-
psnet.ahrq.gov/node/43512/psn-pdf
September 29, 2017 - interruptions in health care, this commentary reveals that most studies
focus on the rate of interruptions rather … than the relationship between interruptions and errors.
-
psnet.ahrq.gov/node/33587/psn-pdf
June 15, 2024 - concluded the activities most
frequently missed are those related to emotional and psychological needs, rather … The only exception is that nurses report more
missed care than do nursing assistants. … toward
caring for the whole group of patients, mostly by assisting each other to complete needed care rather … than
focusing only on their own patient assignments. … Indeed, results from a study of Pennsylvania hospitals suggest that more than 30% of nurses had
high
-
psnet.ahrq.gov/node/43858/psn-pdf
February 18, 2015 - study suggested that calling a rapid
response is felt to only be justifiable in extreme situations rather … than beforehand, which severely limits the
potential effectiveness of this intervention.
-
psnet.ahrq.gov/node/44557/psn-pdf
November 20, 2015 - This commentary
highlights the importance of using a systems approach to address problems rather than
-
psnet.ahrq.gov/node/43692/psn-pdf
April 22, 2015 - perioperative deaths were not due to surgical error and advocates
for focusing on failure to rescue rather … than surgeon-specific mortality data in public reporting.
-
psnet.ahrq.gov/node/44984/psn-pdf
April 13, 2016 - The authors recommend screening for physician fitness based
on overall physical and mental health rather … than at a given age threshold.
-
psnet.ahrq.gov/node/44062/psn-pdf
September 09, 2015 - operating
environment of error reporting systems—for example, taking steps to improve safety culture—rather … than
the technical specifications of the systems.
-
psnet.ahrq.gov/node/37120/psn-pdf
March 24, 2011 - patient-safety-culture-primary-care-developing-theoretical-framework-practical-
use
Past research on safety culture in the ambulatory setting has focused on assessment rather … than a
framework for action.
-
psnet.ahrq.gov/issue/addressing-adultification-black-pediatric-patients-emergency-department-framework-decrease
October 27, 2021 - framework to identify and reduce adultification (when children are perceived or treated as being older than … RRC calls for systemic , rather than individual, efforts.
-
psnet.ahrq.gov/web-mm/charcoal-lavage-lungs
January 01, 2016 - Most were solitary case reports, rather than collections or reviews. … In this case, the problems probably arose more from a lack of knowledge than poor technique. … Often anecdotal or personal knowledge, rather than broader experience and data, is passed on. … sufficiently sophisticated.( 4,5 ) Most simulations of common medical procedures focus on elementary technique rather … than the management of complications and recognition and management of pathology.
-
psnet.ahrq.gov/node/49409/psn-pdf
July 01, 2003 - Those problems most likely would be considered errors of omission by the individual nurses,
rather than … compromise patient safety because it focuses attention and reliance on the means of providing care, rather … than on the patient. … Because this analysis was limited to the material in the case report, it
is less comprehensive than … Thus, when analyzing
an incident, rather than focusing solely on the individual care provider-actor,
-
psnet.ahrq.gov/web-mm/diagnostic-overshadowing-dangers
February 12, 2020 - system frequently, have serious medical conditions, and are more likely to be admitted to the hospital than … diagnoses, yet typically their chief complaint in the ED is not related to these conditions, but rather … In such instances, providers may rely on documentation from previous visits rather than taking extra … than to a step-down or intensive care unit setting that would allow for more intensive monitoring. … than automatically labeling a patient as a "poor historian."
-
psnet.ahrq.gov/issue/adaptive-expertise-medical-decision-making
September 18, 2024 - The author suggests that an adaptive rather than linear decision-making approach would support reasoning
-
psnet.ahrq.gov/node/73083/psn-pdf
March 31, 2021 - concluded the investigations
were largely suited to fit the requirements of the supervisory authority rather … than an opportunity for
organizational learning to advance patient safety.
-
psnet.ahrq.gov/node/50824/psn-pdf
January 22, 2020 - research which
found that CRM improved staff outcomes, such as safety culture and situational awareness, rather … than
patient-related outcomes.
-
psnet.ahrq.gov/node/50370/psn-pdf
January 01, 2020 - They conclude that medical errors more often result from errors
of commission or omission rather than
-
psnet.ahrq.gov/web-mm/harm-alarm-fatigue
February 14, 2018 - 170 audible false alarms each day, more than 7 per hour. … Consequently, rather than signaling that something is wrong, the cacophony becomes "background noise" … Another suggestion for industry is to create algorithms that analyze all of the available ECG leads, rather … than only a select few leads. … Take-Home Points Alarms should never be completely silenced; rather, clinical staff should problem-solve
-
psnet.ahrq.gov/issue/risks-prescribing-cascade
December 16, 2020 - article shares how medication side effects can be misdiagnosed to perpetuate harm in older patients rather … than getting to the root of the care concerns.
-
psnet.ahrq.gov/node/43847/psn-pdf
January 28, 2015 - likely to speak up if they noticed an error when paired with an attending surgeon who
used encouraging rather … than dismissive language.
-
psnet.ahrq.gov/node/44213/psn-pdf
July 08, 2015 - The authors recommend increasing patient engagement through partnership rather than
by encouraging patients