequately evaluated … Wesley Valdes, DO Telehealth and Wound Specialist Sacramento, CA wesley.valdes@gmail.com Garth Utter

1131. Overview of Patient Safety Learning Laboratory (PSLL) Projects | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/resources/learning-lab/index.html
      August 01, 2025 - as pressure injury) from exposure to intense and/or prolonged pressure, moisture, friction, and shear … ’s achievements include the creation of a digital bedside display that shows patients’ catheter and wound … injuries (formerly called ‘pressure ulcers’). … injury) and rhythmic motion (for detection of seizure). … caregivers in the design of health information technology (IT) tools to prevent patient falls and related injuries

1132. Survey on Patient Safety (facility version) (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/facilscanform.doc
      June 02, 2025 - · “Patient safety” is defined as the avoidance and prevention of patient injuries or adverse events … Whenever pressure builds up, my supervisor/manager wants us to work faster, even if it means taking shortcuts

1133. Wireless-Motility-Capsule Executive (pdf file)
      effectivehealthcare.ahrq.gov/sites/default/files/related_files/wireless-motility-capsule_executive.pdf
      May 01, 2013 - scintigraphy Motility assessment: pressure patterns Low 3 WMC can measure pressure patterns and … measurement of pressure patterns adds to diagnostic accuracy. … (Scintigraphy does not measure pressure patterns.) … .37, 39 A WMC detects pressure patterns, whereas scintigraphy cannot. … technology provides safe and effective assessment of gastrointestinal function in persons with spinal cord injury

1134. Improving the Delivery of Health Services at the Health Systems Level - Emerging Research | Digital Healthcare Research
      digital.ahrq.gov/2020-year-review/research-summary/improving-delivery-health-services-health-systems-level-emerging-research
      January 01, 2020 - interactions at the bedside and their effect on nurse-sensitive patient outcomes such as patient falls, pressure … ulcer injuries, and hospital-acquired infections.  

1135. Do Me a Favor | PSNet
      psnet.ahrq.gov/web-mm/do-me-favor
      September 12, 2016 - Both doctors and nurses recounted professional requests for health care "favors" include taking blood pressures … In this case, the resident may not have been fully competent to perform the exam (resulting in injury … Additionally, failing to include nursing in procedures exposes patients to risks of injury related to

1136. Behavioral Counseling to Promote a Healthful Diet and Physical Activity for CVD Prevention in Adults Without Known CVD Risk Factors: Updated Evidence Report and Systematic Review for the USPSTF (pdf file)
      www.uspreventiveservicestaskforce.org/home/getfilebytoken/DTRggkjEPQ5-ALArTjrhKT
      July 11, 2017 - There was no evidence of greater incidence of serious adverse events, injuries, or falls in intervention … Seven physical activity– focused trials (n = 3565) reported the incidence of injuries, frac- tures, or … falls; only 1 trial among women aged 40 to 74 years re- ported significantly more injuries (19% vs 14% … Screening for high blood pressure in adults: U.S. … cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study.

1137. Chronic Kidney Disease Stages 1-3: Screening, Monitoring, and Treatment (pdf file)
      effectivehealthcare.ahrq.gov/sites/default/files/related_files/kidney-disease-medicine_disposition-comments.pdf
      August 01, 2012 - There is some data suggesting strict blood pressure control versus standard blood pressure control … include two critical areas not considered in this comparative effectiveness review, acute kidney injury … Acute kidney injury detection in the U.S. is increasing over time. … examinations, exercising caution in NSAID and COX-2 inhibitor use. (3) These agents can cause acute injury … 5 parameters assessed; all-cause and cardiovascular mortality, kidney failure onset, acute kidney injury

1138. Building a Team and Process to Reduce CAUTI Risk (April 8, 2015) | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/cauti-tools/archived-webinars/building-teamwork-transcript.html
      December 01, 2017 - The fourth indication is the healing of open wounds that are close to the groin area. … , such as a motor vehicle accident where they have an injury to the spinal cord. … Assisting healing with a perineal or sacral wound in certain patients. … or multiple traumatic injuries, such as multiple fractures, and you worry that, again, movement will … Wound care nurses, we talked about, the pressure associated with the Foley catheter is helping.

1139. Paul Tedrick (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/building-team-transcript.doc
      April 08, 2014 - The fourth indication is the healing of open wounds that are close to the groin area. … , such as a motor vehicle accident where they have an injury to the spinal cord. … Assisting healing with a perineal or sacral wound in certain patients. … or multiple traumatic injuries, such as multiple fractures, and you worry that, again, movement will … Wound care nurses, we talked about, the pressure associated with the Foley catheter is helping.

1140. Care Coordination Quality Measure for Primary Care (CCQM-PC) (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/prevention-chronic-care/improve/coordination/ccqmpc/cati-script.pdf
      July 01, 2016 - able to walk a flight of stairs without losing your breath, or target rates —for example, a blood pressure … In the last 12 months, if you had an illness or injury, how often did your primary care provider or … professionals in this office ask whether you had enough services to help you take care of this illness or injury … NEEDED] 1 Never 2 Sometimes 3 Usually 4 Always, or 5 I did not have an illness or injury … High blood pressure or hypertension? 66e. Congestive heart failure? 66f.