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4781. Using Precision Performance Measurement to Conduct Focused Quality Improvement | Digital Healthcare Research
      digital.ahrq.gov/ahrq-funded-projects/using-precision-performance-measurement-conduct-focused-quality-improvement
      January 01, 2023 - Using Precision Performance Measurement to Conduct Focused Quality Improvement Project Final Report ( PDF , 195.22 KB) Disclaimer Disclaimer The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily rep…

4782. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49409/psn-pdf
      July 01, 2003 - Feeling No Pain July 1, 2003 Bogner MS. Feeling No Pain. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/feeling-no-pain The Case A 33-year-old female underwent hysterectomy for refractory endometriosis. For pain post-operatively, the patient was placed on a Patient-Controlled Analgesia (PCA) pump containin…

4783. Slide Presentation: An Introduction to Safe Transitions for Patients to New Appointments
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/safetransitions/safetransitions.pptx
      June 02, 2025 - Slide Presentation: An Introduction to Safe Transitions for Patients to New Appointments An Introduction to Safe Transitions for Patients to New Appointments Ambulatory Care Facility Team Presentation Overview Purpose and Benefits Toolkit Components Team Member Roles and Responsibilities Implementation Steps Resourc…

4784. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33815/psn-pdf
      September 01, 2016 - Telemedicine and Patient Safety September 1, 2016 Agboola SO, Kvedar JC. Telemedicine and Patient Safety. PSNet [internet]. 2016. https://psnet.ahrq.gov/perspective/telemedicine-and-patient-safety Perspective A paradigm shift is ongoing in the health care sector. The traditional model of episodic and hospital-base…

4785. Competencies To Improve Diagnosis in Health Professions Education  | Agency for Healthcare Research and Quality
      www.ahrq.gov/diagnostic-safety/resources/issue-briefs/education-dx-outcomes-4.html
      March 01, 2022 - Improving Education—A Key to Better Diagnostic Outcomes Competencies To Improve Diagnosis in Health Professions Education  Previous Page Next Page Table of Contents Improving Education—A Key to Better Diagnostic Outcomes Introduction Foundations of Diagnosis Education Current State of Diagnosi…

4786. Breaking Down Barriers to Aseptic Catheter Insertion | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/cauti-tools/archived-webinars/breaking-down-barriers-slides.html
      December 01, 2017 - Breaking Down Barriers to Aseptic Catheter Insertion Slide Presentation Slide 1 Breaking Down Barriers to Aseptic Catheter Insertion Milisa Manojlovich, PhD, RN, CCRN Associate Professor University of Michigan School of Nursing Stacy Martin, RN, BSN, CIC Manager, Infection Prevention Moffitt Cance…

4787. Facilitator Guide: Build Your SSI Prevention Bundle (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/ptfamcare-facguide.docx
      January 01, 2017 - Facilitator Guide: Build Your SSI Prevention Bundle Slide Title and Commentary Slide Number and Slide Title Slide Patient and Family Involvement in Care of Mechanically Ventilated Patients SAY: This module is about patient and family involvement in patient care. Slide 1 Learning Objectives SAY: At the end of…

4788. The How-To’s of Hand Hygiene | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/education-bundles/infection-prevention/hand-hygiene/hand-hygiene-slides.html
      March 01, 2017 - The How-To’s of Hand Hygiene AHRQ Safety Program for Long-Term Care: HAIs/CAUTI Slide 1: The How-To's of Hand Hygiene Training Module 1 Slide 2: Objectives Upon completion of this training module, long-term care staff will be able to demonstrate a working knowledge of— Why hand hygiene is so imp…

4789. Appendix B8: Unsafe Behavior Worksheet (Text Description) | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/manapb5txt.html
      December 01, 2017 - The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities Appendix B8: Unsafe Behavior Worksheet (Text Description) Previous Page Next Page Table of Contents The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities Chapter 1. Introduction an…

4790. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49839/psn-pdf
      August 01, 2018 - Mixup Beyond the Medication Label August 1, 2018 Pervanas H, VanValkenburgh D. Mixup Beyond the Medication Label. PSNet [internet]. 2018. https://psnet.ahrq.gov/web-mm/mixup-beyond-medication-label The Case An 80-year-old man was admitted to a hospital for recurrent hypoglycemia. He had been seen at another hospi…

4791. References | Agency for Healthcare Research and Quality
      www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-psychological-safety-ref.html
      September 01, 2023 - Strategies for Improving Clinician Psychological Safety in Reporting and Discussing Diagnostic Error References Previous Page   Table of Contents Strategies for Improving Clinician Psychological Safety in Reporting and Discussing Diagnostic Error Learning From Diagnostic Errors The Potential of …

4792. Recognizing and Supporting Nurses in Diagnostic Safety | Agency for Healthcare Research and Quality
      www.ahrq.gov/diagnostic-safety/resources/issue-briefs/nurse-role-dxsafety3.html
      September 01, 2022 - Reinforcing the Value and Roles of Nurses in Diagnostic Safety: Pragmatic Recommendations for Nurse Leaders and Educators Recognizing and Supporting Nurses in Diagnostic Safety Previous Page Next Page Table of Contents Reinforcing the Value and Roles of Nurses in Diagnostic Safety: Pragmatic Recomme…

4793. Missed Nursing Care | PSNet
      psnet.ahrq.gov/primer/missed-nursing-care
      September 15, 2024 - Missed Nursing Care Citation Text: Missed Nursing Care. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …

4794. Kaiser Permanente School of Anesthesia Uses AHRQ’s Surveys on Patient Safety Culture, TeamSTEPPS® | Agency for Healthcare Research and Quality
      www.ahrq.gov/news/newsletters/e-newsletter/956.html
      May 01, 2025 - Kaiser Permanente School of Anesthesia Uses AHRQ’s Surveys on Patient Safety Culture, TeamSTEPPS® Issue Number 956 AHRQ News Now is a weekly newsletter that highlights agency research and program activities. May 6, 2025 AHRQ Stats: Proportionate Healthcare Expenditures Among High Spenders Between 2018 a…

4795. Computerized Provider Order Entry and Patient Safety | PSNet
      psnet.ahrq.gov/perspective/computerized-provider-order-entry-and-patient-safety
      January 01, 2014 - Annual Perspective Computerized Provider Order Entry and Patient Safety Urmimala Sarkar, MD, and Kaveh Shojania, MD | January 1, 2015  View more articles from the same authors. Citation Text: Sarkar U, Shojania KG. Computerized Provider Order Entry and Patien…

4796. Strategies and Approaches for Investigating Patient Safety Events | PSNet
      psnet.ahrq.gov/primer/strategies-and-approaches-investigating-patient-safety-events
      March 15, 2025 - Strategies and Approaches for Investigating Patient Safety Events Citation Text: Shaikh U. Strategies and Approaches for Investigating Patient Safety Events. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022. Copy Citation Fo…

4797. Reinforcing the Value and Roles of Nurses in Diagnostic Safety - Issue Brief (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/reports/issue-briefs/nurse-role-dxsafety.pdf
      September 02, 2022 - Reinforcing the Value and Roles of Nurses in Diagnostic Safety - Issue Brief Issue Brief 10 Reinforcing the Value and Roles of Nurses in Diagnostic Safety: Pragmatic Recommendations for Nurse Leaders and Educators PATIENT SAFETY e This page intentionally left blank. e Issue Brief 10 Reinforcing the Va…

4798. How communication among members of the health care team affects maternal morbidity and mortality. | PSNet
      psnet.ahrq.gov/issue/how-communication-among-members-health-care-team-affects-maternal-morbidity-and-mortality
      November 12, 2014 - Commentary How communication among members of the health care team affects maternal morbidity and mortality. Citation Text: Brennan RA, Keohane CA. How Communication Among Members of the Health Care Team Affects Maternal Morbidity and Mortality. J Obstet Gynecol Neonatal Nurs. 2016;45(6)…

4799. Patient safety: threats and solutions. | PSNet
      psnet.ahrq.gov/issue/patient-safety-threats-and-solutions
      January 19, 2011 - Commentary Patient safety: threats and solutions. Citation Text: McCaughan D, Kaufman G. Patient safety: threats and solutions. Nurs Stand. 2013;27(44):48-55; quiz 56, 58. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubM…

4800. eCoach: Development and Pilot Testing of a Decision Aid for Prostate Cancer - 2012 | Digital Healthcare Research
      digital.ahrq.gov/ahrq-funded-projects/ecoach-development-and-pilot-testing-decision-aid-prostate-cancer/annual-summary/2012
      January 01, 2012 - eCoach: Development and Pilot Testing of a Decision Aid for Prostate Cancer - 2012 Project Name eCoach: Development and Pilot Testing of a Decision Aid for Prostate Cancer Principal Investigator Mohan, Arun Organization Emory University Funding Mechanism PAR: HS08-2…