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421. Adverse drug events among hospitalized Medicare patients: epidemiology and national estimates from a new approach to surveillance. | PSNet
     psnet.ahrq.gov/issue/adverse-drug-events-among-hospitalized-medicare-patients-epidemiology-and-national-estimates
     April 05, 2016 - Study Adverse drug events among hospitalized Medicare patients: epidemiology and national estimates from a new approach to surveillance. Citation Text: Classen D, Jaser L, Budnitz DS. Adverse drug events among hospitalized Medicare patients: epidemiology and national estimates from a new…

422. Families as partners in hospital error and adverse event surveillance. | PSNet
     psnet.ahrq.gov/issue/families-partners-hospital-error-and-adverse-event-surveillance
     December 19, 2018 - Study Classic Families as partners in hospital error and adverse event surveillance. Citation Text: Khan A, Coffey M, Litterer KP, et al. Families as Partners in Hospital Error and Adverse Event Surveillance. JAMA Pediatr. 2017;171(4):372-381. doi:10.1001/jamape…

423. Multicomponent pharmacist intervention did not reduce clinically important medication errors for ambulatory patients initiating direct oral anticoagulants. | PSNet
     psnet.ahrq.gov/issue/multicomponent-pharmacist-intervention-did-not-reduce-clinically-important-medication-errors
     March 17, 2021 - Study Multicomponent pharmacist intervention did not reduce clinically important medication errors for ambulatory patients initiating direct oral anticoagulants. Citation Text: Kapoor A, Patel P, Mbusa D, et al. Multicomponent pharmacist intervention did not reduce clinically important m…

424. Individual characteristics that promote or prevent psychological safety and error reporting in healthcare: a systematic review. | PSNet
     psnet.ahrq.gov/issue/individual-characteristics-promote-or-prevent-psychological-safety-and-error-reporting
     September 14, 2022 - Review Individual characteristics that promote or prevent psychological safety and error reporting in healthcare: a systematic review. Citation Text: Wawersik DM, Boutin ER, Gore T, et al. Individual characteristics that promote or prevent psychological safety and error reporting in heal…

425. Creating highly reliable health care: how reliability-enhancing work practices affect patient safety in hospitals. | PSNet
     psnet.ahrq.gov/issue/creating-highly-reliable-health-care-how-reliability-enhancing-work-practices-affect-patient
     January 12, 2022 - Study Creating highly reliable health care: how reliability-enhancing work practices affect patient safety in hospitals. Citation Text: Vogus TJ, Iacobucci D. Creating Highly Reliable Health Care. ILR Review. 2016;69(4). doi:10.1177/0019793916642759. Copy Citation Format: D…

426. High-alert medications in the pediatric intensive care unit. | PSNet
     psnet.ahrq.gov/issue/high-alert-medications-pediatric-intensive-care-unit
     December 16, 2015 - Study High-alert medications in the pediatric intensive care unit. Citation Text: Franke HA, Woods D, Holl JL. High-alert medications in the pediatric intensive care unit. Pediatr Crit Care Med. 2009;10(1):85-90. doi:10.1097/PCC.0b013e3181936ff8. Copy Citation Format: DOI…

427. Association of pharmaceutical industry marketing of opioid products with mortality from opioid-related overdoses. | PSNet
     psnet.ahrq.gov/issue/association-pharmaceutical-industry-marketing-opioid-products-mortality-opioid-related
     November 17, 2021 - Study Classic Association of pharmaceutical industry marketing of opioid products with mortality from opioid-related overdoses. Citation Text: Hadland SE, Rivera-Aguirre A, Marshall BDL, et al. Association of Pharmaceutical Industry Marketing of Opioid Products …

428. Enhancing patient safety during pediatric sedation: the impact of simulation-based training of nonanesthesiologists. | PSNet
     psnet.ahrq.gov/issue/enhancing-patient-safety-during-pediatric-sedation-impact-simulation-based-training
     January 17, 2012 - Study Enhancing patient safety during pediatric sedation: the impact of simulation-based training of nonanesthesiologists. Citation Text: Shavit I, Keidan I, Hoffmann Y, et al. Enhancing patient safety during pediatric sedation: the impact of simulation-based training of nonanesthesiol…

429. Spotlight Case July 2008 (ppt file)
     psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.293_slideshow.ppt
     March 01, 2013 - Spotlight Case July 2008 Spotlight Case A Weighty Mistake * * Source and Credits This presentation is based on the March 2013 AHRQ WebM&M Spotlight Case See the full article at http://webmm.ahrq.gov CME credit is available Commentary by: Seth J. Bokser, MD, MPH, Associate Professor of Pediatrics & Medical…

430. Improving situation awareness to reduce unrecognized clinical deterioration and serious safety events. | PSNet
     psnet.ahrq.gov/issue/improving-situation-awareness-reduce-unrecognized-clinical-deterioration-and-serious-safety
     December 02, 2014 - Study Improving situation awareness to reduce unrecognized clinical deterioration and serious safety events. Citation Text: Brady PW, Muething S, Kotagal U, et al. Improving situation awareness to reduce unrecognized clinical deterioration and serious safety events. Pediatrics. 2013;131(…

431. Organizational, cultural, and psychological determinants of smart infusion pump work arounds: a study of 3 U.S. health systems. | PSNet
     psnet.ahrq.gov/issue/organizational-cultural-and-psychological-determinants-smart-infusion-pump-work-arounds-study
     May 18, 2022 - Study Organizational, cultural, and psychological determinants of smart infusion pump work arounds: a study of 3 U.S. health systems. Citation Text: Dunford BB, Perrigino M, Tucker SJ, et al. Organizational, Cultural, and Psychological Determinants of Smart Infusion Pump Work Arounds: A …

432. Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated infections in neonatal intensive care units. | PSNet
     psnet.ahrq.gov/issue/effect-antiseptic-handwashing-vs-alcohol-sanitizer-health-care-associated-infections-neonatal
     July 30, 2014 - Study Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated infections in neonatal intensive care units. Citation Text: Larson EL, Cimiotti JP, Haas JP, et al. Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated infections in neonat…

433. The prisoner. | PSNet
     psnet.ahrq.gov/issue/prisoner
     March 29, 2023 - Newspaper/Magazine Article The prisoner. Citation Text: The prisoner. Kent S. NJ.com. March 12, 2023. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL Mar…

434. Simulation-based assessment of the management of critical events by board-certified anesthesiologists. | PSNet
     psnet.ahrq.gov/issue/simulation-based-assessment-management-critical-events-board-certified-anesthesiologists
     February 19, 2010 - Study Simulation-based assessment of the management of critical events by board-certified anesthesiologists. Citation Text: Weinger MB, Banerjee A, Burden AR, et al. Simulation-based assessment of the management of critical events by board-certified anesthesiologists. Anesthesiology. 201…

435. Don’t Wait to Collect an Accurate Weight: A Case of Subtherapeutic Insulin Therapy | PSNet
     psnet.ahrq.gov/web-mm/dont-wait-collect-accurate-weight-case-subtherapeutic-insulin-therapy
     July 01, 2008 - Don’t Wait to Collect an Accurate Weight: A Case of Subtherapeutic Insulin Therapy Citation Text: Newton B, Seitz R. Don’t Wait to Collect an Accurate Weight: A Case of Subtherapeutic Insulin Therapy. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and H…

436. These patients had to lobby for correct diabetes diagnoses. Was their race a reason? | PSNet
     psnet.ahrq.gov/issue/these-patients-had-lobby-correct-diabetes-diagnoses-was-their-race-reason
     July 10, 2024 - Newspaper/Magazine Article These patients had to lobby for correct diabetes diagnoses. Was their race a reason? Citation Text: These patients had to lobby for correct diabetes diagnoses. Was their race a reason? Sable-Smith B. KFF Health News. January 9, 2024. Copy Citation …

437. Partnered pharmacist charting on admission in the general medical and emergency short-stay unit—a cluster-randomised controlled trial in patients with complex medication regimens. | PSNet
     psnet.ahrq.gov/issue/partnered-pharmacist-charting-admission-general-medical-and-emergency-short-stay-unit-cluster
     July 06, 2011 - Study Partnered pharmacist charting on admission in the general medical and emergency short-stay unit—a cluster-randomised controlled trial in patients with complex medication regimens. Citation Text: Tong EY, Roman C, Mitra B, et al. Partnered pharmacist charting on admission in the Gen…

438. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49400/psn-pdf
     May 01, 2003 - Central Line Clot May 1, 2003 Randolph AG. Central Line Clot. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/central-line-clot Case Objectives List the complications of central line manipulation Appreciate the limitations of diagnostic studies for PE in children Describe modalities for prevention of cathe…

439. Between a rock and a hard place: disclosing medical errors. | PSNet
     psnet.ahrq.gov/issue/between-rock-and-hard-place-disclosing-medical-errors
     October 19, 2022 - Commentary Between a rock and a hard place: disclosing medical errors. Citation Text: Crone KG, Muraski MB, Skeel JD, et al. Between a rock and a hard place: disclosing medical errors. Clin Chem. 2006;52(9):1809-14. Copy Citation Format: Google Scholar PubMed BibTeX EndNo…

440. Central Line Clot | PSNet
     psnet.ahrq.gov/web-mm/central-line-clot
     August 04, 2021 - SPOTLIGHT CASE Central Line Clot Citation Text: Randolph AG. Central Line Clot. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML En…