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psnet.ahrq.gov/node/49501/psn-pdf
February 03, 2006 - Lost in Transition
February 1, 2006
Beach C. Lost in Transition. PSNet [internet]. 2006.
https://psnet.ahrq.gov/web-mm/lost-transition
Case Objectives
Provide an overview of transitions in continuously operating industries
Review cognitive error
Describe the complex dynamics of transitions in emergency care
Pro…
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psnet.ahrq.gov/node/49702/psn-pdf
March 01, 2014 - Tough Call: Addressing Errors From Previous Providers
March 1, 2014
Martinez W, Hickson GB. Tough Call: Addressing Errors From Previous Providers. PSNet [internet]. 2014.
https://psnet.ahrq.gov/web-mm/tough-call-addressing-errors-previous-providers
Case Objectives
Define what it means to be a professional.
Identi…
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psnet.ahrq.gov/web-mm/unfamiliar-catheter
November 01, 2006 - The Unfamiliar Catheter
Citation Text:
Swayze SC, James A. The Unfamiliar Catheter. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2013.
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017838-baker-final-report-2013.pdf
January 01, 2013 - Chronic Mental Health: Improving Outcomes through Ambulatory Care Coordination - Final Report
Grant Final Report
Grant ID: R18HS017838
Chronic Mental Health: Improving Outcomes through
Ambulatory Care Coordination
Inclusive Project Dates: 10/01/08 – 09/30/13
Principal Investigator:
Wende Baker, M.Ed.
Tea…
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psnet.ahrq.gov/web-mm/breakage-picc-line
June 21, 2023 - SPOTLIGHT CASE
Breakage of a PICC Line
Citation Text:
Dimov V. Breakage of a PICC Line. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2009.
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www.ahrq.gov/research/findings/final-reports/ssi/ssiapu.html
September 01, 2018 - Improving the Measurement of Surgical Site Infection Risk Stratification/Outcome Detection
Appendix U. Improving the Measurement of Surgical Site Infection (SSI) Risk Stratification and Outcome Detection
Previous Page Next Page
Table of Contents
Improving the Measurement of Surgical Site Infection R…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/learn/learn-about-cusp-facilitator-guide.pdf
May 01, 2017 - Learn About the Comprehensive Unit-Based Safety Program for Perinatal Safety
AHRQ Safety Program for Perinatal Care
Learn About the Comprehensive Unit-Based Safety Program for Perinatal Safety
AHRQ Publication No. 17-0003-1-EF
May 2017
SAY:
This module introduces the comprehensive
unit-based safety program, …
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/educational-bundles/urine-culturing/antibiotic-stewardship/abx-stewardship-part1.pptx
March 01, 2017 - Antibiotic Stewardship Slides, Part 1: Hand Hygiene
How To Avoid the Harms of
Antibiotic Overuse
Training Module 4
AHRQ Pub. No. 16(17)-0003-21-EF
March 2017
AHRQ Safety Program for Long-term Care: HAIs/CAUTI
AHRQ Safety Program for Long-Term Care: HAIs/CAUTI
AHRQ SAFETY PROGRAM FOR LONG-TERM CARE: HAIs/CAUTI
…
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www.ahrq.gov/hai/cauti-tools/cauti-icu/facil-guide/mod1.html
February 01, 2023 - Preventing CAUTI in the ICU Setting: Facilitator’s Guide
Module 1: Overview
Previous Page Next Page
Table of Contents
Preventing CAUTI in the ICU Setting: Facilitator’s Guide
Introduction
Module 1: Overview
Module 2: Urinary Catheter Maintenance
Module 3: Conversations Around Device Necessit…
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psnet.ahrq.gov/web-mm/mechanical-prosthetic-valve-thrombosis-thromboembolism
August 21, 2005 - Mechanical Prosthetic Valve Thrombosis with Thromboembolism.
Citation Text:
Hedayati N, White RO. Mechanical Prosthetic Valve Thrombosis with Thromboembolism.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022.
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psnet.ahrq.gov/web-mm/getting-diagnosis-both-right-and-wrong
May 29, 2024 - Getting the Diagnosis Both Right and Wrong
Citation Text:
Olson AP. Getting the Diagnosis Both Right and Wrong. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/skin-cancer-counseling-2003
October 06, 2003 - Share to Facebook
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archived
Final Recommendation Statement
Skin Cancer: Counseling, 2003
October 06, 2003
Recommendations made by the USPSTF are independent of the U.S. government. They shoul…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/d4b_pdi02-pressureulcer-bestpractices.pdf
January 01, 2012 - Selected Best Practices and Suggestions for Improvement
Pediatric Toolkit for Using the AHRQ Quality Indicators
How To Improve Hospital Quality and Safety
1 Tool D.4b
Selected Best Practices and Suggestions for Improvement
PDI 02: Pressure Ulcer
Why focus on pressure ulcers in children?
• Although childre…
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psnet.ahrq.gov/web-mm/code-blue-where
March 30, 2020 - Code Blue—Where To?
Citation Text:
Adams BD. Code Blue—Where To?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007.
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psnet.ahrq.gov/web-mm/slow-down-right-drug-wrong-formulation
October 13, 2018 - Slow Down: Right Drug, Wrong Formulation
Citation Text:
Amato MG, Schiff G. Slow Down: Right Drug, Wrong Formulation. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018.
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www.uspreventiveservicestaskforce.org/uspstf/recommendation/preeclampsia-screening-1996
January 01, 1996 - Share to Facebook
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archived
Final Recommendation Statement
Preeclampsia: Screening
January 01, 1996
Recommendations made by the USPSTF are independent of the U.S. government. They should …
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digital.ahrq.gov/program-overview/research-reports/2021-year-review/research-overview
January 01, 2021 - Research Overview
Digital healthcare knowledge and tools can enhance the efforts of patients, clinicians, and health systems working to improve healthcare quality and safety. AHRQ’s DHR program funds research to create actionable findings on what and how digital healthcare works best for t…
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www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations
June 01, 2025 - Share to Facebook
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A & B Recommendations
A listing of all the Recommendations with a grade of either A or B.
A and B grade recommendations are services that the Task Force most highly recommends implemen…
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psnet.ahrq.gov/primer/failure-rescue
September 15, 2024 - Failure to Rescue
Citation Text:
Tokareva I, Romano P. Failure to Rescue. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2025.
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digital.ahrq.gov/ahrq-funded-projects/develop-and-validate-health-it-safety-measures-capture-violations-five-rights
January 01, 2023 - Develop and Validate Health IT Safety Measures To Capture Violations of the Five Rights of Medication Safety
Project Final Report ( PDF , 706.51 KB) Disclaimer
Disclaimer
The findings and conclusions in this document are those of the author(s), who are responsible for its content…