-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab11.html
February 01, 2023 - Overall
Yes
14,177
28,212
18,788
9,372
No
19,380
19,211
19,521
20,716
Pressure … Ulcer
Yes
2,730
11,421
3,150
1,840
No
3,506
3,461
3,696
3,731
Injurious … Composite: ACSC Overall
50,783
40,549
9,972
20,001
18,997
10,923
20,108
19,218
Pressure … Ulcer
12,696
8,204
883
4,475
3,415
1,644
3,729
3,459
Injurious Falls
469
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab19.html
March 01, 2023 - 7,387
7,164
Composite: ACSC Overall
23,095
17,584
19,743
18,467
19,802
17,363
Pressure … Ulcer
4,291
3,139
3,655
3,225
3,647
2,945
Injurious Falls
388
259
314
272 … 7,138
7,741
7,427
6,977
Composite: ACSC Overall
18,821
20,092
19,980
16,312
Pressure … Ulcer
3,501
3,452
3,695
2,655
Injurious Falls
301
291
297
299
Notes
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab19d.html
March 01, 2023 - 3,685
2,830
Composite: ACSC Overall
6,401
5,144
6,083
4,903
6,049
4,408
Pressure … Ulcer
1,887
1,225
1,703
1,115
1,573
1,084
Injurious Falls
88
67
77
69
79 … 3,503
3,242
3,720
2,668
Composite: ACSC Overall
5,768
5,111
6,087
4,163
Pressure … Ulcer
1,543
1,223
1,589
999
Injurious Falls
77
67
77
63
Notes:
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab19f.html
March 01, 2023 - 5,990
6,632
Composite: ACSC Overall
23,094
19,763
20,681
21,282
21,204
19,420
Pressure … Ulcer
6,082
4,303
4,919
4,872
4,765
5,535
Injurious Falls
173
119
141
130 … 5,861
6,673
6,037
6,455
Composite: ACSC Overall
20,343
22,153
21,427
18,076
Pressure … Ulcer
4,499
5,846
4,870
5,072
Injurious Falls
140
131
131
168
Notes
-
www.ahrq.gov/patient-safety/reports/engage/appc.html
March 01, 2017 - ab] OR prevention [ab] OR reducing [ab] OR reduction [ab] OR aged [mh] OR elderly OR geriatric)) OR Decubitus … Ulcer [mh] OR ((pressure [ti] OR decubitus [ti]) AND ulcer* [ti]) OR decubiti [ti])) AND ((((Randomised
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/fallspx/factraining-slides.html
October 01, 2017 - Slide 6: On-Time Reports for Four Adverse Events
Four Reports
Pressure Ulcer Prevention
Pressure … Ulcer Healing
Falls Prevention
Preventable Hospital and ED Visits
Slide 7: Common Elements … Large decline in pressure ulcer incidence rate seen in Pressure Ulcer Prevention Program Evaluation.
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/prevhosp/facslides.html
September 01, 2017 - Slide 6: On-Time Reports for Four Adverse Events
Four Reports:
Pressure Ulcer Prevention. … Pressure Ulcer Healing.
Falls Prevention.
Preventable Hospital and ED Visits. … Large decline in pressure ulcer incidence rate seen in Pressure Ulcer Prevention Program Evaluation.
-
www.ahrq.gov/research/publications/ahrq-info-quality-gdlns-update.html
June 01, 2018 - that give easy-to-understand guidance on how to implement quality improvements, such as Preventing Pressure … Ulcers in Hospitals: A Toolkit for Improving the Quality of Care and the AHRQ Health Literacy Universal
-
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
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/abate/faqs/faq-chg-bathing.docx
March 01, 2022 - Be especially thorough if there are any nearby wounds, pressure ulcers, or breaks in the skin. … Using the CHG cloths on superficial wounds/stage 1 and 2 decubitus ulcers
How should we dispose of the
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module5/module5_pressureinjury-msmt_slides.pptx
June 02, 2025 - Care plan addressing every deficit on pressure ulcer risk factor assessment has been developed and is … 46
Next Steps
Over the next several weeks, we will meet weekly to refine your Action Plan for the Pressure … Ulcer Prevention Program.
-
www.ahrq.gov/sites/default/files/wysiwyg/npsd/Data_Submission_Dashboard_Data_2024.xlsx
January 01, 2024 - 10.5%
Surgery or Anesthesia CFER-H V1.1 25,264 9.4%
Surgery or Anesthesia CFER-H V1.2 132,724 5.2%
Pressure … Ulcer CFER-H V1.1 16,374 6.1%
Pressure Ulcer CFER-H V1.2 124,964 4.9%
Device or Medical/Surgical Supply
-
www.ahrq.gov/sites/default/files/2024-05/felix-report.pdf
January 01, 2024 - Being underweight increased the odds of
experiencing a fall, fall with injury, or pressure ulcer but … ulcers/
injuries and UTIs. … Association of overweight and
obesity with the prevalence and incidence of pressure ulcers: A systematic … The paradox of obesity in pressure ulcers of
critically ill patients. … Obesity and pressure ulcers among nursing home
residents. Medical Care. 2013;51(6):478-86.
44.
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/fallsprev/fallpxoverview.pptx
October 01, 2017 - On-Time Overview
5
October 2017
5
On-Time Reports for Four Adverse Events
Four Reports
Pressure Ulcer … Prevention
Pressure Ulcer Healing
Falls Prevention
Preventable Hospital and ED Visits
On-Time Overview … leading clinicians
Reports tested in clinical settings for feasibility and ease of use
Large decline in pressure … ulcer incidence rate seen in Pressure Ulcer Prevention Program Evaluation
October 2017
On-Time Overview
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/prevhosp/ontime-preventablehospitaledvisits-overview.pptx
May 01, 2017 - May 2017
On-Time Overview
5
5
On-Time Reports for Four
Adverse Events
Four Reports
Pressure Ulcer … Prevention
Pressure Ulcer Healing
Falls Prevention
Preventable Hospital and ED Visits
May 2017
On-Time … leading clinicians
Reports tested in clinical settings for feasibility and ease of use
Large decline in pressure … ulcer incidence rate seen in Pressure Ulcer Prevention Program Evaluation
May 2017
On-Time Overview
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/urinary-catheter-indications-notes.docx
April 01, 2022 - strict immobility post-procedure, and urinary incontinence contaminating open (stage 3 or stage 4) pressure … ulcers. … ulcers and weakness from less walking. … ulcers. … ulcers.
-
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
-
www.ahrq.gov/npsd/data/chartbook/index.html
February 01, 2025 - falls, devices and medical/surgical supply, medication and other substances, perinatal incidents, and pressure … ulcers.
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/urinary-catheter-indications.pptx
April 01, 2022 - Closed pressure ulcers: stage I, deep tissue injury No No, unless has chronic ISC needs Yes, if the patient … Open pressure ulcers: stage II Uncertain Yes Yes, if the patient is unable to toilet using other means … , bedpan, bedside commode, bathroom All†
Open pressure ulcers: stages III-IV, unstageable Yes Yes,
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf
June 02, 2025 - Best practices forms exist for the following 14 PSIs:
• PSI 03 Pressure Ulcer Rate
• PSI 05 Retained … 03 Neonatal Blood Stream Infection Rate
• PDI 01 Accidental Puncture or Laceration Rate
• PDI 02 Pressure … Ulcer Rate
• PDI 03 Retained Surgical Item or Unretrieved Device Fragment Count
• PDI 05 Iatrogenic