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Total Results: 1,785 records

Showing results for "problem".

201. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47615/psn-pdf
     January 30, 2019 - The report provides an overview of the burnout crisis and recommends strategies to address the problem

202. A framework for assessing reasoning about controversial end-of-life clinical decisions. | PSNet
     psnet.ahrq.gov/web-mm/framework-assessing-reasoning-about-controversial-end-life-clinical-decisions
     November 30, 2023 - and the absence of an applicable strategy for responding to what we might call an “order-of-reasons" problem … superseded other reasons, and that this case therefore serves as an example of an “order-of-reasons" problem … team of physicians, along with the palliative care team, could have recognized an order-of-reasons problem … clinician refuses to follow a care plan, the following strategy may be effective in overcoming the problem … team as needed if all else fails, then advocate for the patient by escalating the issue until the problem

203. Diagnostic Errors: A New Chapter in Patient Safety Science, Policy, and Practice | PSNet
     psnet.ahrq.gov/perspective/diagnostic-errors-new-chapter-patient-safety-science-policy-and-practice
     January 01, 2016 - It struck me that this was a patient safety problem, just like all the others we were dealing with at … There are way too many patients being harmed from diagnostic error, and the problem needs to be addressed … It wasn't because we were getting pushback; it was because people didn't recognize it as a problem—and … The problem of diagnostic error was analyzed by an incredibly talented and knowledgeable committee that … This problem of variability really does need to be addressed at some point to try to narrow those bands

204. Missed Opportunities for Suicide Risk Assessment | PSNet
     psnet.ahrq.gov/web-mm/missed-opportunities-suicide-risk-assessment
     September 27, 2023 - Prioritizing Suicidal Ideation and Attempt on the Medical History/Problem List : Suicidal ideation or … attempt should be entered on the patient’s problem list along with an appropriate plan that is carried … By doing so, the “problem” of suicidal ideation and attempt will be more likely to be carried over from … The suicide item on a patient’s problem list should carry forward until an appropriate suicide risk assessment … collaborative, multidisciplinary, systems-based approaches are critically needed to address the dual problem

205. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33571/psn-pdf
     March 15, 2025 - medmarxr https://psnet.ahrq.gov/issue/incident-reporting-system-does-not-detect-adverse-drug-events-problem-quality-improvement … adverse-event-reporting-practices-us-hospitals-results-national-survey https://psnet.ahrq.gov/issue/problem-incident-reporting

206. African Partnerships for Patient Safety. | PSNet
     psnet.ahrq.gov/issue/african-partnerships-patient-safety
     April 30, 2024 - December 12, 2014 Healthcare-associated infections: a national patient safety problem

207. Culture of Safety | PSNet
     psnet.ahrq.gov/primer/culture-safety
     September 15, 2024 - The culture of individual blame is still a pervasive problem in health care and undoubtedly impairs … Safety culture is fundamentally a local problem, in that wide  variations  in the perception of safety

208. Antibiotics for URI/Sinusitis—A Simple Decision Gone Bad | PSNet
     psnet.ahrq.gov/web-mm/antibiotics-urisinusitis-simple-decision-gone-bad
     January 01, 2014 - rare but dangerous reactions such as Clostridium difficile colitis, anaphylaxis, or this patient's problem … The chief population-level effect of antibiotic overuse is the widespread and growing problem of antimicrobial … AMR is a worsening problem among many bacteria, including Staphylococcus aureus , Streptococcus pneumoniae … While the complications and ultimate outcome of this case are exceedingly rare, unfortunately, the problem … aureus (MRSA) ( 18 ) is but one example of the clinical implications of drug-resistant bacteria—a problem

209. Disruptive and Unprofessional Behavior | PSNet
     psnet.ahrq.gov/primer/disruptive-and-unprofessional-behavior
     September 15, 2024 - issue was underscored by a 2008 Joint Commission sentinel event alert , which called attention to this problem … emphasis; Vanderbilt University has achieved notable success in this area through identification of problem

210. Safety In Dentistry | PSNet
     psnet.ahrq.gov/perspective/safety-dentistry
     August 01, 2016 - The problem is that, unlike hospitals, dental offices are not supervised until a serious adverse event … A good example is the problem with disinfection and sterilization procedures. … BPP : We have a problem because we have developed anonymous reporting systems, but the judge can ask … That's a problem we have not resolved. … Once you know the problem and how to mitigate it, I think it's impossible to stop the process.

211. Handoffs | PSNet
     psnet.ahrq.gov/primer/handoffs
     October 18, 2023 - To avert this problem, hospitals are required to "reconcile" medications across the continuum of care … A ssessment: What do you think the problem is?

212. Establishing a Safety Culture: Thinking Small | PSNet
     psnet.ahrq.gov/perspective/establishing-safety-culture-thinking-small
     December 01, 2006 - workers find comfort in their existing way of life and resist trying new behaviors, regardless of the problem … to a cockpit, you come to an abrupt halt in the analogy when you start looking at how to tackle the problem … of ICUs and specifically how comfortable the frontline nurses are in speaking up if they perceive a problem … The problem is that we're not studying the components of what makes structured communication powerful … Policy changes need to be contingent upon evidence, not just enthusiasm and an awareness of the problem

213. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/39307/psn-pdf
     February 24, 2010 - intimidation-concept-analysis https://psnet.ahrq.gov/issue/intimidation-practitioners-speak-about-unresolved-problem

214. Electronic Err | PSNet
     psnet.ahrq.gov/web-mm/electronic-err
     April 01, 2014 - Analogous discrepancies were found for problem lists: patients' main EHR problem lists often continued … ask about modifications to the current system that would allow automatic updating of medication and problem … lists or, in the absence of such a system, add a flag to medication and problem lists indicating that

215. Pocket Syringe Swap | PSNet
     psnet.ahrq.gov/web-mm/pocket-syringe-swap
     July 01, 2006 - The Commentary At first glance, the problem represented by this case seems trivially obvious. … inherent to the anesthesia system of drug administration that contribute to the persistence of the problem … Mass-produced prefilled syringes would essentially eliminate the problem of mislabeled syringes, and … The problem of cross-connection of anesthesia gasses was recognized more than 50 years ago, and has been

216. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/35460/psn-pdf
     June 17, 2014 - drug names, mistakes that can result from them, and successful hospital initiatives to combat the problem

217. Medical Devices in the "Wild" | PSNet
     psnet.ahrq.gov/web-mm/medical-devices-wild
     March 27, 2024 - multitude of users.( 8,9 ) Although new SCD equipment with shorter tubes may work for this particular problem … An HFE approach for such a problem would be to redesign the system while involving the users throughout … The $17.1 billion problem: the annual cost of measurable medical errors.

218. Our Maturing Understanding of Safety Culture: How to Change It and How It Changes Safety | PSNet
     psnet.ahrq.gov/perspective/our-maturing-understanding-safety-culture-how-change-it-and-how-it-changes-safety
     March 01, 2017 - MDW : About 7 or 8 years ago, I spent a lot of time looking at the problem of bad apples and became … They're a relatively rare problem, but they're not an unknown problem. … It's too easy to forget how important it is that you actually know how to solve the problem. … They were able to demonstrate it really was a problem and that it was tractable. … That won't be the same for every single safety problem that you come across.

219. Pulse oximeters for medical purposes - non-clinical and clinical performance testing, labeling, and premarket submission recommendations. | PSNet
     psnet.ahrq.gov/issue/pulse-oximeters-medical-purposes-non-clinical-and-clinical-performance-testing-labeling-and
     January 22, 2025 - Related Resources Addressing racial and ethnic bias in pulse oximeters—a wicked problem

220. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33587/psn-pdf
     June 15, 2024 - First, missed nursing care is primarily a problem of time pressure and competing demands, and adequate … Cultivating cross-monitoring and cooperative problem- solving skills among staff may decrease the frequency