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psnet.ahrq.gov/node/33606/psn-pdf
December 15, 2024 - interventions to reduce opioid prescribing include
measures such as state-level prescription drug monitoring … psnet.ahrq.gov/primer/measurement-patient-safety
https://psnet.ahrq.gov/issue/implementation-prescription-drug-monitoring-programs-associated-reductions-opioid-related
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psnet.ahrq.gov/issue/safe-practice-recommendations-use-copy-forward-nursing-flow-sheets-hospital-settings
May 18, 2022 - January 21, 2019
Improving situation awareness to reduce unrecognized clinical deterioration
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psnet.ahrq.gov/node/74121/psn-pdf
November 30, 2021 - Medical devices are a valuable adjunct for
monitoring patient status since physiological triggers are … There are three types of alarms
generated by monitoring devices: arrhythmia alarms (change in cardiac … and include appropriate responses in high-risk areas, setting alarm limits
relevant to the clinical situation … Alarm fatigue is a well-known result of frequent false alarms from monitoring devices. … Adequate
staffing and training are critically important in the management of monitoring devices.
-
psnet.ahrq.gov/sites/default/files/2023-04/april_2023_spotlight_the_dose_makes_the_poison.pdf
January 01, 2023 - • Implement procedural sedation best practices including use of adequate personnel,
continuous monitoring … Take-Home Points
49
Medication selection for procedural sedation should be guided by each clinical
situation … Pre-procedure checklists and continuous monitoring should be routinely utilized
during procedural … Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic … Guidelines for Monitoring and Management of Pediatric Patients
Before, During, and After Sedation for
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psnet.ahrq.gov/node/73998/psn-pdf
October 27, 2021 - Proper Intravenous Catheter Site Monitoring and Detection of Infiltration
Intravenous infiltration is
-
psnet.ahrq.gov/curated-library/organizational-learning
November 03, 2025 - resilience both focus on what goes right in healthcare and adjusting to disturbances through anticipation, monitoring … technology has improved many aspects of care, but can also introduce new safety concerns that require active monitoring … resilience both focus on what goes right in healthcare and adjusting to disturbances through anticipation, monitoring … technology has improved many aspects of care, but can also introduce new safety concerns that require active monitoring
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psnet.ahrq.gov/node/50612/psn-pdf
October 30, 2019 - These communication structures may vary from those utilized to convey clinical
information—the Situation … first contacted by the bedside nurse, the intern would likely have been better supported to
manage the situation
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psnet.ahrq.gov/node/49583/psn-pdf
April 01, 2009 - processes for managing high-
risk/high-alert medications, enhanced continuity of care, and increased monitoring … The use of standardized checklists and simple communication tools such as SBAR
(situation, background
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psnet.ahrq.gov/web-mm/who-nose-where-airway
May 01, 2016 - This case highlights two aspects that complicate the situation. … In this situation, a full handoff may not have been done since the CRNA was not actually leaving the … or aspirated airway devices, we can potentially extrapolate from a similar but more widely studied situation
-
psnet.ahrq.gov/node/863308/psn-pdf
February 28, 2024 - outlined in the 2022 American Society of Anesthesiologists Guidelines
provides useful guidance in any situation … to the risk of pushing aspirate further into the
airway, but it may be unavoidable in this critical situation
-
psnet.ahrq.gov/node/33855/psn-pdf
April 01, 2018 - Every patient
is different and things happen in the hospitalization, so to get the acute situation under … Getting
better at monitoring that can help us meet our targets for people to be strong.
-
psnet.ahrq.gov/node/49614/psn-pdf
November 01, 2010 - Engaging patients in actively contributing to their care and monitoring their clinical conditions.
-
psnet.ahrq.gov/node/49616/psn-pdf
December 01, 2010 - Subsequent dexamethasone doses were given as
ordered, with close monitoring for adverse effects. … prescribed using protocols or order sets,
which include individualization of dose along with appropriate monitoring
-
psnet.ahrq.gov/sites/default/files/2021-09/spotlight_lost_in_transitions_of_care_09.22.2021_final.pdf
January 01, 2021 - • For unclear reasons, the physician did not access the state’s
prescription drug monitoring program … Programs
(PDMPs)
26
PDMPs (1)
• A Prescription Drug Monitoring Program is an electronic database … a time, as seen with this case, suggest that
prescriber(s) may not trust the patient or their home situation … Prescription Drug Monitoring Programs (PDMPs). … Prescription Drug Monitoring Programs (PDMPS): What Healthcare Providers Need to Know.
-
psnet.ahrq.gov/web-mm/other-hand
December 12, 2012 - The patient was admitted at 6:00 p.m. to the intensive care unit (ICU) for monitoring, pain medication … The resident caring for the patient was placed in a difficult situation because he had received only … Nonetheless, neither the nurse nor the resident recognized the potential critical nature of the situation
-
psnet.ahrq.gov/web-mm/hidden-danger-insidious-postpartum-bleeding-after-emergency-cesarean-delivery
November 25, 2020 - Medical devices are a valuable adjunct for monitoring patient status since physiological triggers are … There are three types of alarms generated by monitoring devices: arrhythmia alarms (change in cardiac … and include appropriate responses in high-risk areas, setting alarm limits relevant to the clinical situation … Alarm fatigue is a well-known result of frequent false alarms from monitoring devices. … Adequate staffing and training are critically important in the management of monitoring devices.
-
psnet.ahrq.gov/node/867676/psn-pdf
February 26, 2025 - staff and patient concerns,
supporting and role-modeling efforts to improve safety, and continually monitoring
-
psnet.ahrq.gov/perspective/innovations-promoting-hand-hygiene-compliance
May 01, 2014 - Another system for monitoring hand hygiene is to assess handwash product utilization, which can be used … These monitoring methods can vary; some use sensors that detect alcohol vapors on the HCW's hands ( 13 … Performance monitoring and feedback was a third element of the strategy. … The benefit of direct monitoring is that you know exactly what you are observing, and when you offer … But it is feasible once people have really standardized the monitoring of hand hygiene performance.
-
psnet.ahrq.gov/node/33595/psn-pdf
December 15, 2024 - psnet.ahrq.gov//#2
effective performance in health care environments requires naturalistic decision-making and situation
-
psnet.ahrq.gov/node/867497/psn-pdf
February 26, 2025 - the exchange of knowledge and
information across multiple healthcare providers in any patient care situation … represent active
and latent factors or failure modes that may become active at any time, place, or situation … psnet.ahrq.gov//#1
anesthesiologist placed devices on the skin and inserted a central venous line for monitoring … retained sponge because they thought the sponge
radiopaque markers were just wires from electrode monitoring