The patient safety domain

The PSI 90 is a patient safety/complication measure produced by the Agency for Healthcare Research and Quality (AHRQ). In 2017, it measured the patient safety and complication rates at hospitals using 10 measures:

  • PSI 03: Pressure Ulcer Rate: Pressure ulcers are skin lesions that form when the patient has been in a bed in the same position for too long. It is commonly used as a measure of hospital care quality/neglect.
  • PSI 06: Iatrogenic Pneumothorax Rate: A pneumothorax is a tear in the lung wall that causes air to fill up in the cavity surrounding the lung, preventing the patient from breathing properly. Some pneumothoraces are caused by hospital procedures and these are known as iatrogenic pneumothoraces.
  • PSI 08: In-Hospital Fall with Hip Fracture Rate: Falls are common in elderly patients in hospitals, especially following an operation or procedure. There are certain precautions that can be taken to prevent falls in such patients, and hospitals that fail to do so are often labeled as providing poor quality of care.
  • PSI 09: Perioperative Hemorrhage or Hematoma Rate: This measure gauges the amount of excessive bleeding that occurs when patients undergo procedures at the hospital.
  • PSI 10: Postoperative Acute Kidney Injury Rate: Following procedures or operations, patients are at risk for injury to their kidneys due to decreased blood flow or harmful contrast agents for x-rays.
  • PSI 11: Postoperative Respiratory Failure Rate: Following an operation, complications also include respiratory failure, which is a life-threatening condition that requires placing the patient on a ventilator under anesthesia and constant supervision in an intensive care unit (ICU). Respiratory failure incidents can be reduced by coaching patients to perform proper breathing exercises.
  • PSI 12: Perioperative Pulmonary Embolism (PE) or Deep Vein Thrombosis (DVT) Rate: DVT is a blood clot that forms in the veins of the lower leg muscles. Pulmonary embolism is when the clot travels via the bloodstream to the lung and is a life-threatening complication. Many DVTs can be prevented by administering heparin and other treatments during the hospital stay and encouraging the patient to be active.
  • PSI 13: Postoperative Sepsis Rate: This measure gauges how often patients that undergo operations at the hospital get infected after the operation. Sepsis is a life-threatening condition in which bacteria have colonized the bloodstream and are affecting organ function.
  • PSI 14: Postoperative Wound Dehiscence Rate: Wound dehiscence is the failure of the operative site to close or heal correctly following the surgery. It is a sign of poor surgical procedure and/or poor nutrition following the surgery.
  • PSI 15: Unrecognized Abdominopelvic Accidental Puncture/Laceration Rate: This measure gauges the frequency with which accidental punctures/lacerations occur during abdominal or pelvic surgery.
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