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  1. psnet.ahrq.gov/perspective/conversation-paul-mcgann-md
    July 10, 2024 - In Conversation With… Paul McGann, MD March 1, 2016  Citation Text: In Conversation With… Paul McGann, MD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016. Copy Citation Format: …
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49699/psn-pdf
    February 01, 2014 - Multifactorial Medication Mishap February 1, 2014 Yang A. Multifactorial Medication Mishap. PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/multifactorial-medication-mishap Case Objectives Understand the system-based causes of medication errors. Describe a model for a systems approach to error analysis. Id…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33608/psn-pdf
    February 01, 2024 - Maternal Safety January 31, 2024 Shauer M, Nichols A, Lyndon A. Maternal Safety. PSNet [internet]. 2024. https://psnet.ahrq.gov/primer/maternal-safety Originally published in 2018 by researchers at the University of California, San Francisco. Updated in February 2024 by Marla Shauer, PhD(c), MSN, CNM, Amy Nichols,…
  4. psnet.ahrq.gov/perspective/conversation-sharon-k-inouye-md-mph
    December 01, 2012 - In Conversation With… Sharon K. Inouye, MD, MPH December 1, 2012  Also Read an Essay Citation Text: In Conversation With… Sharon K. Inouye, MD, MPH. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Ser…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867805/psn-pdf
    February 26, 2025 - In Conversation with David W. Bates about Are We Safer Today? February 26, 2025 Bates DW, Lee M, Mossburg SE. In Conversation with David W. Bates about Are We Safer Today? PSNet [internet]. 2025. https://psnet.ahrq.gov/perspective/conversation-david-w-bates-about-are-we-safer-today Editor’s note: David W. Bates, …
  6. psnet.ahrq.gov/web-mm/lap-burn
    March 01, 2018 - Lap Burn Citation Text: Ball K. Lap Burn. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2004. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Download Cita…
  7. psnet.ahrq.gov/web-mm/nonsustained-ventricular-tachycardia-after-acute-coronary-syndromes-recognizing-high-risk
    September 20, 2011 - Nonsustained Ventricular Tachycardia After Acute Coronary Syndromes: Recognizing High-Risk Patients Citation Text: Piccini JP, Newby KL, Califf R. Nonsustained Ventricular Tachycardia After Acute Coronary Syndromes: Recognizing High-Risk Patients. PSNet [internet]. Rockville (MD): Agency for Healthcare Rese…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49538/psn-pdf
    June 01, 2007 - Abnormal Volunteer Results June 1, 2007 Fernandez C. Abnormal Volunteer Results. PSNet [internet]. 2007. https://psnet.ahrq.gov/web-mm/abnormal-volunteer-results The Case A healthy 52-year-old woman volunteered to participate in a radiology study in which she underwent magnetic resonance imaging (MRI) of her abdo…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33665/psn-pdf
    March 01, 2008 - Creation of a Medical Procedure Service to Improve Patient Safety March 1, 2008 Smith CC, CHuang G. Creation of a Medical Procedure Service to Improve Patient Safety. PSNet [internet]. 2008. https://psnet.ahrq.gov/perspective/creation-medical-procedure-service-improve-patient-safety Perspective Introduction and …
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60242/psn-pdf
    March 01, 2021 - Team-Developed Care Plan and Ongoing Care Management by Social Workers and Nurse Practitioners Result in Better Outcomes and Reduced Acute Care Utilization in Low-Income Seniors and other High-Risk Populations Originally published on June 12, 2020 Last updated on January 11, 2021 https://psnet.ahrq.gov/innovatio…
  11. psnet.ahrq.gov/periodic-issue/periodic-issue-407
    September 27, 2023 - September 6, 2023 Weekly Issue PSNet highlights the latest patient safety literature, news, and expert commentary, including Weekly Updates, WebM&M, and Perspectives on Safety. The current issue highlights what's new this week in patient safety literature, news, conferences, repor…
  12. psnet.ahrq.gov/perspective/safety-prehospital-emergency-medical-services-setting
    May 01, 2019 - Safety in the Prehospital Emergency Medical Services Setting P. Daniel Patterson, PhD, NRP, and Donald M. Yealy, MD | May 1, 2019  Also Read a Conversation View more articles from the same authors. Citation Text: Patterson DP, Yealy DM. Safety in the Prehospital…
  13. psnet.ahrq.gov/web-mm/patient-safety-events-involving-opioid-dose-stacking
    July 08, 2022 - SPOTLIGHT CASE Patient Safety Events Involving Opioid Dose Stacking Citation Text: Porras H, Lammers C. Patient Safety Events Involving Opioid Dose Stacking. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022. Copy Cita…
  14. psnet.ahrq.gov/web-mm/autopsy-revelation
    December 01, 2007 - Autopsy Revelation Citation Text: Shojania KG. Autopsy Revelation. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2004. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RI…
  15. psnet.ahrq.gov/issue/isqua-2013-edinburgh-recorded-sessions
    November 02, 2011 - Audiovisual Presentation ISQua 2013: Edinburgh Recorded Sessions. Citation Text: ISQua; International Society for Quality in Health Care. Copy Citation Save Save to your library Print Share Facebook Twitter Linkedin Copy URL …
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49731/psn-pdf
    April 01, 2015 - Fire in the Hole!—An OR Fire April 1, 2015 Mehta SP, Domino KM. Fire in the Hole!—An OR Fire. PSNet [internet]. 2015. https://psnet.ahrq.gov/web-mm/fire-hole-or-fire The Case A patient was taken to the operating room (OR) to undergo a planned laparoscopic subtotal colon resection for a biopsy-proven adenocarcinom…
  17. psnet.ahrq.gov/perspective/quality-and-safety-challenges-critical-care-preventing-and-treating-delirium-intensive
    December 01, 2012 - Quality and Safety Challenges in Critical Care: Preventing and Treating Delirium in the Intensive Care Unit Eduard E. Vasilevskis, MD; E. Wesley Ely, MD, MPH; Robert S. Dittus, MD, MPH | December 1, 2012  Also Read a Conversation View more articles from the same authors. …
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49783/psn-pdf
    February 01, 2017 - The Hazards of Distraction: Ticking All the EHR Boxes February 1, 2017 Easty AC. The Hazards of Distraction: Ticking All the EHR Boxes. PSNet [internet]. 2017. https://psnet.ahrq.gov/web-mm/hazards-distraction-ticking-all-ehr-boxes Case Objectives List the goals of having order sets in the electronic health record…
  19. psnet.ahrq.gov/web-mm/delay-treatment-failure-contact-patient-leads-significant-complications
    February 01, 2004 - SPOTLIGHT CASE Delay in Treatment: Failure to Contact Patient Leads to Significant Complications Citation Text: Shapiro DS. Delay in Treatment: Failure to Contact Patient Leads to Significant Complications. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Departmen…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867672/psn-pdf
    February 26, 2025 - Misdiagnosis of Small Bowel Obstruction in the Setting of Previous Abdominal Operations February 26, 2025 Brown S, Utter GH, Barnes DK. Misdiagnosis of Small Bowel Obstruction in the Setting of Previous Abdominal Operations. PSNet [internet]. 2025. https://psnet.ahrq.gov/web-mm/misdiagnosis-small-bowel-obstruction…

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