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psnet.ahrq.gov/web-mm/check-twice-transport-once
March 15, 2023 - This Universal Protocol involves confirmation of the correct patient, correct procedure, and correct surgical … The final safety check is performed during the pre-incision surgical time out which requires all staff
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psnet.ahrq.gov/web-mm/spinal-epidural-abscess
November 13, 2019 - signs and symptoms through clinical judgment and vigilance can lead to prompt diagnosis, allowing rapid surgical … Prompt treatment, generally in the form of surgical evacuation, before the onset of severe neurological
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psnet.ahrq.gov/web-mm/coming-undone-failure-closure-device
April 01, 2006 - man—who underwent coronary angiography and had a major complication that required an unplanned vascular surgical … larger pseudoaneurysms will usually be treated with ultrasound-guided occlusion, thrombin injection, surgical
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psnet.ahrq.gov/web-mm/discharge-fumbles
September 09, 2009 - a discharge planning and home follow-up intervention on elders hospitalized with common medical and surgical … Validation of new ICD-10-based patient safety indicators for identification of in-hospital complications in surgical
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psnet.ahrq.gov/web-mm/perils-contrast-media
March 01, 2007 - Unless there is significant patient frailty and/or comorbidities that precluded surgical intervention … It remains widely accepted among surgical specialists that making a prompt diagnosis of a potential life-threatening
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psnet.ahrq.gov/node/49485/psn-pdf
August 29, 2024 - appreciated by many clinicians, POVL may occur in relatively healthy patients, even when
the hemodynamic and surgical … course appeared to be uneventful.(1) Although the incidence may be as low
as 1 in 61,000 non-ocular surgical
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psnet.ahrq.gov/node/49543/psn-pdf
September 01, 2007 - For
example, the Figure illustrates a sample medication reconciliation process for surgical patients … cross-functional flow chart, defining the responsibilities for medication reconciliation for
elective surgical
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psnet.ahrq.gov/node/61078/psn-pdf
October 28, 2020 - Insulin needs
can change rapidly with illness, stress, new medications, diet changes, and surgical procedures … Contraindications to insulin pump therapy – including critical illness, prolonged
surgical procedures
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psnet.ahrq.gov/sites/default/files/2020-12/final_dec_spotlight_code_status_vs_care_status.pdf
January 01, 2020 - palliative care team had left for the day,
the patient was transferred out of the ICU to the medical/surgical … patients,
a patient’s perceived lack of needs may make them a lower priority
— Had bedside medical/surgical
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psnet.ahrq.gov/web-mm/root-cause-analysis-gone-wrong
August 28, 2024 - The surgical team was preparing to close the incision when the clinicians noticed blood in the surgical
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psnet.ahrq.gov/node/49408/psn-pdf
July 01, 2003 - The case was reported to AHRQ WebM&M by this circulating
nurse, who noted, “I went to the surgical day … I had to take the patient off the OR table
and return her to the surgical day care unit.”
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psnet.ahrq.gov/web-mm/failure-rescue-mother
September 23, 2020 - period is uncommon, which should have raised suspicion that this might be a particularly complicated surgical … patients with placenta accreta spectrum disorder should be cared for in tertiary care centers with skilled surgical
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psnet.ahrq.gov/node/49798/psn-pdf
July 01, 2017 - gastroesophageal reflux disease, refractory to
medical management, was admitted to the hospital for surgical … patients with small perforations and absence of peritonitis.(14,15) However, some patients may
require surgical
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psnet.ahrq.gov/web-mm/when-indications-drug-administration-blur
May 26, 2021 - focused on patients in the intensive care and step-down units and do not round regularly on the medical-surgical … Sleep hygiene Protocol to Improve Sleep and Delirium In a Surgical Intensive Care Unit.
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psnet.ahrq.gov/web-mm/production-pressures
November 16, 2022 - the application of industrial and systems engineering tools to workload management in the context of surgical … Variability in surgical caseload and access to intensive care services.
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psnet.ahrq.gov/node/33875/psn-pdf
March 01, 2019 - Some of the surgical chiefs were concerned
about taking on these hospitals with these surgeons and ways … it's totally different to say we're going to send you to this rural hospital to help them
with their surgical
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psnet.ahrq.gov/node/49654/psn-pdf
June 01, 2012 - Early the next day, the patient was taken to the operating room for surgical repair of her hip fracture … The surgical
team proceeded, but the case was complicated by significant hemodynamic instability.
-
psnet.ahrq.gov/node/72811/psn-pdf
September 01, 2022 - The team included 33
emergency, anesthesiology, surgical, and critical care medical and nursing staff … The review encompassed emergency medical, radiological,
anesthesiology, surgical, and nursing texts.
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psnet.ahrq.gov/web-mm/thin-air
March 01, 2006 - The recently standardized "timeout" required by JCAHO and the VA before surgical incision is a procedural … surgery cannot proceed unless all team members have re-verified the patient's identity, the proposed surgical
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psnet.ahrq.gov/web-mm/discharged-iv-antibiotics-when-issues-arise-who-manages-complications
October 10, 2017 - The surgical team also ordered weekly blood counts, metabolic panel, and Vancomycin trough levels. … 2018
Association of coworker reports about unprofessional behavior by surgeons with surgical