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  1. psnet.ahrq.gov/issue/smart-pumps-practice-survey-results-reveal-widespread-use-optimization-challenging
    December 27, 2018 - Newspaper/Magazine Article Smart pumps in practice: survey results reveal widespread use, but optimization is challenging. Citation Text: Smart pumps in practice: survey results reveal widespread use, but optimization is challenging. ISMP Medication Safety Alert! Acute Care Edition. Apri…
  2. psnet.ahrq.gov/issue/common-formats-patient-safety-data-collection-diagnostic-safety-01
    May 19, 2021 - Press Release/Announcement Common Formats for Patient Safety Data Collection: Diagnostic Safety 0.1. Citation Text: Common Formats for Patient Safety Data Collection: Diagnostic Safety 0.1. The Agency for Healthcare Research and Quality. Fed Register. 2021;86(103): 29263-29264. Copy …
  3. psnet.ahrq.gov/issue/medication-reconciliation-acute-care-setting-opportunity-and-challenge-nursing
    June 02, 2021 - Commentary Medication reconciliation in the acute care setting: opportunity and challenge for nursing. Citation Text: Sullivan C, Gleason KM, Rooney D, et al. Medication reconciliation in the acute care setting: opportunity and challenge for nursing. J Nurs Care Qual. 2005;20(2):95-98.…
  4. psnet.ahrq.gov/issue/next-generation-doctors-may-be-learning-bad-habits-teaching-hospitals-many-safety-violations
    June 28, 2023 - Newspaper/Magazine Article The next generation of doctors may be learning bad habits at teaching hospitals with many safety violations. Citation Text: The next generation of doctors may be learning bad habits at teaching hospitals with many safety violations. Blau M. STAT. April 20, 2018…
  5. psnet.ahrq.gov/issue/staying-safe-simple-tools-safe-surgery
    August 02, 2015 - Commentary Staying safe: simple tools for safe surgery. Citation Text: Karl RC. Staying safe: simple tools for safe surgery. Bull Am Coll Surg. 2007;92(4):16-22. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …
  6. psnet.ahrq.gov/issue/opioids-iatrogenic-harm-and-disclosure-medical-error
    November 21, 2021 - Commentary Opioids, iatrogenic harm and disclosure of medical error. Citation Text: Blinderman CD. Opioids, iatrogenic harm and disclosure of medical error. J Pain Symptom Manage. 2010;39(2):309-13. doi:10.1016/j.jpainsymman.2009.11.242. Copy Citation Format: DOI Google Sc…
  7. psnet.ahrq.gov/issue/2012-ismp-international-medication-safety-self-assessment-oncology
    January 26, 2023 - Press Release/Announcement 2012 ISMP International Medication Safety Self Assessment for Oncology. Citation Text: 2012 ISMP International Medication Safety Self Assessment for Oncology. Institute for Safe Medication Practices and Institute for Safe Medication Practices Canada. Copy…
  8. psnet.ahrq.gov/issue/healthgrades-quality-study-fifth-annual-patient-safety-american-hospitals-study
    August 27, 2013 - Book/Report HealthGrades Quality Study: Fifth Annual Patient Safety in American Hospitals Study. Citation Text: HealthGrades Quality Study: Fifth Annual Patient Safety in American Hospitals Study. Golden, CO: HealthGrades, Inc.; April 2008. Copy Citation Save …
  9. psnet.ahrq.gov/issue/detection-patient-risk-nurses-theoretical-framework
    September 24, 2010 - Commentary Detection of patient risk by nurses: a theoretical framework. Citation Text: Despins LA, Scott-Cawiezell J, Rouder JN. Detection of patient risk by nurses: a theoretical framework. J Adv Nurs. 2010;66(2). doi:10.1111/j.1365-2648.2009.05215.x. Copy Citation Format: …
  10. psnet.ahrq.gov/issue/interruptions-and-medication-errors-part-i
    January 03, 2017 - Commentary Interruptions and medication errors: part I. Citation Text: Flanders S, Clark AP. Interruptions and medication errors: part I. Clin Nurse Spec. 2010;24(6):281-5. doi:10.1097/NUR.0b013e3181faf78b. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 X…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49528/psn-pdf
    January 01, 2015 - The "Customer" Is Always Right February 1, 2007 Sehgal NL. The "Customer" Is Always Right. PSNet [internet]. 2007. https://psnet.ahrq.gov/web-mm/customer-always-right Case Objectives Understand the importance of identifying a patient's agenda. Appreciate the factors that contribute to unmet patient expectations. …
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/852808/psn-pdf
    August 30, 2023 - Prolonged DKA in Pregnancy: A Case of Communication Breakdown. August 30, 2023 Marshall S, Boe NM. Prolonged DKA in Pregnancy: A Case of Communication Breakdown. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/prolonged-dka-pregnancy-case-communication-breakdown Disclosure of Relevant Financial Relationship…
  13. Spotlight (pdf file)

    psnet.ahrq.gov/sites/default/files/2023-08/spotlight_case_prolonged_dka_in_pregnancy_-_slides_-_revised.pdf
    January 01, 2023 - Spotlight Spotlight Prolonged DKA in Pregnancy: A Case of Communication Breakdown Source and Credits • This presentation is based on the August 2023 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahrq.gov/webmm o CME credit is available o Commentary by: Sarah Marshall, MD and Nina M. …
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49633/psn-pdf
    September 01, 2011 - The Safety and Quality of Long Term Care September 1, 2011 Vogelsmeier AA. The Safety and Quality of Long Term Care. PSNet [internet]. 2011. https://psnet.ahrq.gov/web-mm/safety-and-quality-long-term-care Case Objectives Identify commonly reported adverse events in long-term care. Identify two to three challenges…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/865376/psn-pdf
    March 27, 2024 - Navigating Chaos: Fatal Iatrogenic Liver Injury in a Patient Admitted for Leg Fractures March 27, 2024 Loseth C. Navigating Chaos: Fatal Iatrogenic Liver Injury in a Patient Admitted for Leg Fractures. PSNet [internet]. 2024. https://psnet.ahrq.gov/web-mm/navigating-chaos-fatal-iatrogenic-liver-injury-patient-admi…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33696/psn-pdf
    June 01, 2010 - In Conversation with…Pat Croskerry, MD, PhD June 1, 2010 In Conversation with…Pat Croskerry, MD, PhD. PSNet [internet]. 2010. https://psnet.ahrq.gov/perspective/conversation-withpat-croskerry-md-phd Editor's note: Pat Croskerry, MD, PhD, is a professor in emergency medicine at Dalhousie University in Halifax, Nova…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33738/psn-pdf
    December 01, 2012 - In Conversation With... John G. Reiling, PhD December 1, 2012 In Conversation With.. John G. Reiling, PhD. PSNet [internet]. 2012. https://psnet.ahrq.gov/perspective/conversation-john-g-reiling-phd Editor's note: John G. Reiling, PhD, is president and CEO of Safe by Design. Dr. Reiling consults with hospitals and…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33635/psn-pdf
    July 01, 2006 - In Conversation with...Allan Frankel, MD July 1, 2006 In Conversation with..Allan Frankel, MD. PSNet [internet]. 2006. https://psnet.ahrq.gov/perspective/conversation-withallan-frankel-md Dr. Robert Wachter, Editor, AHRQ WebM&M: Tell us a little bit about how you became interested in this kind of work. Dr. Allan …
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33818/psn-pdf
    November 01, 2016 - In Conversation With… Andrew Bindman, MD November 1, 2016 In Conversation With… Andrew Bindman, MD. PSNet [internet]. 2016. https://psnet.ahrq.gov/perspective/conversation-andrew-bindman-md Editor's note: Dr. Bindman was appointed as Director of the Agency for Healthcare Research and Quality (AHRQ) in May 2016. P…
  20. psnet.ahrq.gov/web-mm/dangerous-dialysis
    June 12, 2024 - SPOTLIGHT CASE Dangerous Dialysis Citation Text: Holley JL. Dangerous Dialysis . PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2010. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML …

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