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Showing results for "aware".

  1. psnet.ahrq.gov/perspective/conversation-christine-cassel-md
    February 26, 2025 - In Conversation With… Christine Cassel, MD June 1, 2015  Citation Text: In Conversation With… Christine Cassel, MD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015. Copy Citation For…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33654/psn-pdf
    August 01, 2007 - In Conversation with...James L. Reinertsen, MD August 1, 2007 In Conversation with..James L. Reinertsen, MD. PSNet [internet]. 2007. https://psnet.ahrq.gov/perspective/conversation-withjames-l-reinertsen-md Editor's Note: James L. Reinertsen, MD, heads the Reinertsen Group, a prominent health care consulting firm …
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49606/psn-pdf
    August 01, 2010 - Weighing In on Surgical Safety August 1, 2010 Brodsky JB, Margarson M. Weighing In on Surgical Safety. PSNet [internet]. 2010. https://psnet.ahrq.gov/web-mm/weighing-surgical-safety Case Objectives Identify the comorbidites associated with obesity that place patients at higher risk for surgical complications. Un…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49857/psn-pdf
    March 01, 2019 - Duplicate Insulin Order March 1, 2019 Acquisto NM, Cobaugh DJ. Duplicate Insulin Order. PSNet [internet]. 2019. https://psnet.ahrq.gov/web-mm/duplicate-insulin-order The Case A 45-year-old man with a history of insulin-dependent diabetes mellitus was seen in the emergency department (ED) for complaints of letharg…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867475/psn-pdf
    February 26, 2025 - From Pain Relief to Risk: A Case of Suspected Opioid Overdose in a Pediatric Patient February 26, 2025 Markham K, Usui M, Smith C. From Pain Relief to Risk: A Case of Suspected Opioid Overdose in a Pediatric Patient. PSNet [internet]. 2025. https://psnet.ahrq.gov/web-mm/pain-relief-risk-case-suspected-opioid-overd…
  6. psnet.ahrq.gov/web-mm/emergency-error
    January 18, 2013 - SPOTLIGHT CASE Emergency Error Citation Text: Symons NRA. Emergency Error. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2013. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote…
  7. psnet.ahrq.gov/web-mm/pain-relief-risk-case-suspected-opioid-overdose-pediatric-patient
    October 04, 2023 - From Pain Relief to Risk: A Case of Suspected Opioid Overdose in a Pediatric Patient Citation Text: Markham K, Usui M, Smith C. From Pain Relief to Risk: A Case of Suspected Opioid Overdose in a Pediatric Patient. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of…
  8. psnet.ahrq.gov/perspective/impact-system-failures-healthcare-workers
    August 30, 2023 - Annual Perspective Impact of System Failures on Healthcare Workers George Zangaro, PhD, RN, FAAN, Cindy Manaoat Van, MHSA, Sarah Mossburg, RN, PhD | March 21, 2023  View more articles from the same authors. Citation Text: Zangaro G, Van CM, Mossburg S. Imp…
  9. psnet.ahrq.gov/web-mm/weight-and-height-juxtaposition-electronic-medical-record-causing-accidental-medication
    March 15, 2023 - Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose Citation Text: Jain NP, Dakwa D. Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose. PSNet [internet]. Rockville (MD): Agency for Healthcare Rese…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/852808/psn-pdf
    August 30, 2023 - Prolonged DKA in Pregnancy: A Case of Communication Breakdown. August 30, 2023 Marshall S, Boe NM. Prolonged DKA in Pregnancy: A Case of Communication Breakdown. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/prolonged-dka-pregnancy-case-communication-breakdown Disclosure of Relevant Financial Relationship…
  11. Spotlight (pdf file)

    psnet.ahrq.gov/sites/default/files/2023-08/spotlight_case_prolonged_dka_in_pregnancy_-_slides_-_revised.pdf
    January 01, 2023 - Spotlight Spotlight Prolonged DKA in Pregnancy: A Case of Communication Breakdown Source and Credits • This presentation is based on the August 2023 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahrq.gov/webmm o CME credit is available o Commentary by: Sarah Marshall, MD and Nina M. …
  12. psnet.ahrq.gov/curated-library/diagnostic-error
    August 10, 2025 - Breadcrumb Home The PSNet Collection Curated Libraries Subscribed Diagnostic Error  Download  Share Facebook Twitter Linkedin Copy URL Subscribe Created By: Karen Cosby, AHRQ Date Created: May 8, …
  13. psnet.ahrq.gov/issue/cognitive-forcing-tool-mitigate-cognitive-bias-randomised-control-trial
    November 07, 2018 - Study A cognitive forcing tool to mitigate cognitive bias—a randomised control trial. Citation Text: O'Sullivan ED, Schofield SJ. A cognitive forcing tool to mitigate cognitive bias - a randomised control trial. BMC Med Educ. 2019;19(1):12. doi:10.1186/s12909-018-1444-3. Copy Citation …
  14. psnet.ahrq.gov/issue/responding-large-scale-testing-errors
    December 18, 2008 - Commentary Responding to large-scale testing errors. Citation Text: Valenstein PN, Alpern GA, Keren DF. Responding to Large-Scale Testing Errors: Table 1. Am J Clin Pathol. 2010;133(3). doi:10.1309/ajcpxlze0yynid0x. Copy Citation Format: DOI Google Scholar BibTeX EndNote …
  15. psnet.ahrq.gov/issue/latency-ecg-displays-hospital-telemetry-systems-science-advisory-american-heart-association
    March 14, 2018 - Commentary Latency of ECG displays of hospital telemetry systems: a science advisory from the American Heart Association. Citation Text: Turakhia MP, Estes NAM, Drew BJ, et al. Latency of ECG displays of hospital telemetry systems: a science advisory from the American Heart Association.…
  16. psnet.ahrq.gov/issue/preventing-medication-errors-community-pharmacy-root-cause-analysis-transcription-errors
    March 24, 2011 - Study Preventing medication errors in community pharmacy: root-cause analysis of transcription errors. Citation Text: Knudsen P, Herborg H, Mortensen AR, et al. Preventing medication errors in community pharmacy: root-cause analysis of transcription errors. Qual Saf Health Care. 2007;1…
  17. psnet.ahrq.gov/issue/development-rating-system-surgeons-non-technical-skills
    June 12, 2008 - Study Development of a rating system for surgeons' non-technical skills. Citation Text: Yule S, Flin R, Paterson-Brown S, et al. Development of a rating system for surgeons' non-technical skills. Med Educ. 2006;40(11):1098-104. Copy Citation Format: Google Scholar PubMed …
  18. psnet.ahrq.gov/issue/going-solid-model-system-dynamics-and-consequences-patient-safety
    August 01, 2018 - Commentary Classic "Going solid": a model of system dynamics and consequences for patient safety. Citation Text: Cook R, Rasmussen J. "Going solid": a model of system dynamics and consequences for patient safety. Qual Saf Health Care. 2005;14(2):130-4. Copy …
  19. psnet.ahrq.gov/issue/excuse-me-teaching-interns-speak
    January 18, 2013 - Study "Excuse me": teaching interns to speak up. Citation Text: O'Connor P, Byrne D, O'Dea A, et al. "Excuse me:" teaching interns to speak up. Jt Comm J Qual Patient Saf. 2013;39(9):426-431. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML En…
  20. psnet.ahrq.gov/issue/managing-clinical-failure-complex-adaptive-system-perspective
    August 13, 2014 - Study Managing clinical failure: a complex adaptive system perspective. Citation Text: Matthews JI, Thomas PT. Managing clinical failure: a complex adaptive system perspective. Int J Health Care Qual Assur. 2007;20(3):184-194. doi:10.1108/09526860710743336. Copy Citation Format: …

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