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www.ahrq.gov/sites/default/files/2024-07/rothberg-report.pdf
January 01, 2024 - patients for whom the risks of bleeding may outweigh the benefits. … However, typical
baseline risks in the US are closer to 1%. … The risks and the thresholds for high- and low-risk categories will be calculated and
determined using … Individual
predicted risks ranged from 0.03% to >28%. … 8011 (75%) as high risk (average risk, 0.69%)
and 3102 (25%) as low risk (average risk, 0.06%).
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/001-clabsi-prevention-webinar-slides.pptx
October 01, 2024 - Factors10,11
Nonmodifiable Risk Factors10
Comorbidities
Age
Modifiable Risk Factors10
Location and duration … Subclavian Vein18
Considered the best choice for most patients
Risks include:
Iatrogenic pneumothorax … during insertion
Central vein stenosis
Femoral Vein18
Avoid using if possible
Risks include:
Infection … due to proximity to the groin
Catheter-related thrombosis
Internal Jugular Vein
Risks include:
Central … Catheter-related thrombosis: risks, diagnosis, and management.
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www.ahrq.gov/ncepcr/reports/index.html
August 01, 2025 - Technical Brief on Incorporation of Social Risk in Primary Care The U.S. … Preventive Services Task Force (USPSTF) published a manuscript in JAMA that assesses how social risks … statements and identifies current gaps in the evidence needed to expand the systematic inclusion of social risks
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www.ahrq.gov/patient-safety/diagnostic-error-grants/index.html
January 01, 2021 - combine adjudication data with data from Vizient to determine which specific factors contribute to risks … for diagnostic errors, and to use risk estimates to calculate incidence and impact of factors contributing … An expert-guided machine-learning approach to estimate the incidence, risk and harms associated with … To identify the risk factors associated with diagnostic delays for infectious diseases that are frequently
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www.ahrq.gov/funding/policies/nofoguidance/index.html
January 01, 2025 - Priorities include: Research on patient safety Identification of risks, hazards, and patient harm. … patient safety practices) and the adaptation, refinement, and sustainment of those strategies to address risks … Patient characteristics that might influence the risk of experiencing a patient safety event, for example … to develop, implement, evaluate, and spread effective patient-centered models of care for people at risk … public health to address social determinants of health (SDoH) and optimize health outcomes among high-risk
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www.ahrq.gov/hai/tools/mvp/modules/cusp/overview-cuspmvp-slides.html
February 01, 2017 - Conduct a premortem exercise with your team to proactively identify risks. … How will you reduce the risk of it happening again?
How will you know that risk is reduced? … Helps providers understand the patient safety risks in their clinical areas.
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www.ahrq.gov/sites/default/files/2024-01/dierks-report.pdf
January 01, 2024 - understanding of the safety implications and
without formal evaluation of the ‘hidden’ system-based risks … Given this exposure, we are clearly
overdue for a formal analysis of the systems-based risks associated … number of powerful probabilistic modeling formalisms to help understand and manage systems-
based risks … performance of each component
(human, technical, and organizational), our goal was to gain insight into risks … tolerance among the clinicians
Perceptions about the risks associated with a specific case
Confidence
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www.ahrq.gov/sites/default/files/2024-10/li-chang-report.pdf
January 01, 2024 - and min( –C), respectively; the second type is about trade-offs
between the expected returns and the relative … risks, especially when objectives are
inconsistent with each other; and the third type is about trade-offs … Second, for trade-offs between returns and risks, we apply the portfolio theory. … Regarding the
expected return as the mean or as the first-order effect, and the variance as the risk … expected value of deviations D, cannot be further minimized or, given an expected value of
D, the risk
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www.ahrq.gov/hai/tools/mvp/modules/cusp/science-of-safety-fac-guide.html
February 01, 2017 - must develop or improve the ability to learn from mistakes and implement procedures that reduce the risk … as checklists, and create independent checks for key processes, we improve our ability to reduce the risks … By leveraging staff member knowledge, the Staff Safety Assessment allows teams to determine risks that
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www.ahrq.gov/news/newsletters/e-newsletter/943.html
January 01, 2025 - suggested a need for more research and a more effective approach to protecting postpartum women from the risks … ET: Approaches to Address Health Risks in Older Adults , sponsored by AHRQ’s National Center for Excellence … A novel risk-adjusted metric to compare hospitals on their antibiotic prescribing at hospital discharge
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/fallsprev/fallspximpl-handouts.docx
June 02, 2025 - factors are important for falls so that they are more sensitive to changes in these risks and to helping … us identify residents whose risks are changing and to alert Nurse Managers earlier. … Facilitator: Sally [Nurse Manager B], do you use a standardized assessment tool to assess resident risks … Focusing our team discussions on those residents with new and changing risks seems like it would allow … The Falls High-Risk Report is definitely helping us identify residents with risks associated with falls
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www.ahrq.gov/sites/default/files/2024-12/lin-report.pdf
January 01, 2024 - In addition, after PCI, many patients think
they are cured, have little knowledge of their risk factors … , and do not adhere to risk factor
modification. … This
instrument contains 18 statements about the various risks and benefits of each treatment
option … /benefits Risks of medical therapy, angioplasty, bypass surgery
Comparison of risk of repeat procedure … and benefits Were risks and benefits discussed in a way that
patient understood?
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/no-more-cauti-preventing-cauti.pptx
June 02, 2025 - Inappropriate catheter indications
Patient or family request
Educate patient and family on catheter risks
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www.ahrq.gov/sites/default/files/2024-07/liebman-hyman-report.pdf
January 01, 2024 - Presenters explored
the benefits and risks of apology and disclosure after an adverse event or medical … Physicians, nurses, risk managers, hospital and other healthcare facility
administrators, defense and … medical malpractice claims allowed the attendees to hear
the actual experiences of a chief of medicine, risk … The risk manager discussed the importance of hearing
the plaintiffs identify the factors at the hospital … The attendees explored
the benefits and risks of apology and considered its powerful impact on patients
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module2/mod2-slides.html
March 01, 2017 - Experiment and take risks by constantly generating small wins and learning from mistakes. … Images: The purpose of the Staff Safety Assessment is to tap into your experience to determine risks
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www.ahrq.gov/patient-safety/reports/engage/interventions/index.html
June 01, 2023 - These tools will also help to identify risks for an adverse drug event, such as overdosing, underdosing
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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/medication/tool-safe-mgso4.html
July 01, 2023 - Probabilistic risk assessment.
Causal tree worksheet. … of transition communication techniques assures a shared mental model of plan of care and perceived risks … Patient and Family Engagement (CUSP)
Discuss risks and benefits of intrapartum or postpartum magnesium … Use unit-established process for conveying risks and benefits of magnesium sulfate use to patient and … Patient comfort and education
Discuss risks and benefits of magnesium sulfate with patient and
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www.ahrq.gov/teamstepps-program/welcome-guides/caregivers.html
July 01, 2023 - TeamSTEPPS 3.0 tools and concepts can help you learn to better understand these risks and how to constructively … The expanded functionalities available in electronic health records risk an overdependence on technologies … all these factors contribute to fatigue and burnout that create additional challenges for teams and risks
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www.ahrq.gov/news/newsroom/press-releases/nac-meeting-members.html
July 01, 2022 - Because of the continued risks of in-person meetings during the pandemic, the meeting will be available
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www.ahrq.gov/teamstepps-program/welcome-guides/experienced-trainers.html
July 01, 2023 - TeamSTEPPS 3.0 tools and concepts can help you teach your students to better understand these risks and … The expanded functionalities available in electronic health records risk an overdependence on technologies … all these factors contribute to fatigue and burnout that create additional challenges for teams and risks