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Patient safety event:ID:Pt:^Event:Nom:AHRQ
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Date form completed
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{mm/dd/yyyy}
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Age at time of event:Find:Pt:^Patient:Nom:AHRQ
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Ethnicity:Type:Pt:^Patient:Nom:AHRQ
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Race:Type:Pt:^Patient:Nom:AHRQ
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Dx ICD code
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Rescue intervention was attempted:Find:Pt:^Patient:Ord:AHRQ
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Documented rescue interventions:Type:Pt:^Patient:Nom:AHRQ
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Extent of harm to the patient:Find:Pt:^Patient:Nom:AHRQ
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Anticipated duration of harm to the patient:Find:Pt:^Patient:Ord:AHRQ
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Timing of harm assessment:Find:Pt:^Patient:Ord:AHRQ
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Increased length of stay due to incident:Find:Pt:^Patient:Ord:AHRQ
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Family or guardian was notified:Find:Pt:^Patient:Ord:AHRQ
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