-
psnet.ahrq.gov/node/837728/psn-pdf
July 27, 2022 - adverse
drug events, hospital-acquired infections, postoperative adverse events, hospital-acquired pressure … ulcers,
falls) over time among patients hospitalized for four common conditions – acute myocardial
-
psnet.ahrq.gov/node/60846/psn-pdf
January 01, 2021 - 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.
-
www.ahrq.gov/funding/training-grants/disgrants.html
October 01, 2014 - University of Illinois at Chicago
Using an Electronic Health Record to Examine Nurse Continuity and Pressure … Ulcers
8/31/2015
Van Parys, Jessica
R36 HS23504-01
Columbia University Health Sciences
-
psnet.ahrq.gov/issue/swarming-improve-patient-care-novel-approach-root-cause-analysis
September 23, 2020 - Evaluation of the suitability of root cause analysis frameworks for the investigation of community-acquired pressure … ulcers: a systematic review and documentary analysis.
-
psnet.ahrq.gov/node/851555/psn-pdf
July 31, 2023 - Bandemia as a Harbinger of Stercoral Colitis and
Impending Perforation
July 31, 2023
Flynn S, Barnes DK. Bandemia as a Harbinger of Stercoral Colitis and Impending Perforation. PSNet
[internet]. 2023.
https://psnet.ahrq.gov/web-mm/bandemia-harbinger-stercoral-colitis-and-impending-perforation
The Case
A 56-year-…
-
hcup-us.ahrq.gov/reports/factsandfigures/figures/2005/2005_2_4.jsp
January 01, 2005 - Exhibit 2.4 Average Length of Stay and Average Charges
Exhibit 2.4 Average Length of Stay and Average Charges
Inpatient Hospital Stays for Principal Diagnosis: Number of Discharges, Average Length of Stay and Average Charges, Ordered by Average Length of Stay, 2005
Principal Diagnosis CCS Conditio…
-
psnet.ahrq.gov/issue/can-patient-involvement-improve-patient-safety-cluster-randomised-control-trial-patient
December 21, 2016 - Investigators compared a global measure of safety, which included pressure ulcers , venous thromboembolism
-
psnet.ahrq.gov/issue/challenges-and-remediation-patient-safety-indicators-transition-icd-10-cm
September 23, 2020 - For example, the PSI for pressure ulcers demonstrated a high false-negative rate , meaning that ICD-
-
psnet.ahrq.gov/issue/one-size-fits-all-mixed-methods-evaluation-impact-100-single-room-accommodation-staff-and
July 01, 2016 - room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure … ulcers or medication errors?
-
www.ahrq.gov/research/findings/nhqrdr/2014chartbooks/hispanichealth/part3-nqs2.html
October 01, 2015 - restrained daily can become weak, lose their ability to go to the bathroom by themselves, and develop pressure … ulcers or other medical conditions.
-
psnet.ahrq.gov/node/60616/psn-pdf
June 24, 2020 - central-line-associated
blood stream infections, catheter-associated urinary tract infections, hospital-acquired pressure … ulcers, and
ventilator-associated events).
-
psnet.ahrq.gov/node/45879/psn-pdf
July 02, 2017 - This study aimed to use modeling, a strategy to detect safety hazards, to characterize the risk of pressure … ulcers and catheter-associated infections.
-
www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-harms.pdf
August 01, 2025 - Ulcer Prevention in
Nursing Homes
2015–2018
$1,783,070
Purpose: 1) Disseminate the On-Time Pressure … effective pressure ulcer prevention
practices. … Key Findings/Impact: A final report was not available; however, the
Preventing Pressure Ulcers in Hospitals … : Implement and evaluate the effectiveness of a pressure ulcer module,
“On-Time Quality Improvement … rates, in reducing the rate
of pressure ulcers among nursing home residents.
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-trache.pdf
June 02, 2025 - NICU Family Information Packet, Appendix B, Tracheostomies
Tracheostomies
Tracheostomy Basics
■ Indications: upper airway obstruction, long term ventilation, ease of pulmonary toilet, to
protect the airway.
■ Tube selection based on:
– Indication for tracheostomy.
– Tracheal width/length/shape.
– Upper a…
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Cunningham_11.pdf
January 29, 2008 - ulcer (bed sores); or postoperative
sepsis (blood infection). … Decubitus ulcer
5. Failure to rescue
6. Foreign body left during procedure
7. … • Monitoring errors, such as bedsores, failure to rescue, and patient falls. … ulcer
monitoring error
• Increased
checking of
inpatients for
decubitus ulcers
• Monitoring … forms or
behavioral checklists
• Decubitus ulcer
incidence rate
feedback
• Supervisor praise
-
psnet.ahrq.gov/node/46041/psn-pdf
September 20, 2017 - retrospective-and
This economic analysis estimated the impact of nurse-sensitive adverse events—including pressure … ulcers,
falls, medication administration errors, pneumonia, and urinary tract infection—for the Canadian
-
psnet.ahrq.gov/node/47349/psn-pdf
January 30, 2019 - networks on several patient safety outcomes, including medication errors,
falls, and hospital-acquired pressure … ulcers, across 24 medical and surgical inpatient units at 3 hospitals.
-
www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/chartbooks/patientsafety/qdr2015-ptschartbook.pdf
March 04, 2016 - Among the most frequent HACs, between 2010 and 2014, the rate of pressure ulcers
decreased the … Nursing home residents who have pressure ulcers. … Pressure Ulcers
Low-risk short-stay and high-risk long-stay nursing home
residents who have pressure … Overall Percentage: In 2013, the percentage of low-risk short-stay residents with pressure
ulcers … was 1.3% and the percentage of high-risk long-stay residents with pressure ulcers was
7.7%
-
psnet.ahrq.gov/node/60856/psn-pdf
August 26, 2020 - Prolonged hospital bedrest leads to loss of muscle and bone mass and increases
the risk of pressure … ulcers, venous thromboembolism and hospital acquired-infection.8 Pneumonia leading
to sepsis and organ … Pressure Ulcer Prevention in the Hospital Setting Using
Silicone Foam Dressings.
-
digital.ahrq.gov/sites/default/files/docs/lesson/08-0087-ef-lt-care.pdf
October 01, 2009 - ulcers, urinary and bowel incontinence, infections,
delirium, and medication errors (due in part to … ulcer development. … ulcer risk factors. … PPROJECT RESULTS:Ro R TS
Reduction in pressure ulcer rates in participating nursing homes
PFQ Grant … ulcers care and other LTC quality
improvement (QI) areas.