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Showing results for "wrong".

  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/851352/psn-pdf
    July 12, 2023 - The most frequent never events were wrong site or wrong patient surgery, wrong surgical procedure, and … identifying-list-healthcare-never-events-effect-system-change-systematic-review-and-narrative https://psnet.ahrq.gov/primer/never-events https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46436/psn-pdf
    May 30, 2018 - Effect of number of open charts on intercepted wrong- patient medication orders in an emergency department … Effect of number of open charts on intercepted wrong- patient medication orders in an emergency department … https://psnet.ahrq.gov/issue/effect-number-open-charts-intercepted-wrong-patient-medication-orders- … Researchers analyzed intercepted wrong-patient medication orders in an emergency department over a 6 … ://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44967/psn-pdf
    March 16, 2016 - Wrong site surgery: a critical incident analysis of a near miss. March 16, 2016 Tichanow S. … Wrong site surgery: A critical incident analysis of a near miss. … https://psnet.ahrq.gov/issue/wrong-site-surgery-critical-incident-analysis-near-miss Despite efforts … to prevent wrong-site surgeries, they continue to occur. … /primer/wrong-site-wrong-procedure-and-wrong-patient-surgery https://psnet.ahrq.gov/issue/using-near-misses-analysis-prevent-wrong-site-surgery

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60168/psn-pdf
    March 25, 2020 - Right Electrocardiogram, Wrong Patient March 25, 2020 Chen C, Venugopal S. … Right Electrocardiogram, Wrong Patient. PSNet [internet]. 2020. … All of the cases involved the nurse or EKG technician either entering the wrong medical record number … Documentation of a normal EKG in the wrong chart may have unintended consequences as well. … Oops, Sorry, Wrong Patient!

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44001/psn-pdf
    May 06, 2015 - Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. … Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. … https://psnet.ahrq.gov/issue/wrong-site-nerve-blocks-10-yr-experience-large-multihospital-health-care … - system Wrong-surgery errors continue to occur despite their status as never events. … https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery https://psnet.ahrq.gov

  6. Time Series | Digital Healthcare Research

    digital.ahrq.gov/research-method/time-series
    January 01, 2023 - and Wrong-Patient Errors With Indication Alerts in CPOE Systems - Final Report Citation Lambert … Preventing Wrong-Drug and Wrong-Patient Errors With Indication Alerts in CPOE Systems – Final Report. … Principal Investigator Lambert, Bruce Project Name Preventing Wrong-Drug and Wrong-Patient … Effect of number of open charts on intercepted wrong-patient medication orders in an emergency department … Principal Investigator Lambert, Bruce Project Name Preventing Wrong-Drug and Wrong-Patient

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45512/psn-pdf
    October 05, 2016 - When doctors get the wrong patient. October 5, 2016 Whitman E. Mod Healthc. September 25, 2016. … https://psnet.ahrq.gov/issue/when-doctors-get-wrong-patient Misidentification of patients can result … https://psnet.ahrq.gov/issue/when-doctors-get-wrong-patient https://psnet.ahrq.gov/issue/wrong-patient … https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery https://psnet.ahrq.gov … /issue/improvement-detection-wrong-patient-errors-when-radiologists-include-patient-photographs

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38892/psn-pdf
    August 26, 2009 - Wrong site surgery near misses and actual occurrences. … Wrong site surgery near misses and actual occurrences. … https://psnet.ahrq.gov/issue/wrong-site-surgery-near-misses-and-actual-occurrences This analysis of … wrong-site surgery cases and near misses reported to the Pennsylvania Patient Safety Authority found … /issue/incidence-patterns-and-prevention-wrong-site-surgery https://psnet.ahrq.gov/issue/universal-protocol-preventing-wrong-site-wrong-procedure-wrong-person-surgery

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41843/psn-pdf
    November 21, 2012 - sharing-lessons-learned-prevent-incorrect-surgery The Veterans Affairs (VA) system has published important studies on the incidence of wrong-site … , wrong- procedure, and wrong-patient surgery. … issue/incorrect-surgical-procedures-within-and-outside-operating-room https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery … https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46736/psn-pdf
    December 17, 2018 - https://psnet.ahrq.gov/issue/back-basics-universal-protocol Wrong-site, wrong-procedure, and wrong-patient … https://psnet.ahrq.gov/issue/back-basics-universal-protocol https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery … enhanced-time-out-improved-communication-process https://psnet.ahrq.gov/issue/universal-protocol-preventing-wrong-site-wrong-procedure-wrong-person-surgery

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43309/psn-pdf
    August 02, 2015 - Wrong-side thoracentesis: lessons learned from root cause analysis. … Wrong-side thoracentesis: lessons learned from root cause analysis. … https://psnet.ahrq.gov/issue/wrong-side-thoracentesis-lessons-learned-root-cause-analysis Wrong-site … This analysis of 14 cases of wrong-site thoracenteses, a procedure to remove fluid from around the lung … /primer/wrong-site-wrong-procedure-and-wrong-patient-surgery https://psnet.ahrq.gov/issue/incorrect-surgical-procedures-within-and-outside-operating-room

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44585/psn-pdf
    November 04, 2015 - Evaluation of near-miss wrong-patient events in radiology reports. … JOURNAL CLUB: Evaluation of Near-Miss Wrong-Patient Events in Radiology Reports. … https://psnet.ahrq.gov/issue/evaluation-near-miss-wrong-patient-events-radiology-reports Despite The … This retrospective case review study determined the prevalence of reported near-miss wrong-patient events … /issue/joint-commission-international-center-patient-safety https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery

  13. Patients use an internet technology to report when things go wrong. | PSNet

    psnet.ahrq.gov/issue/patients-use-internet-technology-report-when-things-go-wrong
    July 21, 2009 - Study Patients use an internet technology to report when things go wrong. … Patients use an internet technology to report when things go wrong. … Patients use an internet technology to report when things go wrong. … Cases Medication Reconciliation Pitfalls February 1, 2010 Wrong-side … /wrong-site, wrong-procedure, and wrong-patient adverse events: are they preventable?

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49448/psn-pdf
    June 01, 2004 - Wrong side, wrong site, or wrong patient surgery is no small problem. … In 2003, JCAHO published "The Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person … , wrong- patient, wrong-procedure surgery … Take-Home Points Of wrong side, wrong site, and wrong patient mistakes, 35% involve operating on the … Universal protocol for preventing wrong site, wrong procedure, wrong person surgery.

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46828/psn-pdf
    August 08, 2018 - implementation-colour-coded-universal-protocol-safety-initiative-guatemala The Universal Protocol is designed to prevent wrong … site, wrong procedure, and wrong person surgery. … implementation-colour-coded-universal-protocol-safety-initiative-guatemala https://psnet.ahrq.gov/issue/universal-protocol-preventing-wrong-site-wrong-procedure-wrong-person-surgery … https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery https://psnet.ahrq.gov

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46222/psn-pdf
    June 21, 2017 - enhanced-time-out-improved-communication-process The Universal Protocol requires hospitals to adopt time outs as a strategy to prevent wrong-site … enhanced-time-out-improved-communication-process https://psnet.ahrq.gov/issue/universal-protocol-preventing-wrong-site-wrong-procedure-wrong-person-surgery … https://psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery https://psnet.ahrq.gov … /issue/wrong-site-and-wrong-patient-procedures-universal-protocol-era-analysis-prospective-database https

  17. Confirmation bias: why psychiatrists stick to wrong preliminary diagnoses. | PSNet

    psnet.ahrq.gov/issue/confirmation-bias-why-psychiatrists-stick-wrong-preliminary-diagnoses
    June 13, 2011 - Study Confirmation bias: why psychiatrists stick to wrong preliminary diagnoses. … Confirmation bias: why psychiatrists stick to wrong preliminary diagnoses. … Confirmation bias: why psychiatrists stick to wrong preliminary diagnoses.

  18. 5 cataract surgeries, 5 people blinded: what went wrong? | PSNet

    psnet.ahrq.gov/issue/5-cataract-surgeries-5-people-blinded-what-went-wrong
    June 08, 2011 - Newspaper/Magazine Article 5 cataract surgeries, 5 people blinded: what went wrong … Citation Text: 5 cataract surgeries, 5 people blinded: what went wrong? Kowalczyk L. … Cite Citation Citation Text: 5 cataract surgeries, 5 people blinded: what went wrong

  19. When doing wrong feels so right: normalization of deviance. | PSNet

    psnet.ahrq.gov/issue/when-doing-wrong-feels-so-right-normalization-deviance
    September 03, 2011 - Review When doing wrong feels so right: normalization of deviance. … When Doing Wrong Feels So Right: Normalization of Deviance. … When Doing Wrong Feels So Right: Normalization of Deviance.

  20. Spotlight Case [MONTH] 2003 (ppt file)

    psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.33_slideshow.ppt
    October 01, 2003 - Spotlight Case [MONTH] 2003 Spotlight Case October 2003 Hemivulvectomy: Wrong Side Removed Source … site surgery Understand key components of the Universal Protocol for eliminating wrong site, wrong … Wrong Side Surgery: Scope of the Problem JCAHO: 114 wrong site surgeries from 1152 sentinel events ( … Incidence of wrong-site surgery among hand surgeons. … Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery. http://www.jcaho.org
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