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Total Results: 3,040 records

Showing results for "situations".

341. Medical Device Use Error: Root Cause Analysis. | PSNet
     psnet.ahrq.gov/issue/medical-device-use-error-root-cause-analysis
     January 10, 2018 - examples of RCAs to illustrate how the method can uncover flaws that contribute to error in various situations

342. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/41942/psn-pdf
     July 24, 2017 - Improving situation awareness to reduce unrecognized clinical deterioration and serious safety events. July 24, 2017 Brady PW, Muething S, Kotagal U, et al. Improving situation awareness to reduce unrecognized clinical deterioration and serious safety events. Pediatrics. 2013;131(1):e298-308. doi:10.1542/peds.2012-…

343. Improving shared situation awareness for high-risk therapies in hospitalized children. | PSNet
     psnet.ahrq.gov/issue/improving-shared-situation-awareness-high-risk-therapies-hospitalized-children
     October 20, 2021 - Study Improving shared situation awareness for high-risk therapies in hospitalized children. Citation Text: Sosa T, Mayer B, Chakkalakkal B, et al. Improving shared situation awareness for high-risk therapies in hospitalized children. Hosp Pediatr. 2022;12(1):37-46. doi:10.1542/hpeds.202…

344. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/43959/psn-pdf
     September 01, 2016 - adverse-drug-events A persistent challenge in patient safety is detecting and intervening in unsafe situations

345. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/60851/psn-pdf
     August 26, 2020 - Situativity: A Family of Social Cognitive Theories for Clinical Reasoning and Error. August 26, 2020 Durning S, Holmboe E, Graber ML, eds. Diagnosis(Berl). 2020;7(3):151-344. https://psnet.ahrq.gov/issue/situativity-family-social-cognitive-theories-clinical-reasoning-and-error Challenges to effective clinical reas…

346. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/46137/psn-pdf
     August 03, 2017 - Frequency and type of situational awareness errors contributing to death and brain damage: a closed claims analysis. August 3, 2017 Schulz CM, Burden A, Posner KL, et al. Frequency and Type of Situational Awareness Errors Contributing to Death and Brain Damage: A Closed Claims Analysis. Anesthesiology. 2017;127(2)…

347. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49503/psn-pdf
     February 01, 2006 - importance of human factors in their work will be better able to anticipate and guard against hazardous situations … Hospitals must include some excess nurse capacity into each shift to provide for unexpected situations … administrators must reduce the workload for nurses and build in extra nursing staff to accommodate emergency situations

348. ISMP Guidelines for Safe Medication Use in Perioperative and Procedural Settings. | PSNet
     psnet.ahrq.gov/issue/ismp-guidelines-safe-medication-use-perioperative-and-procedural-settings
     November 16, 2022 - November 15, 2023 Guidelines on Human Factors in Critical Situations 2023.

349. Frequency and type of situational awareness errors contributing to death and brain damage: a closed claims analysis. | PSNet
     psnet.ahrq.gov/issue/frequency-and-type-situational-awareness-errors-contributing-death-and-brain-damage-closed
     September 01, 2021 - Study Frequency and type of situational awareness errors contributing to death and brain damage: a closed claims analysis. Citation Text: Schulz CM, Burden A, Posner KL, et al. Frequency and Type of Situational Awareness Errors Contributing to Death and Brain Damage: A Closed Claims Anal…

350. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/74271/psn-pdf
     January 19, 2022 - Improving shared situation awareness for high-risk therapies in hospitalized children. January 19, 2022 Sosa T, Mayer B, Chakkalakkal B, et al. Improving shared situation awareness for high-risk therapies in hospitalized children. Hosp Pediatr. 2022;12(1):37-46. doi:10.1542/hpeds.2021-006193. https://psnet.ahrq.go…

351. Effective approaches to control non-actionable alarms and alarm fatigue. | PSNet
     psnet.ahrq.gov/issue/effective-approaches-control-non-actionable-alarms-and-alarm-fatigue
     January 15, 2025 - July 10, 2017 Medication errors associated with code situations in U.S. hospitals: direct

352. EMS Patient Safety in the Field | PSNet
     psnet.ahrq.gov/perspective/ems-patient-safety-field
     July 28, 2021 - the patient, if necessary. 1 EMS personnel often have to work in very challenging, time-sensitive situations … To assist EMS personnel in decision making in high-pressure situations and to support standardized care … A medical director who participates actively in training, who knows the situations that the EMS personnel … The hospital may not the right place for individuals who have needs in those situations. … There are always unexpected situations and circumstances that quality measures are not designed to take

353. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/44260/psn-pdf
     November 06, 2015 - Innovative teaching in situational awareness. November 6, 2015 Gregory A, Hogg G, Ker J. Innovative teaching in situational awareness. Clin Teach. 2015;12(5):331-5. doi:10.1111/tct.12310. https://psnet.ahrq.gov/issue/innovative-teaching-situational-awareness Nontechnical skills contribute to successful teamwork an…

354. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/42878/psn-pdf
     January 29, 2014 - A qualitative study examining the influences on situation awareness and the identification, mitigation and escalation of recognised patient risk. January 29, 2014 Brady PW, Goldenhar LM. A qualitative study examining the influences on situation awareness and the identification, mitigation and escalation of recogni…

355. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/46458/psn-pdf
     May 30, 2018 - Development of the Huddle Observation Tool for structured case management discussions to improve situation awareness on inpatient clinical wards. May 30, 2018 Edbrooke-Childs J, Hayes J, Sharples E, et al. Development of the Huddle Observation Tool for structured case management discussions to improve situation aw…

356. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/44858/psn-pdf
     February 10, 2016 - Situation awareness errors in anesthesia and critical care in 200 cases of a critical incident reporting system. February 10, 2016 Schulz CM, Krautheim V, Hackemann A, et al. Situation awareness errors in anesthesia and critical care in 200 cases of a critical incident reporting system. BMC Anesthesiol. 2016;16:4. …

357. A culture of safety in EMS systems. | PSNet
     psnet.ahrq.gov/issue/culture-safety-ems-systems-0
     February 18, 2011 - Emergency medical services (EMS) are often provided in stressful situations that require an orientation

358. Rework and workarounds in nurse medication administration process: implications for work processes and patient safety. | PSNet
     psnet.ahrq.gov/issue/rework-and-workarounds-nurse-medication-administration-process-implications-work-processes
     July 31, 2008 - to efficient medication administration and investigate the workarounds that nurses used in these situations

359. Impact of critical event checklists on anaesthetist performance in simulated operating theatre emergencies. | PSNet
     psnet.ahrq.gov/issue/impact-critical-event-checklists-anaesthetist-performance-simulated-operating-theatre
     August 16, 2017 - The authors recommend use of these checklists to enhance performance in rare critical situations.

360. Self-reported violations during medication administration in two paediatric hospitals. | PSNet
     psnet.ahrq.gov/issue/self-reported-violations-during-medication-administration-two-paediatric-hospitals
     December 01, 2010 - nurses reported frequently violating medication administration policies, especially in emergency situations