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6441. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49707/psn-pdf
      April 01, 2014 - CYP450 Drugs: Expect the Unexpected April 1, 2014 Gonzalez CJ. CYP450 Drugs: Expect the Unexpected. PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/cyp450-drugs-expect-unexpected The Case A 42-year-old man with acquired immunodeficiency syndrome (AIDS) (CD4 count 198), hip dystocia, and generalized anxiety …

6442. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49493/psn-pdf
      November 01, 2005 - Infused, Not Ingested November 1, 2005 Foley M. Infused, Not Ingested. PSNet [internet]. 2005. https://psnet.ahrq.gov/web-mm/infused-not-ingested The Case A patient in the ICU was scheduled for a CT scan. The nurse prepared the patient by administering contrast, an unfamiliar task for this particular nurse. Rathe…

6443. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49397/psn-pdf
      May 01, 2003 - The Dropped Lung May 1, 2003 Heffner JR. The Dropped Lung. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/dropped-lung The Case A 79-year-old woman was admitted for hypoxia and shortness of breath. Two weeks prior she had been hospitalized for dyspnea and was found to have multiple bilateral pulmonary nodu…

6444. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49797/psn-pdf
      June 01, 2017 - Diagnostic Overshadowing Dangers June 1, 2017 Raven MC. Diagnostic Overshadowing Dangers. PSNet [internet]. 2017. https://psnet.ahrq.gov/web-mm/diagnostic-overshadowing-dangers The Case A 72-year-old woman with history of opioid abuse was sent to the emergency department (ED) from a methadone clinic because she a…

6445. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49604/psn-pdf
      June 01, 2010 - Tacit Handover, Overt Mishap June 1, 2010 Cooper JB, Kamdar BB. Tacit Handover, Overt Mishap. PSNet [internet]. 2010. https://psnet.ahrq.gov/web-mm/tacit-handover-overt-mishap The Case A 61-year-old man was admitted for management of an infected aortic stent, which had been placed 3 years earlier to treat an abdo…

6446. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49739/psn-pdf
      August 21, 2015 - Breathe Easy: Safe Tracheostomy Management August 21, 2015 Russell MS, Russell MD. Breathe Easy: Safe Tracheostomy Management. PSNet [internet]. 2015. https://psnet.ahrq.gov/web-mm/breathe-easy-safe-tracheostomy-management The Case A 75-year-old man was admitted to the hospital with sepsis due to multilobar pneumo…

6447. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49434/psn-pdf
      February 01, 2004 - Undiagnosed Vaginal Bleeding February 1, 2004 Mandelblatt J. Undiagnosed Vaginal Bleeding . PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/undiagnosed-vaginal-bleeding The Case The patient is a 34-year-old gravida 3, para 3 woman with a 2-year history of increasingly profuse vaginal bleeding. Over the past…

6448. Delayed Clozapine Prescription in an Elderly Man With Dementia | PSNet
      psnet.ahrq.gov/web-mm/delayed-clozapine-prescription-elderly-man-dementia
      August 06, 2014 - Delayed Clozapine Prescription in an Elderly Man With Dementia Citation Text: Tsourounis C, Ghomeshi KK. Delayed Clozapine Prescription in an Elderly Man With Dementia. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019. Copy Cita…

6449. Outbreak | PSNet
      psnet.ahrq.gov/web-mm/outbreak
      January 29, 2015 - Outbreak Citation Text: Rothman R, Stapleton S. Outbreak. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …

6450. Specimen Almost Lost | PSNet
      psnet.ahrq.gov/web-mm/specimen-almost-lost
      September 21, 2022 - Specimen Almost Lost Citation Text: Hehe YK. Specimen Almost Lost. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RI…

6451. Periodic Issue | PSNet
      psnet.ahrq.gov/periodic-issue/periodic-issue-472
      February 26, 2025 - February 26, 2025 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…

6452. Building a Safety Program Using Principles of Resilience Engineering | PSNet
      psnet.ahrq.gov/perspective/building-safety-program-using-principles-resilience-engineering
      October 23, 2013 - Building a Safety Program Using Principles of Resilience Engineering Sudeep Hegde, PhD; Ann M. Bisantz, PhD; and Rollin J. Fairbanks, MD, MS | June 1, 2019  View more articles from the same authors. Citation Text: Hegde S, Fairbanks RJ, Bisantz A. Building a Safety…

6453. In Conversation With… Nicholas G. Castle, MHA, PhD | PSNet
      psnet.ahrq.gov/perspective/conversation-nicholas-g-castle-mha-phd
      August 01, 2012 - In Conversation With… Nicholas G. Castle, MHA, PhD August 1, 2012  Also Read an Essay Citation Text: In Conversation With… Nicholas G. Castle, MHA, PhD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human…

6454. In Conversation with...J. Bryan Sexton, PhD, MA | PSNet
      psnet.ahrq.gov/perspective/conversation-withj-bryan-sexton-phd-ma
      December 01, 2006 - In Conversation with...J. Bryan Sexton, PhD, MA December 1, 2006  Also Read an Essay Citation Text: In Conversation with..J. Bryan Sexton, PhD, MA. PSNet [internet]. 2006.In Conversation with...J. Bryan Sexton, PhD, MA. PSNet [internet]. Rockville (MD): Agency for…

6455. Patient Engagement and Patient Safety | PSNet
      psnet.ahrq.gov/perspective/patient-engagement-and-patient-safety
      February 01, 2013 - Patient Engagement and Patient Safety Saul N. Weingart, MD, PhD | February 1, 2013  Also Read a Conversation View more articles from the same authors. Citation Text: Weingart SN. Patient Engagement and Patient Safety. PSNet [internet]. Rockville (MD): Agency fo…

6456. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/836877/psn-pdf
      May 16, 2022 - In Conversation With... Remle P. Crowe, PhD May 16, 2022 In Conversation With.. Remle P. Crowe, PhD . PSNet [internet]. 2022. https://psnet.ahrq.gov/perspective/conversation-remle-p-crowe-phd Editor’s Note: Remle Crowe, PhD, NREMT, is the Director of Clinical and Operational Research at ESO. In her professional ro…

6457. Establishing a Safety Culture: Thinking Small | PSNet
      psnet.ahrq.gov/perspective/establishing-safety-culture-thinking-small
      December 01, 2006 - Establishing a Safety Culture: Thinking Small Timothy J. Hoff, PhD | December 1, 2006  Also Read a Conversation View more articles from the same authors. Citation Text: Hoff TJ. Establishing a Safety Culture: Thinking Small. PSNet [internet]. Rockville (MD): Age…

6458. Patient Safety Papers. | PSNet
      psnet.ahrq.gov/issue/patient-safety-papers-0
      April 26, 2012 - Special or Theme Issue Patient Safety Papers. Citation Text: Patient Safety Papers. Healthc Q. 2006;9 Spec No:1-140. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL …

6459. Patient Safety. | PSNet
      psnet.ahrq.gov/issue/patient-safety-16
      January 21, 2015 - Special or Theme Issue Patient Safety. Citation Text: Patient Safety. GMS J Med Educ. 2019;36:Doc11-Doc22. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL …

6460. AORN Position Statement on Criminalization of Human Errors in the Perioperative Setting. | PSNet
      psnet.ahrq.gov/issue/aorn-position-statement-criminalization-human-errors-perioperative-setting
      May 01, 2022 - Organizational Policy/Guidelines AORN Position Statement on Criminalization of Human Errors in the Perioperative Setting. Citation Text: AORN Position Statement on Criminalization of Human Errors in the Perioperative Setting. AORN J. 2018;108(1):64-65. doi:10.1002/aorn.12292. Copy Cita…