-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8b.html
February 01, 2023 - 19,884
Min
8,723
s
s
s
s
Max
39,914
44,860
74,074
109,091
s
Pressure … Ulcer
3,472
6,789
3,352
1,525
3,397
Min
1,663
s
s
s
s
Max
7,916 … 11,656
7,935
10,256
Max
34,059
41,284
22,863
50,576
50,856
32,463
44,228
Pressure … Ulcer
4,095
3,804
3,300
3,854
5,806
3,982
3,777
Min
1,775
1,548
1,208
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8f.html
February 01, 2023 - 22,643
Min
s
s
s
s
s
Max
42,799
51,459
68,293
75,000
s
Pressure … Ulcer
4,950
5,948
3,051
2,700
4,615
Min
1,710
s
s
s
s
Max
19,029 … 5,672
s
s
3,977
6,993
Max
41,783
55,696
50,219
s
s
49,115
47,727
Pressure … Ulcer
7,200
3,327
4,903
s
s
4,833
5,101
Min
2,944
1,030
2,139
s
s
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8c.html
February 01, 2023 - 12,152
Min
3,503
s
s
s
s
Max
29,139
28,882
33,333
57,143
s
Pressure … Ulcer
2,008
3,468
1,508
1,305
1,829
Min
s
s
s
s
s
Max
6,520 … s
s
3,109
s
Max
19,830
35,256
29,840
68,293
96,970
25,549
36,882
Pressure … Ulcer
2,944
1,761
2,317
1,619
2,209
2,206
2,570
Min
509
377
567
s
s
-
www.ahrq.gov/hai/pfp/interimhacrate2014.html
January 01, 2018 - About 40 percent of this reduction is from adverse drug events, about 28 percent from pressure ulcers … Most of the deaths averted occurred as a result of reductions in the rates of pressure ulcers and adverse
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/prevhosp/impmaterials.html
June 01, 2017 - |___|
Confusion/mental status change
|___|
|___|
Any full thickness wound (e.g., pressure … ulcers [Stage II or greater], surgical wound, stasis ulcer)
|___|
|___|
Polypharmacy (15 or … Chronic pressure ulcers
Yes |___|
No |___|
L.
-
www.ahrq.gov/news/newsroom/case-studies/201419.html
November 01, 2014 - other patient safety issues such as falls prevention, medication safety, urinary tract infection, and pressure … ulcers.
-
www.ahrq.gov/sites/default/files/2024-12/thorpe-rask-report.pdf
January 01, 2024 - ulcers
ii. 17 selected a collaborative HFMEA focusing on patient flow
iii. 20 opted for an Independent … Hospital Acquired Pressure Ulcers Self-Assessment:
• Improvement Plan Documentation Form
• Reassessment … ulcers, develop an improvement plan,
and evaluate actions completed. … Ulcer Self-Assessment
• Diabetes Survey
• DVT Policy and Procedure Survey
• Failure Mode Effects … Ulcer Self-Assessment, Diabetes
Survey, and DVT Policy and Procedure Survey.
-
www.ahrq.gov/hai/cusp/toolkit/content-calls/small-hospitals.html
April 01, 2013 - What is your fall rate or your pressure ulcer rate or whatever? … Let’s think about how you can eliminate hospital-acquired Stage 3 and 4 pressure ulcers. … We want to eliminate preventable Stage 3 and 4 pressure ulcers. … Standardize the pressure ulcer risk assessment. … Your CUSP piece of that, for instance with pressure ulcers under daily goals, when you’re looking at
-
www.ahrq.gov/practiceimprovement/index.html
June 01, 2025 - On-Time Pressure Ulcer Prevention Tools to assist nursing homes that have electronic medical record systems
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/find5.html
December 01, 2012 - higher rates on all measures other than Short-Term Complications of Diabetes, Bacterial Pneumonia, and Pressure … Ulcer. … The exceptions are Pressure Ulcer, which is effectively equal in urban and nonurban areas, and Infection … Rates for women in the Medicaid-only population are always higher than for men except in Pressure Ulcer … The main exception to the county-level age pattern is the Pressure Ulcer measure, for which rates are
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/prevhosp/transfer.html
September 01, 2017 - DNR,DNH, MOLST, or POLST Order in Place
Oxygen Therapy
Catheter or Ostomy Present
Stage II or > Pressure … Ulcer
Fall Risk
Late-Loss ADL Score ≥12
Cognitive Impairment
Medical Conditions **
High-Risk
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module4/module4_pu-implementation_slides.pptx
June 02, 2025 - Tool 4C
34
Staff Knowledge Assessment
Tool 2G: Pieper Pressure Ulcer Knowledge Test
35
Staff
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/c2_combo_prioritizationworksheetexample.xlsx
June 02, 2025 - Patient Safety PSI 03 Pressure Ulcer 1.2 1.3 7 $109,870 $ 769,087 N 6 7 7 Y Y Y Y Y
PSI 06 Iatrogenic … Y N
Pediatric PDI 01 Accidental Puncture 0.3 0.6 1 $41,204 $ 41,204 N 9 9 9 Y Y Y Y Y
PDI 02 Pressure … Ulcer 0.0 0.2 0 $85,344 $ - 0 N 6 6 6 Y Y Y Y Y
PDI 05 Iatrogenic Pneumothorax Rate 0.0 0.1 0
-
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
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/cauti-learning-from-defects-revised.docx
April 01, 2022 - · Comfort care
· Urological/perineal procedure
· Stage 3 or greater pressure ulcer in perineal area with
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/c2_pdi_prioritizationworksheetexample.pdf
June 02, 2025 - N
PDI 01 Accidental
Puncture
0.3 0.6 1 $41,204 $ 41,204 N 9 9 9 Y Y Y Y Y
PDI 02 Pressure … Ulcer 0.0 0.2 0 $85,344 $ - N 6 6 6 Y Y Y Y Y
PDI 05 Iatrogenic
Pneumothorax
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/c2_pdi_prioritizationworksheetexample.xlsx
June 02, 2025 - Y N
Pediatric PDI 01 Accidental Puncture 0.3 0.6 1 $41,204 $ 41,204 N 9 9 9 Y Y Y Y Y
PDI 02 Pressure … Ulcer 0.0 0.2 0 $85,344 $ - 0 N 6 6 6 Y Y Y Y Y
PDI 05 Iatrogenic Pneumothorax Rate 0.0 0.1 0
-
www.ahrq.gov/sites/default/files/wysiwyg/npsd/data/npsd-chartbook-2019.pdf
January 01, 2019 - There are no detailed sections
for the Perinatal, Pressure Ulcer, or Surgery or Anesthesia EVENT TYPES … No harm was reported for more than one-quarter (13,101 / 47,110; 27.8%) of Pressure Ulcer
Incidents … This was unexpected, as pressure ulcers,
like HAIs and venous thromboembolism (VTE), result in harm … Ulcer
A pressure ulcer that, on admission, was at stage/category III or stage/category IV or was … /category I or stage/category II
A pressure ulcer whose most advanced stage is unknown
A mucosal
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/cauti-learning-from-defects-revised.pdf
April 01, 2022 - � Comfort care
� Urological/perineal procedure
� Stage 3 or greater pressure ulcer in perineal area
-
www.ahrq.gov/npsd/data/dashboard/info.html
June 01, 2019 - Technology (HIT); Fall; Healthcare-Associated Infection; Medication or Other Substance; Perinatal; Pressure … Ulcer; Surgery or Anesthesia; and Venous Thromboembolism.