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Total Results: 2,246 records

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  1. Chronology of medication errors by nurses: accumulation of stresses and PTSD symptoms. | PSNet

    psnet.ahrq.gov/issue/chronology-medication-errors-nurses-accumulation-stresses-and-ptsd-symptoms
    September 23, 2020 - March 19, 2019 Patients' perceptions of importance for self-administered correct site

  2. Spotlight (ppt file)

    psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.458_slideshow.ppt
    October 01, 2018 - Had the correct diagnosis been made earlier, the outcome might have been different. 7 Sepsis Morbidity … cardiogenic, obstructive, and distributive A thorough physical examination can aid in diagnosing the correct … diagnoses while the clinicians initiated treatment for possible sepsis The misdiagnosis delayed the correct

  3. Twelve-month review of infusion pump near-miss medication and dose selection errors and user-initiated "good save" corrections: retrospective study. | PSNet

    psnet.ahrq.gov/issue/twelve-month-review-infusion-pump-near-miss-medication-and-dose-selection-errors-and-user
    November 04, 2020 - Study Twelve-month review of infusion pump near-miss medication and dose selection errors and user-initiated "good save" corrections: retrospective study. Citation Text: Waterson J, Al-Jaber R, Kassab T, et al. Twelve-month review of infusion pump near-miss medication and dose selection …

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60694/psn-pdf
    January 01, 2021 - Reporting incidents involving the use of advanced medical technologies by nurses in home care: a cross- sectional survey and an analysis of registration data. July 15, 2020 ten Haken I, Ben Allouch S, van Harten WH. Reporting incidents involving the use of advanced medical technologies by nurses in home care: a cr…

  5. MRSA Infections. | PSNet

    psnet.ahrq.gov/issue/mrsa-infections
    September 26, 2018 - November 21, 2016 Ensuring Correct Surgery.

  6. Too many abandon the "second victims" of medical errors. | PSNet

    psnet.ahrq.gov/issue/too-many-abandon-second-victims-medical-errors
    June 10, 2018 - January 23, 2019 Strategies used by critical care nurses to identify, interrupt, and correct

  7. Physician leadership is key to creating a safer, more reliable health care system. | PSNet

    psnet.ahrq.gov/issue/physician-leadership-key-creating-safer-more-reliable-health-care-system
    November 17, 2009 - March 18, 2010 Doing the "right" things to correct wrong-site surgery.

  8. Managing risk at the point-of-care: preventing errors. | PSNet

    psnet.ahrq.gov/issue/managing-risk-point-care-preventing-errors
    February 06, 2018 - January 14, 2015 Are amended surgical pathology reports getting to the correct responsible

  9. Stranded in the ER, seniors await hospital care and suffer avoidable harm. | PSNet

    psnet.ahrq.gov/issue/stranded-er-seniors-await-hospital-care-and-suffer-avoidable-harm
    December 05, 2018 - March 6, 2024 These patients had to lobby for correct diabetes diagnoses.

  10. Microsoft PowerPoint - FINAL SLIDES Sept_Spotlight Case_When the Lytes Go Out_SLIDES_08.25.2020-revised.pptx (pdf file)

    psnet.ahrq.gov/sites/default/files/2020-09/final_slides_sept_spotlight_case_when_the_lytes_go_out_slides_08.25.2020-revised.pdf
    January 01, 2020 - Microsoft PowerPoint - FINAL SLIDES Sept_Spotlight Case_When the Lytes Go Out_SLIDES_08.25.2020-revised.pptx Spotlight When the Lytes Go Out: A Case of Inpatient Cardiac Arrest Source and Credits • This presentation is based on the September 2020 AHRQ WebM&M Spotlight Case o See the full article at https://psne…

  11. Effectiveness of the surgical safety checklist in correcting errors: a literature review applying Reason's Swiss cheese model. | PSNet

    psnet.ahrq.gov/issue/effectiveness-surgical-safety-checklist-correcting-errors-literature-review-applying-reasons
    January 10, 2018 - Review Effectiveness of the surgical safety checklist in correcting errors: a literature review applying Reason's Swiss cheese model. Citation Text: Collins SJ, Newhouse R, Porter J, et al. Effectiveness of the surgical safety checklist in correcting errors: a literature review applying …

  12. Frequent diagnostic errors in cardiac PET/CT due to misregistration of CT attenuation and emission PET images: a definitive analysis of causes, consequences, and corrections. | PSNet

    psnet.ahrq.gov/issue/frequent-diagnostic-errors-cardiac-petct-due-misregistration-ct-attenuation-and-emission-pet
    December 22, 2018 - Study Frequent diagnostic errors in cardiac PET/CT due to misregistration of CT attenuation and emission PET images: a definitive analysis of causes, consequences, and corrections. Citation Text: Gould L, Pan T, Loghin C, et al. Frequent diagnostic errors in cardiac PET/CT due to misre…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37183/psn-pdf
    October 06, 2011 - Frequent diagnostic errors in cardiac PET/CT due to misregistration of CT attenuation and emission PET images: a definitive analysis of causes, consequences, and corrections. October 6, 2011 Gould L, Pan T, Loghin C, et al. Frequent diagnostic errors in cardiac PET/CT due to misregistration of CT attenuation and …

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836812/psn-pdf
    March 30, 2022 - Strategies and Approaches for Investigating Patient Safety Events March 30, 2022 Shaikh U. Strategies and Approaches for Investigating Patient Safety Events. PSNet [internet]. 2022. https://psnet.ahrq.gov/primer/strategies-and-approaches-investigating-patient-safety-events Background This primer provides a broad …

  15. Another round of the blame game: a paralyzing criminal indictment that recklessly "overrides" just culture. | PSNet

    psnet.ahrq.gov/issue/another-round-blame-game-paralyzing-criminal-indictment-recklessly-overrides-just-culture
    May 02, 2018 - July 27, 2022 Correct use of inhalers: help patients breathe easier.

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47473/psn-pdf
    December 05, 2018 - Holding out for an apology. December 5, 2018 Holding out for an apology. BMJ. 2018;363:k3033. doi:10.1136/bmj.k3033. https://psnet.ahrq.gov/issue/holding-out-apology Patients who experience care complications are vulnerable to psychological consequences that can affect their relationship with their clinical teams.…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837737/psn-pdf
    July 27, 2022 - Patients' willingness and ability to identify and respond to errors in their personal health records: mixed methods analysis of cross-sectional survey data. July 27, 2022 Lear R, Freise L, Kybert M, et al. Patients' willingness and ability to identify and respond to errors in their personal health records: mixed m…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/61099/psn-pdf
    November 04, 2020 - Twelve-month review of infusion pump near-miss medication and dose selection errors and user-initiated "good save" corrections: retrospective study. November 4, 2020 Waterson J, Al-Jaber R, Kassab T, et al. Twelve-month review of infusion pump near-miss medication and dose selection errors and user-Initiated "good…

  19. Analysis of an academic medical center’s corrective action plan in response to fatal medication error using the Institute for Safe Medication Practices’ Hierarchy of Effectiveness. | PSNet

    psnet.ahrq.gov/issue/analysis-academic-medical-centers-corrective-action-plan-response-fatal-medication-error
    February 21, 2018 - Commentary Analysis of an academic medical center’s corrective action plan in response to fatal medication error using the Institute for Safe Medication Practices’ Hierarchy of Effectiveness. Citation Text: Stolte AR, Siwy YM, Tanios SB, et al. Analysis of an academic medical center’s co…

  20. Automated adverse event detection collaborative: electronic adverse event identification, classification, and corrective actions across academic pediatric institutions. | PSNet

    psnet.ahrq.gov/issue/automated-adverse-event-detection-collaborative-electronic-adverse-event-identification
    July 03, 2016 - Study Automated adverse event detection collaborative: electronic adverse event identification, classification, and corrective actions across academic pediatric institutions. Citation Text: Stockwell DC, Kirkendall E, Muething S, et al. Automated adverse event detection collaborative: e…
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