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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49711/psn-pdf
    June 01, 2014 - Wandering Off the Floors: Safety and Security Risks of Patient Wandering June 1, 2014 Smith TA. Wandering Off the Floors: Safety and Security Risks of Patient Wandering. PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/wandering-floors-safety-and-security-risks-patient-wandering Case Objectives Define patie…
  2. 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…
  3. psnet.ahrq.gov/web-mm/situational-awareness-and-patient-safety
    May 01, 2012 - Situational Awareness and Patient Safety Citation Text: Farnan JE. Situational Awareness and Patient Safety. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016. Copy Citation Format: Google Scholar BibTeX EndNote X3 XM…
  4. psnet.ahrq.gov/perspective/handoffs-and-transitions
    February 01, 2007 - Annual Perspective Handoffs and Transitions Niraj Sehgal, MD, MPH | January 22, 2014  View more articles from the same authors. Citation Text: Sehgal NL. Handoffs and Transitions. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, U…
  5. psnet.ahrq.gov/web-mm/dangerous-detour
    November 28, 2018 - The Dangerous Detour Citation Text: Gibson J, HTaylor D. The Dangerous Detour. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged…
  6. psnet.ahrq.gov/web-mm/wrong-blade-lack-familiarity-pediatric-emergency-equipment
    June 01, 2018 - The Wrong Blade: A Lack of Familiarity With Pediatric Emergency Equipment Citation Text: Katznelson J. The Wrong Blade: A Lack of Familiarity With Pediatric Emergency Equipment. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018. …
  7. 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…
  8. psnet.ahrq.gov/perspective/medication-safety-nursing-homes-whats-wrong-and-how-fix-it
    August 01, 2012 - Medication Safety in Nursing Homes: What's Wrong and How to Fix It Jerry Gurwitz, MD | August 1, 2012  Also Read a Conversation View more articles from the same authors. Citation Text: Gurwitz JH. Medication Safety in Nursing Homes: What's Wrong and How to Fix I…
  9. psnet.ahrq.gov/web-mm/dropping-ball-despite-integrated-emr
    January 07, 2015 - Dropping the Ball Despite an Integrated EMR Citation Text: Karsh B-T. Dropping the Ball Despite an Integrated EMR. 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…
  10. psnet.ahrq.gov/web-mm/bloody-bp-cuff
    June 21, 2016 - Bloody BP Cuff Citation Text: Madan AK. Bloody BP Cuff. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33597/psn-pdf
    April 10, 2024 - Long-term Care and Patient Safety April 10, 2024 Bakerjian D. Long-term Care and Patient Safety. PSNet [internet]. 2024. https://psnet.ahrq.gov/primer/long-term-care-and-patient-safety Background For many years, the patient safety field focused on improving safety in hospital and ambulatory care settings. More re…
  12. psnet.ahrq.gov/web-mm/good-nights-sleep-gone-wrong
    September 01, 2015 - Good Night's Sleep Gone Wrong Citation Text: Gillis CM, Degrado J, Anger KE. Good Night's Sleep Gone Wrong. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/852699/psn-pdf
    August 30, 2023 - Beyond the Pandemic: Creating Total Systems Safety August 30, 2023 Van CM, Mossburg S, McGaffigan P. Beyond the Pandemic: Creating Total Systems Safety. PSNet [internet]. 2023. https://psnet.ahrq.gov/perspective/beyond-pandemic-creating-total-systems-safety The COVID-19 pandemic necessitated a shift in operations …
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50756/psn-pdf
    December 18, 2019 - A Mistaken Dose of Naloxone? December 18, 2019 Cutler E, Gunawardena D. A Mistaken Dose of Naloxone?. PSNet [internet]. 2019. https://psnet.ahrq.gov/web-mm/mistaken-dose-naloxone The Case A 55-year-old man with widely metastatic gastric cancer presented to his oncologist's office for a follow-up appointment. He h…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49872/psn-pdf
    August 08, 2019 - Spinal Epidural Abscess August 8, 2019 Lu Y, Salvador D. Spinal Epidural Abscess. PSNet [internet]. 2019. https://psnet.ahrq.gov/web-mm/spinal-epidural-abscess The Case A 30-year-old woman with a history of prior spine surgery presented to the emergency department with a few days of progressive low back pain. She…
  16. psnet.ahrq.gov/web-mm/suicidal-man-gun
    May 01, 2005 - Suicidal Man With Gun Citation Text: Simon RI. Suicidal Man With Gun. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId…
  17. psnet.ahrq.gov/web-mm/acute-care-admission-behavioral-health-patient
    July 19, 2023 - Acute Care Admission of the Behavioral Health Patient Citation Text: Weiss AP, Rosenbaum JF. Acute Care Admission of the Behavioral Health Patient. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2013. Copy Citation Format: …
  18. psnet.ahrq.gov/web-mm/surgical-personality-threat-patient-safety
    February 24, 2021 - SPOTLIGHT CASE Is the "Surgical Personality" a Threat to Patient Safety? Citation Text: Bosk CL. Is the "Surgical Personality" a Threat to Patient Safety?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2006. Copy Citati…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49495/psn-pdf
    December 01, 2005 - Low on the Totem Pole December 1, 2005 Wachter R. Low on the Totem Pole. PSNet [internet]. 2005. https://psnet.ahrq.gov/web-mm/low-totem-pole Case Objectives Understand the concept of authority gradient List steps that can be taken to increase communication across an authority gradient Consider the current cultu…
  20. psnet.ahrq.gov/web-mm/allergy-holter
    May 01, 2008 - Allergy to Holter Citation Text: Williams M. Allergy to Holter. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2004. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …

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