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psnet.ahrq.gov/issue/kenneth-w-kizer-md-mph-health-care-quality-evangelist
July 28, 2014 - Conversation With… Christine Cassel, MD
June 1, 2015
Preventing in-facility pressure … ulcers as a patient safety strategy: a systematic review. … March 20, 2013
Inpatient fall prevention programs as a patient safety strategy: a systematic
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psnet.ahrq.gov/issue/maximizing-smart-pump-technology-enhance-patient-safety
April 25, 2018 - July 13, 2022
Are evidence-based practices associated with effective prevention of hospital-acquired … pressure ulcers in US academic medical centers?
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www.ahrq.gov/sites/default/files/wysiwyg/data/infographics/hac-rates-2019-updated.pdf
January 01, 2019 - CLABSI+
-6%
Clostridioides
difficile
Infections
-37%
Falls
-5%
Obstetric
Adverse
Events
-3%
Pressure … Ulcers
Surgical
Site
Infections
Ventilator-
Associated
Pneumonias
-13%
Venous
Thrombo-
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/a2_pdi_boardpresentation.pptx
October 01, 2015 - Ulcer Rate
PDI 03 Retained Surgical Item or Unretrieved Device Fragment Count
PDI 05 Iatrogenic Pneumothorax … ulcer)
Denominator = population at risk (e.g., hospitalized patients)
Observed rate = numerator/denominator … ulcer in any secondary diagnosis field among cases meeting the inclusion and exclusion rules for the … Several exclusions (e.g., length of stay <5 days, principal diagnosis of pressure ulcer). … An Example: Pressure Ulcer (PDI 02)
Tool A.2 Slide ‹#›
Pediatric Toolkit for Using the AHRQ Quality
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psnet.ahrq.gov/perspective/conversation-nicholas-g-castle-mha-phd
August 01, 2012 - ulcer or were put in physical restraints. … We looked at the outcomes on falls, pressure ulcers, and restraint use. … We didn't find it for pressure ulcers. … ulcers. … But they are mainly medical-based outcomes or process-based outcomes like pressure ulcers, use of restraints
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psnet.ahrq.gov/node/43121/psn-pdf
April 16, 2014 - implementing a patient safety
measurement tool that incentivized improvement in four areas: falls, pressure … ulcers, venous
thromboembolisms, and catheter-associated urinary tract infections.
-
psnet.ahrq.gov/node/41985/psn-pdf
October 26, 2016 - The most common adverse events reported were pressure ulcers and fall-
related injuries or deaths.
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psnet.ahrq.gov/issue/using-pharmacogenetics-improve-drug-safety-and-efficacy
November 18, 2016 - October 6, 2021
Barriers and facilitators to reporting medical device-related pressure … ulcers: a qualitative exploration of international practice. … medication review followed by face-to-face feedback to prescribers on adverse drug events recognition and prevention
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www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/quality-measures/qsrs/qsrs-2021-2023-adverse-event-data-report.pdf
January 01, 2023 - https://www.ahrq.gov/patient-safety/settings/index.html
2
Centers for Disease Control and Prevention … xx Office of Disease Prevention and Health Promotion, "National Action Plan for Adverse Drug Event Prevention
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psnet.ahrq.gov/issue/culture-civility-positively-impacting-practice-and-patient-safety
July 13, 2022 - July 29, 2015
Are evidence-based practices associated with effective prevention of hospital-acquired … pressure ulcers in US academic medical centers?
-
www.ahrq.gov/sites/default/files/wysiwyg/data/infographics/hac-interim-data-graphic-2014.pdf
January 01, 2014 - hospital-acquired conditions (HACs) such as adverse drug
events, healthcare-associated infections, and pressure … ulcers have been prevented in
hospital patients.
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/osteoarthritis-pain_executive.pdf
October 01, 2011 - includes studies of these drugs
for treating osteoarthritis or rheumatoid arthritis and for
cancer prevention … safety in patients with
rheumatoid arthritis or who were taking the drug for
cancer or Alzheimer’s prevention … Much of the evidence for increased risks comes from
two large colon polyp prevention trials. … and 6.7% vs. 8.2% per year,
p<0.0001 for secondary prevention). … An update on the epidemiology of knee
and hip osteoarthritis with a view to prevention.
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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 … ulcers or medication errors? … Hospitals
Medicine
Medication Errors/Preventable Adverse Drug Events
Nosocomial Infections
Pressure … Ulcers
View More
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/oirtab.html
December 01, 2012 - Composite: ACSC Acute Conditions
6,913
2,846
Composite: ACSC Overall
17,971
7,139
Pressure … Ulcer
3,067
1,136
Injurious Falls
287
105
Source: Schultz, et al., 2012 (see
-
www.ahrq.gov/sites/default/files/wysiwyg/research/findings/evidence-based-reports/services/quality/patientsftyupdate/ptsafetysum.pdf
March 01, 2013 - ulcers. … Examples include
most fall prevention programs, VTE prophylaxis, and
medical history abbreviations … Examples include some
fall prevention programs, many clinical pharmacist
interventions, and participation … ulcers;
and PSPs designed to improve the overall system or to
address multiple patient safety targets … ulcers, and other
nursing sensitive outcomes (other than
mortality); in-depth review
Common/High
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psnet.ahrq.gov/issue/improved-outcomes-fewer-cesarean-deliveries-and-reduced-litigation-results-new-paradigm
November 27, 2012 - September 23, 2020
Universal protection: operationalizing infection prevention guidance … November 14, 2018
A comprehensive program to reduce rates of hospital-acquired pressure … ulcers in a system of community hospitals.
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psnet.ahrq.gov/issue/engagement-leadership-quality-improvement-initiatives-executive-quality-improvement-survey
October 04, 2006 - June 8, 2016
Are evidence-based practices associated with effective prevention of hospital-acquired … pressure ulcers in US academic medical centers?
-
psnet.ahrq.gov/issue/patient-safety-indicators-during-initial-covid-19-pandemic-surge-united-states
August 03, 2022 - Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention … About The Topic
Hospitals
Public Health
Infectious Diseases
Medical Complications
Pressure … Ulcers
View More
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psnet.ahrq.gov/node/49701/psn-pdf
February 01, 2014 - fully closed system that collects and contains liquid or semi-liquid stools and can assist
in the prevention
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digital.ahrq.gov/sites/default/files/docs/citation/r03hs027006-sun-final-report-2023.pdf
January 01, 2023 - ulcer injuries (PUIs), and hospital acquired
infections (HAIs)—through the following specific aims: … of patient deterioration,
infection, falls, and pressure ulcer injury.11 For example, nurses … play a critical role in infection prevention
both in primary prevention such as education and … Ulcer Injuries
•Hospital Aquired
Infections
Design. … ulcer injuries, and patient falls.