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Showing results for "deaths".

  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49638/psn-pdf
    January 01, 2012 - Communication Failure—Who's in Charge? October 1, 2011 Fackler J, Schwartz JM. Communication Failure—Who's in Charge? PSNet [internet]. 2011. https://psnet.ahrq.gov/web-mm/communication-failure-whos-charge The Case A 20-month-old boy was admitted to the intensive care unit (ICU) following a Fontan surgical procedu…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49794/psn-pdf
    May 01, 2017 - Communication Error in a Closed ICU May 1, 2017 Haas B, Conn LG. Communication Error in a Closed ICU. PSNet [internet]. 2017. https://psnet.ahrq.gov/web-mm/communication-error-closed-icu The Case A 70-year-old man with a complex medical history including end-stage renal disease (status post kidney transplant), co…

  3. Final Progress Report: An Intervention to Reduce Falls Among Adults with Intellectual Disability (pdf file)

    www.ahrq.gov/sites/default/files/2024-04/bonardi-report.pdf
    January 01, 2024 - Final Progress Report: An Intervention to Reduce Falls Among Adults with Intellectual Disability Final Progress Report: An Intervention to Reduce Falls Among Adults with Intellectual Disability R03 HS022353-02 Title of Project: An Intervention to Reduce Falls Among Adults with Intellectual Disability Principal Inv…

  4. Patient Safety and Adherence to Self-Administered Medications | PSNet

    psnet.ahrq.gov/web-mm/patient-safety-and-adherence-self-administered-medications
    September 29, 2011 - Patient Safety and Adherence to Self-Administered Medications Citation Text: Spall H, Van-Spall C, Nieuwlaat R, et al. Patient Safety and Adherence to Self-Administered Medications. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73229/psn-pdf
    May 26, 2021 - Norepinephrine Dosing Error Associated with Multiple Health System Vulnerabilities May 26, 2021 Duby JJ, Schomer K, Oyewole V, et al. Norepinephrine Dosing Error Associated with Multiple Health System Vulnerabilities. PSNet [internet]. 2021. https://psnet.ahrq.gov/web-mm/norepinephrine-dosing-error-associated-mult…

  6. Primary Workaround, Secondary Complication | PSNet

    psnet.ahrq.gov/web-mm/primary-workaround-secondary-complication
    January 24, 2018 - Primary Workaround, Secondary Complication Citation Text: Debono D, Levett-Jones T. Primary Workaround, Secondary Complication. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018. Copy Citation Format: Google Scholar B…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/851555/psn-pdf
    July 31, 2023 - Bandemia as a Harbinger of Stercoral Colitis and Impending Perforation July 31, 2023 Flynn S, Barnes DK. Bandemia as a Harbinger of Stercoral Colitis and Impending Perforation. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/bandemia-harbinger-stercoral-colitis-and-impending-perforation The Case A 56-year-…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33697/psn-pdf
    June 01, 2010 - What Do We Know About Emergency Department Safety? June 1, 2010 Sklar DP, Crandall CS. What Do We Know About Emergency Department Safety? PSNet [internet]. 2010. https://psnet.ahrq.gov/perspective/what-do-we-know-about-emergency-department-safety Perspective Emergency medicine has evolved from a location, with var…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49640/psn-pdf
    November 01, 2011 - The Case for Patient Flow Management November 1, 2011 Litvak E, Bernheim SA. The Case for Patient Flow Management. PSNet [internet]. 2011. https://psnet.ahrq.gov/web-mm/case-patient-flow-management The Case A 52-year-old woman with a history of major depression, posttraumatic stress disorder, and alcohol abuse wa…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49458/psn-pdf
    September 01, 2004 - Poor Prognosis September 1, 2004 Lamont EB. Poor Prognosis. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/poor-prognosis Case Objectives Understand the current limitations of physicians' ability to provide prognoses. List the variables that can be used to guide treatment decisions and prognostication in e…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50612/psn-pdf
    October 30, 2019 - The Safety Challenges of Supervision and Night Coverage in Academic Residency October 30, 2019 Raffel K. The Safety Challenges of Supervision and Night Coverage in Academic Residency. PSNet [internet]. 2019. https://psnet.ahrq.gov/web-mm/safety-challenges-supervision-and-night-coverage-academic-residency The Case…

  12. Final Progress Report: Transitional Care Medication Safety and Reducing Medical Liability: Closing the Chasm (pdf file)

    www.ahrq.gov/sites/default/files/2024-01/corbett-report.pdf
    January 01, 2024 - Final Progress Report: Transitional Care Medication Safety and Reducing Medical Liability: Closing the Chasm Transitional Care Medication Safety and Reducing Medical Liability: Closing the Chasm Cynthia F. Corbett, PhD, RN: Principal Investigator Alice A. Dupler, JD, APRN-BC Stephen M. Setter, PharmD, DVM, CGP Ke…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49554/psn-pdf
    January 01, 2008 - Chemotherapy Extravasation January 1, 2008 Schulmeister L. Chemotherapy Extravasation. PSNet [internet]. 2008. https://psnet.ahrq.gov/web-mm/chemotherapy-extravasation The Case A 73-year-old woman with no past medical history was diagnosed with stage IIIA breast cancer. She and her oncologist decided to begin sys…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49432/psn-pdf
    February 09, 2004 - Delay in Initiating Antibiotics Results in Fatal Error February 1, 2004 Bellini LM. Delay in Initiating Antibiotics Results in Fatal Error. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/delay-initiating-antibiotics-results-fatal-error Case Objectives Understand the importance of ongoing patient re-evaluati…

  15. I Just Want to Go Home: Understanding Delirium’s Impact on Treatment Preferences | PSNet

    psnet.ahrq.gov/web-mm/i-just-want-go-home-understanding-deliriums-impact-treatment-preferences
    December 18, 2019 - I Just Want to Go Home: Understanding Delirium’s Impact on Treatment Preferences Citation Text: Steinberg K. I Just Want to Go Home: Understanding Delirium’s Impact on Treatment Preferences. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Servi…

  16. A Potent Medication Administered in a Not So Viable Route | PSNet

    psnet.ahrq.gov/web-mm/potent-medication-administered-not-so-viable-route
    July 20, 2016 - A Potent Medication Administered in a Not So Viable Route Citation Text: Loubani O. A Potent Medication Administered in a Not So Viable Route. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017. Copy Citation Format: G…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49529/psn-pdf
    February 01, 2007 - Crossed Coverage February 1, 2007 Kayser SR. Crossed Coverage. PSNet [internet]. 2007. https://psnet.ahrq.gov/web-mm/crossed-coverage The Case A 27-year-old woman with a history of congenital heart disease was admitted for cardiac transplantation evaluation. She had already undergone multiple surgeries, including…

  18. Engaging Senior Executives in Care of Mechanically Ventilated Patients: Facilitator's Guide | Agency for Healthcare Research and Quality

    www.ahrq.gov/hai/tools/mvp/modules/cusp/engaging-sr-exec-fac-guide.html
    February 01, 2017 - Engaging Senior Executives in Care of Mechanically Ventilated Patients: Facilitator's Guide AHRQ Safety Program for Mechanically Ventilated Patients Slide 1: Engaging Senior Executives in Care of Mechanically Ventilated Patients Say: In this module, we will discuss the importance of senior executive eng…

  19. Presentation: Program Overview

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/ptfamcare-slides.pptx
    January 01, 2017 - Presentation: Program Overview Patient and Family Involvement in Care of Mechanically Ventilated Patients AHRQ Safety Program for Mechanically Ventilated Patients AHRQ Pub. No. 16(17)-0018-37-EF January 2017 Patient/Family Involvement ‹#› AHRQ Safety Program for Mechanically Ventilated Patients 1 Learning Obje…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49728/psn-pdf
    March 01, 2015 - Medication Mix-Up: From Bad to Worse March 1, 2015 Wollitz A, O'Connor MF. Medication Mix-Up: From Bad to Worse. PSNet [internet]. 2015. https://psnet.ahrq.gov/web-mm/medication-mix-bad-worse The Case A 69-year-old man with chronic kidney disease and essential hypertension was admitted to the hospital with chest …
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