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psnet.ahrq.gov/web-mm/getting-good-report-card-unintended-consequences-public-reporting-hospital-quality
October 01, 2004 - quality of care or patient outcomes. … where to seek care or direct patients. … First, the current immunization measures apply only to patients with pneumonia, so while this patient … For example, if a sufficient number of hospitals reported that patients on heparins experienced hematomas … Public reporting of surgical mortality: a survey of New York State cardiothoracic surgeons.
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psnet.ahrq.gov/web-mm/stable-airway-fatal-airway-occlusion-after-inadequate-post-tracheostomy-care
June 28, 2023 - to ventilate the patient. … In addition, although we do not know the race or ethnicity of this patient, it has been found that patients … Practice patterns, safety, and rationale for tracheostomy tube changes: a survey of otolaryngology training … to the UK National Patient Safety Agency. … December 3, 2008
Effect of a central call center on employee perceptions of safety culture
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psnet.ahrq.gov/web-mm/abdominal-pain-early-pregnancy
November 13, 2024 - Patients may actually present with right upper quadrant pain. … Institutions should develop an algorithm for optimal imaging of pregnant patients with an acute abdominal … Consultation with an obstetric specialist should be strongly considered in patients with abdominal pain … The National Hospital Ambulatory Medical Care Survey: 2011 Emergency Department Summary Tables. … ACOG Committee on Obstetric Practice.
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psnet.ahrq.gov/perspective/african-partnerships-patient-safety-lessons-learned
December 01, 2014 - Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients … The World Alliance on Patient Safety was the first global effort to put patient safety on the international … and our Patients for Patient Safety program . … Future of artificial intelligence applications in cancer care: a global cross-sectional survey … March 16, 2023
Failure to rescue as a patient safety indicator for neurosurgical patients
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psnet.ahrq.gov/web-mm/code-status-vs-care-status
September 30, 2020 - and so the team was going to focus its limited time and energy on patients who were “full code” which … If patients knew they would be treated differently with a DNR order on their charts, would they consent … Systemic Pressures on Patient Care
In this patient case, there are two systemic influences on patient … As hospital censuses increase and bedside staff take on more patients, a patient’s perceived lack of … July 21, 2017
Patients as teachers: a randomised controlled trial on the use of personal
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psnet.ahrq.gov/web-mm/urinary-retention-dilemma
March 01, 2013 - If this patient was unable to adequately empty his bladder, then he could have been placed on a regimen … Patients with indwelling catheters had higher bacteriuria than patients with intermittent catheterization … For the case at hand, the patient was placed on a medication (terazosin) that can take days to relax … The management of acute urinary retention in France: a cross-sectional survey in 2618 men with benign … International Consultation on Continence. 2nd ed.
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psnet.ahrq.gov/node/49447/psn-pdf
June 01, 2004 - The patient had seen her oncologist the week before admission, who
had erroneously written her dapsone … Fortunately for this patient, this mistake did not cause her
adverse long-term clinical consequences … Once the error was discovered, the patient was promptly started
on cimetidine 300 mg IV daily, and her … each shift.(3) A survey of community pharmacists confirms that they perceive
environment and workload … studies reflect how many times pharmacists may have stopped the interacting combination from reaching
patients
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psnet.ahrq.gov/web-mm/chemotherapy-extravasation
September 24, 2010 - The patient arrived for her first day of treatment. … The patient immediately began complaining of pain at the infusion site. … The nurse removed the IV catheter and placed an ice pack on the site. … Implanted ports ( Figure ) are usually placed under the skin on the chest wall. … 2018
Medication double-checking procedures in clinical practice: a cross-sectional survey
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psnet.ahrq.gov/node/49792/psn-pdf
May 01, 2017 - diagnostic errors.(3,11) Other methods of identifying or estimating
diagnostic errors include autopsies, surveys … the
available evidence, regardless of patient harm.(16) This definition helps identify, on a retrospective … National Hospital Ambulatory Medical Care Survey: 2013 Emergency
Department Summary Tables. … Effect of emergency department crowding on outcomes of admitted
patients. … Ebola US Patient Zero: lessons on misdiagnosis and effective use of
electronic health records.
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psnet.ahrq.gov/perspective/care-transitions
December 01, 2007 - On the receiving end, PCPs often first learn of the hospitalization when the patient calls in with a … In other words, 5 months after the coach had disengaged with the patient, these patients were still staying … A coach sits on his or her hands. … Joint Commission Accreditation Surveys. … May 19, 2021
Hospital ward adaptation during the COVID-19 pandemic: a national survey
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psnet.ahrq.gov/perspective/harm-reduction-strategies-improve-safety-people-who-use-substances
October 30, 2024 - References Highlights from the 2023 National Survey on Drug Use and Health. … [Free full text] Highlights from the 2020 National Survey on Drug Use and Health. … A qualitative exploration of client and provider perspectives. Harm Reduct J . 2024;21(1):92. … It’s also one extra step for patients, but if you're prescribing other meds and you know your patient … and Workforce Safety Culture in Healthcare
March 27, 2024
Perspective
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psnet.ahrq.gov/perspective/patient-and-family-roles-safety
June 14, 2023 - shows that partnering with families and patients results in better patient outcomes, especially on emotional … Patient and family engagement: a survey of US hospital practices. … Could you speak to the impact that family partnership has on patients and the health system? … Patient and family advisors should serve on the Patient Safety Committees. … They have wonderful resources available on their website that teach patients and families, and patient
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psnet.ahrq.gov/perspective/safety-considerations-building-point-care-ultrasound-program
June 01, 2018 - (POCUS)—ultrasound performed by the examining and treating clinician at the bedside.( 2 )
A 2001 survey … These patients can go to the OR. … If a patient comes in with a swollen right leg on a Friday afternoon and a vascular ultrasound lab is … To my knowledge, there have not been any recorded cases of patients injured from ultrasound. … Safety
Safety Culture in EMS
May 26, 2021
WebM
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psnet.ahrq.gov/perspective/suicide-prevention
March 24, 2025 - Health Questionnaire-9 (PHQ-9), which is a measure of depression that has an item that screens for thoughts … Key Substance Use and Mental Health Indicators in the United States: Results from the 2022 National Survey … There are other tools, like the Ask Suicide Questionnaire (ASQ), and then there is the Columbia Suicide … It is designed by the patient and provider together so that patients have, in their own words, things … Safety Culture in Healthcare
March 27, 2024
Perspective
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psnet.ahrq.gov/perspective/conversation-elizabeth-salisbury-afshar-about-harm-reduction-strategies-improve-safety
October 30, 2024 - It’s also one extra step for patients, but if you're prescribing other meds and you know your patient … References Highlights from the 2023 National Survey on Drug Use and Health. … [Free full text] Highlights from the 2020 National Survey on Drug Use and Health. … A qualitative exploration of client and provider perspectives. Harm Reduct J . 2024;21(1):92. … and Workforce Safety Culture in Healthcare
March 27, 2024
Perspective
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psnet.ahrq.gov/perspective/conversation-edwin-boudreaux-about-suicide-prevention
March 25, 2025 - There are other tools, like the Ask Suicide Questionnaire (ASQ), and then there is the Columbia Suicide … It is designed by the patient and provider together so that patients have, in their own words, things … Key Substance Use and Mental Health Indicators in the United States: Results from the 2022 National Survey … Safety planning: why it is essential on the day of discharge from in-patient psychiatric hospitalization … Safety Culture in Healthcare
March 27, 2024
Perspective
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psnet.ahrq.gov/web-mm/challenging-case-multiple-suicide-attempts-complex-patient-psychiatric-comorbidities
September 27, 2023 - The following month, the patient attempted to commit suicide by overdosing on her prescription antidepressants … A consulting psychiatrist evaluated the patient but recommended sending her home on a benzodiazepine … patient flow in the ED, appeals by family members) to discharge the patient despite high clinical acuity … associations among mental disorders and suicidal behavior: findings from the WHO World Mental Health Surveys … June 14, 2023
Patients who die by suicide: a study of treatment patterns and patient
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psnet.ahrq.gov/perspective/conversation-withwilliam-b-weeks-md-mba
May 01, 2009 - The study suggested that the providers might lose on certain patients, they might gain on others, and … Patient Safety: A Perspective from Office Practice
May 1, 2009
Perspective
Most patient … we and our patients experience, and we focus our attention on "real medicine." … National Ambulatory Medical Care Survey: 2002 summary. Adv Data. 2004;346:15. [go to PubMed]
9. … Patient Safety.
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psnet.ahrq.gov/perspective/conversation-withpatrick-tighe-about-artificial-intelligence
March 27, 2024 - Instead of monitoring once an hour or once every 15 minutes, we can monitor patients on a minute-to-minute … and the likelihoods of patient outcomes, and better monitoring of patients and clinical care in nontraditional … things that clinicians do for our patients on a minute-to-minute basis, that for many patients eclipses … A survey in 2020 by the American Academy of Radiology found that 30% of radiologists were currently using … Allen B, Agarwal S, Coombs L, Wald C, Dreyer K. 2020 ACR Data Science Institute Artificial Intelligence Survey
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psnet.ahrq.gov/node/49546/psn-pdf
October 17, 2007 - their questions.(6)
Systems-Based Practice: On-Duty and On-Call Systems
One defining aspect of medical … Physicians may take on more patient
responsibility than they can safely handle. … Emphasis on Professionalism in Medical Education
The Accreditation Council on Graduate Medical Education … These are more serious risks to quality patient care than failing to provide continuous care to
patients … operators, and
other team members; for example, the National Board of Medical Examiners is testing a survey