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Total Results: 4,259 records

Showing results for "wrong".

101. Application of human error theory in case analysis of wrong procedures. | PSNet
     psnet.ahrq.gov/issue/application-human-error-theory-case-analysis-wrong-procedures
     November 14, 2018 - Application of Human Error Theory in Case Analysis of Wrong Procedures. … Application of Human Error Theory in Case Analysis of Wrong Procedures. … March 29, 2023 Insurance claims for wrong-side, wrong-organ, wrong-procedure, or … February 8, 2023 Wrong Site Surgery - Wrong Patient: Invasive Procedures in Outpatient … Site, Wrong Procedure and Wrong Person Surgery.

102. Evaluating serial strategies for preventing wrong-patient orders in the NICU. | PSNet
     psnet.ahrq.gov/issue/evaluating-serial-strategies-preventing-wrong-patient-orders-nicu
     November 03, 2015 - Study Evaluating serial strategies for preventing wrong-patient orders in the NICU … Evaluating Serial Strategies for Preventing Wrong-Patient Orders in the NICU. … Wrong-patient errors are a well-established risk in the health care setting. … Evaluating Serial Strategies for Preventing Wrong-Patient Orders in the NICU. … November 30, 2022 Wrong-patient orders in obstetrics.

103. Association of display of patient photographs in the electronic health record with wrong-patient order entry errors. | PSNet
     psnet.ahrq.gov/issue/association-display-patient-photographs-electronic-health-record-wrong-patient-order-entry
     May 29, 2019 - Association of display of patient photographs in the electronic health record with wrong-patient … Association of display of patient photographs in the electronic health record with wrong-patient order … The authors suggest this may be a simple and cost-effective strategy for reducing wrong-patient errors … Association of display of patient photographs in the electronic health record with wrong-patient order … May 30, 2018 Intercepting wrong-patient orders in a computerized provider order entry

104. Serious hazards of transfusion: evaluating the dangers of a wrong patient autologous salvaged blood in cardiac surgery. | PSNet
     psnet.ahrq.gov/issue/serious-hazards-transfusion-evaluating-dangers-wrong-patient-autologous-salvaged-blood
     May 11, 2022 - Commentary Serious hazards of transfusion: evaluating the dangers of a wrong patient … Serious hazards of transfusion: evaluating the dangers of a wrong patient autologous salvaged blood in … Wrong-patient transfusion errors can lead to serious patient harm. … Serious hazards of transfusion: evaluating the dangers of a wrong patient autologous salvaged blood in … March 2, 2022 Wrong-patient blood transfusion error: leveraging technology to overcome

105. A multiobserver study of the effects of including point-of-care patient photographs with portable radiography: a means to detect wrong-patient errors. | PSNet
     psnet.ahrq.gov/issue/multiobserver-study-effects-including-point-care-patient-photographs-portable-radiography
     March 04, 2015 - effects of including point-of-care patient photographs with portable radiography: a means to detect wrong-patient … March 4, 2015 Improvement in detection of wrong-patient errors when radiologists include … July 29, 2020 Evaluation of near-miss wrong-patient events in radiology reports. … November 20, 2015 Evaluation of near-miss wrong-patient events in radiology reports. … March 4, 2015 Wrong-patient, wrong-site procedures persist despite safety protocol.

106. Frequency and clinical importance of pages sent to the wrong physician. | PSNet
     psnet.ahrq.gov/issue/frequency-and-clinical-importance-pages-sent-wrong-physician
     October 31, 2011 - Study Frequency and clinical importance of pages sent to the wrong physician. … Frequency and clinical importance of pages sent to the wrong physician. … This study discovered that 14% of text pages were sent to the wrong physician, with nearly 50% of them … Frequency and clinical importance of pages sent to the wrong physician. … 2011 Getting the message: a quality improvement initiative to reduce pages sent to the wrong

107. Risk of wrong-patient orders among multiple vs singleton births in the neonatal intensive care units of 2 integrated health care systems. | PSNet
     psnet.ahrq.gov/issue/risk-wrong-patient-orders-among-multiple-vs-singleton-births-neonatal-intensive-care-units-2
     December 21, 2017 - Study Risk of wrong-patient orders among multiple vs singleton births in the neonatal … Risk of Wrong-Patient Orders Among Multiple vs Singleton Births in the Neonatal Intensive Care Units … The rate of wrong-patient errors was significantly higher among multiple-birth infants, most of which … Risk of Wrong-Patient Orders Among Multiple vs Singleton Births in the Neonatal Intensive Care Units … January 17, 2024 Wrong-patient orders in obstetrics.

108. Wrong-side thoracentesis: lessons learned from root cause analysis. | PSNet
     psnet.ahrq.gov/issue/wrong-side-thoracentesis-lessons-learned-root-cause-analysis
     July 16, 2015 - Study Wrong-side thoracentesis: lessons learned from root cause analysis. … Wrong-side thoracentesis: lessons learned from root cause analysis. … Wrong-side thoracentesis: lessons learned from root cause analysis. … May 6, 2015 Wrong-site and wrong-patient procedures in the Universal Protocol era: analysis … September 15, 2010 Wrong site surgery near misses and actual occurrences.

109. Neuromuscular blocking agents: reducing associated wrong-drug errors. | PSNet
     psnet.ahrq.gov/issue/neuromuscular-blocking-agents-reducing-associated-wrong-drug-errors
     April 26, 2023 - Newspaper/Magazine Article Neuromuscular blocking agents: reducing associated wrong-drug

110. Understanding and preventing wrong-patient electronic orders: a randomized controlled trial. | PSNet
     psnet.ahrq.gov/issue/understanding-and-preventing-wrong-patient-electronic-orders-randomized-controlled-trial
     December 21, 2017 - Study Understanding and preventing wrong-patient electronic orders: a randomized … Understanding and preventing wrong-patient electronic orders: a randomized controlled trial. … Patient misidentification errors —such as laboratory results or notes being entered into the wrong … Understanding and preventing wrong-patient electronic orders: a randomized controlled trial. … January 7, 2015 Indication-based prescribing prevents wrong-patient medication errors

111. Verification Screen That Includes Prominent Patient Photograph Significantly Reduces Errors Caused by Orders Placed in Wrong Chart | PSNet
     psnet.ahrq.gov/innovation/verification-screen-includes-prominent-patient-photograph-significantly-reduces-errors
     October 30, 2024 - That Includes Prominent Patient Photograph Significantly Reduces Errors Caused by Orders Placed in Wrong … receiving or nearly receiving care intended for someone else due to an order being entered into the wrong … care due to patient misidentification resulted from a medication or test order being placed in the wrong … Physicians may inadvertently open the wrong chart by clicking on the incorrect name in a long, electronic … November 8, 2023 Adding automation and independent dual verification to reduce wrong

112. Health information technology-related wrong-patient errors: context is critical. | PSNet
     psnet.ahrq.gov/issue/health-information-technology-related-wrong-patient-errors-context-critical
     June 01, 2022 - Study Health information technology-related wrong-patient errors: context is critical … Citation Text: Health information technology-related wrong-patient errors: context is critical. … This study analyzed the processes of care involved in 1,189 wrong-patient events.  … reached the patient, most commonly involving inappropriate medication administration or receiving the wrong … The authors recommend several strategies for reducing wrong-patient errors. 

113. Never Events | PSNet
     psnet.ahrq.gov/primer/never-events
     June 15, 2024 - site Surgery or other invasive procedure performed on the wrong patient Wrong surgical or other invasive … drug, wrong dose, wrong patient, wrong time, wrong rate, wrong preparation, or wrong route of administration … Since February 2009, CMS has not paid for any costs associated with  wrong-site surgeries . … , Wrong-Procedure, and Wrong-Patient Surgery December 15, 2024 Editor's Picks Sentinel … , Wrong-Procedure, and Wrong-Patient Surgery December 15, 2024 Identifying

114. Effect of restriction of the number of concurrently open records in an electronic health record on wrong-patient order errors: a randomized clinical trial. | PSNet
     psnet.ahrq.gov/issue/effect-restriction-number-concurrently-open-records-electronic-health-record-wrong-patient
     July 09, 2018 - Effect of restriction of the number of concurrently open records in an electronic health record on wrong-patient … Effect of Restriction of the Number of Concurrently Open Records in an Electronic Health Record on Wrong-Patient … September 4, 2019 Evaluating serial strategies for preventing wrong-patient orders in … June 2, 2019 Wrong-patient blood transfusion error: leveraging technology to overcome … September 1, 2016 Intercepting wrong-patient orders in a computerized provider order

115. Adding automation and independent dual verification to reduce wrong blood in tube (WBIT) events. | PSNet
     psnet.ahrq.gov/issue/adding-automation-and-independent-dual-verification-reduce-wrong-blood-tube-wbit-events
     October 21, 2020 - Study Adding automation and independent dual verification to reduce wrong blood in … Adding automation and independent dual verification to reduce wrong blood in tube (WBIT) events. … Wrong blood in tube (WBIT) errors are rare but can lead to complications . … Adding automation and independent dual verification to reduce wrong blood in tube (WBIT) events. … June 2, 2019 Wrong-patient blood transfusion error: leveraging technology to overcome

116. Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. | PSNet
     psnet.ahrq.gov/issue/wrong-site-nerve-blocks-10-yr-experience-large-multihospital-health-care-system
     January 14, 2011 - Study Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care … Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. … Wrong-surgery errors continue to occur despite their status as never events . … Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. … , Wrong-Procedure, and Wrong-Patient Surgery December 15, 2024 Grading recommendations

117. Evaluation of near-miss wrong-patient events in radiology reports. | PSNet
     psnet.ahrq.gov/issue/evaluation-near-miss-wrong-patient-events-radiology-reports
     June 13, 2015 - Study Evaluation of near-miss wrong-patient events in radiology reports. … JOURNAL CLUB: Evaluation of Near-Miss Wrong-Patient Events in Radiology Reports. … This retrospective case review study determined the prevalence of reported near-miss wrong-patient … JOURNAL CLUB: Evaluation of Near-Miss Wrong-Patient Events in Radiology Reports. … September 24, 2016 Improvement in detection of wrong-patient errors when radiologists

118. Preventing wrong-site surgery in Minnesota: a 5-year journey. | PSNet
     psnet.ahrq.gov/issue/preventing-wrong-site-surgery-minnesota-5-year-journey
     December 19, 2007 - Newspaper/Magazine Article Preventing wrong-site surgery in Minnesota: a 5-year journey … Citation Text: Preventing wrong-site surgery in Minnesota: a 5-year journey. … April 1, 2020 Hospitals collaborate to prevent wrong-site surgery. … August 18, 2010 Wrong-site sinus surgery in otolaryngology. … August 11, 2010 Avoiding wrong site surgery: a systematic review.

119. When Things Go Wrong: Responding to Adverse Events. | PSNet
     psnet.ahrq.gov/issue/when-things-go-wrong-responding-adverse-events
     November 19, 2014 - Book/Report Classic When Things Go Wrong: Responding to … Citation Text: When Things Go Wrong: Responding to Adverse Events. … Copy URL Cite Citation Citation Text: When Things Go Wrong

120. Wrong-site surgery, retained surgical items, and surgical fires: a systematic review of surgical never events. | PSNet
     psnet.ahrq.gov/issue/wrong-site-surgery-retained-surgical-items-and-surgical-fires-systematic-review-surgical
     March 13, 2013 - Review Wrong-site surgery, retained surgical items, and surgical fires: a systematic … Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires : A Systematic Review of Surgical Never … Incidence estimates for retained surgical items and wrong-site surgery varied across studies, with … April 7, 2021 Concept analysis: wrong-site surgery. … site, wrong procedure, and wrong patient operations.