-
psnet.ahrq.gov/node/49699/psn-pdf
February 01, 2014 - Multifactorial Medication Mishap
February 1, 2014
Yang A. Multifactorial Medication Mishap. PSNet [internet]. 2014.
https://psnet.ahrq.gov/web-mm/multifactorial-medication-mishap
Case Objectives
Understand the system-based causes of medication errors.
Describe a model for a systems approach to error analysis.
Id…
-
psnet.ahrq.gov/node/43112/psn-pdf
July 03, 2016 - A systematic review of the effects of resident duty hour
restrictions in surgery: impact on resident wellness,
training, and patient outcomes.
July 3, 2016
Ahmed N, Devitt KS, Keshet I, et al. A systematic review of the effects of resident duty hour restrictions in
surgery: impact on resident wellness, training, a…
-
psnet.ahrq.gov/node/837194/psn-pdf
January 01, 2023 - National improvements in resident physician-reported
patient safety after limiting first-year resident physicians'
extended duration work shifts: a pooled analysis of
prospective cohort studies.
May 25, 2022
Weaver MD, Landrigan CP, Sullivan JP, et al. National improvements in resident physician-reported patient
…
-
psnet.ahrq.gov/node/73200/psn-pdf
April 28, 2021 - A Sweet Case of Hidden Hydrogen Ions
April 28, 2021
Plante D, Falero A. A Sweet Case of Hidden Hydrogen Ions. PSNet [internet]. 2021.
https://psnet.ahrq.gov/web-mm/sweet-case-hidden-hydrogen-ions
The Case
A?24-year-old, Arabic-speaking?woman?with a history of type 1?diabetes?mellitus, gastroparesis,?and
severe e…
-
psnet.ahrq.gov/node/49758/psn-pdf
April 01, 2016 - Dropping to New Lows
April 1, 2016
Juang PC, Kulasa K. Dropping to New Lows. PSNet [internet]. 2016.
https://psnet.ahrq.gov/web-mm/dropping-new-lows
Case Objectives
State how to manage diabetes medications when patients are admitted to the hospital
Describe a guideline-recommended insulin regimen for a hospitaliz…
-
psnet.ahrq.gov/node/72563/psn-pdf
December 07, 2020 - They were designed to be read in under a minute and had key educational messaging
focused on the epidemiology
-
psnet.ahrq.gov/issue/does-perception-severity-medical-error-differ-between-varying-levels-clinical-seniority
August 31, 2022 - Study
Does the perception of severity of medical error differ between varying levels of clinical seniority?
Citation Text:
Khan I, Arsanious M. Does the perception of severity of medical error differ between varying levels of clinical seniority? Adv Med Educ Pract. 2018;9:443-452. doi:10…
-
psnet.ahrq.gov/issue/recognizing-quality-improvement-and-patient-safety-activities-academic-promotion-departments
April 20, 2011 - Study
Recognizing quality improvement and patient safety activities in academic promotion in departments of medicine: innovative language in promotion criteria.
Citation Text:
Staiger TO, Mills LM, Wong BM, et al. Recognizing Quality Improvement and Patient Safety Activities in Academic …
-
psnet.ahrq.gov/issue/why-didnt-you-call-me-factors-junior-learners-consider-when-deciding-whether-call-their
July 14, 2021 - Study
Why didn't you call me? Factors junior learners consider when deciding whether to call their supervisor.
Citation Text:
Alibhai KM, Zabolotniuk TR, Raîche I, et al. Why didn't you call me? Factors junior learners consider when deciding whether to call their supervisor. J Surg Educ.…
-
psnet.ahrq.gov/issue/graduating-pediatrics-residents-reports-impact-fatigue-over-past-decade-duty-hour-changes
July 21, 2010 - Study
Graduating pediatrics residents' reports on the impact of fatigue over the past decade of duty hour changes.
Citation Text:
Schumacher DJ, Frintner MP, Winn A, et al. Graduating Pediatrics Residents' Reports on the Impact of Fatigue Over the Past Decade of Duty Hour Changes. Acad P…
-
psnet.ahrq.gov/issue/medical-error-using-storytelling-and-reflection-impact-error-response-factors-family-medicine
June 05, 2019 - Study
Medical error: using storytelling and reflection to impact error response factors in family medicine residents.
Citation Text:
Adkins S, Alta’any R, Brar K, et al. Medical error: using storytelling and reflection to impact error response factors in family medicine residents. J Med …
-
psnet.ahrq.gov/issue/establishing-multi-institutional-quality-and-patient-safety-consortium-collaboration-across
June 24, 2009 - Commentary
Establishing a multi-institutional quality and patient safety consortium: collaboration across affiliates in a community-based medical school.
Citation Text:
Hillman E, Paul J, Neustadt M, et al. Establishing a multi-institutional quality and patient safety consortium: collab…
-
psnet.ahrq.gov/issue/debunking-myth-majority-medical-errors-are-attributed-communication
February 14, 2024 - Journal Article
Debunking the myth that the majority of medical errors are attributed to communication.
Citation Text:
Clapper TC, Ching K. Debunking the myth that the majority of medical errors are attributed to communication. Med Educ. 2020;54(1):74-81. doi:10.1111/medu.13821.
Copy C…
-
psnet.ahrq.gov/issue/interventions-improve-safe-sleep-among-hospitalized-infants-eight-childrens-hospitals
April 24, 2018 - Study
Interventions to improve safe sleep among hospitalized infants at eight children's hospitals.
Citation Text:
Kuhlmann S, Ahlers-Schmidt CR, Lukasiewicz G, et al. Interventions to Improve Safe Sleep Among Hospitalized Infants at Eight Children's Hospitals. Hosp Pediatr. 2016;6(2):88…
-
psnet.ahrq.gov/issue/information-gathering-patterns-associated-higher-rates-diagnostic-error
June 27, 2018 - Study
Information-gathering patterns associated with higher rates of diagnostic error.
Citation Text:
Delzell JE, Chumley H, Webb R, et al. Information-gathering patterns associated with higher rates of diagnostic error. Adv Health Sci Educ Theory Pract. 2009;14(5):697-711. doi:10.1007…
-
psnet.ahrq.gov/issue/evaluation-interventions-improve-inpatient-hospital-documentation-within-electronic-health
June 28, 2011 - Review
Evaluation of interventions to improve inpatient hospital documentation within electronic health records: a systematic review.
Citation Text:
Wiebe N, Varela LO, Niven DJ, et al. Evaluation of interventions to improve inpatient hospital documentation within electronic health recor…
-
psnet.ahrq.gov/issue/duty-hours-emergency-medicine-balancing-patient-safety-resident-wellness-and-resident
August 04, 2021 - Commentary
Duty hours in emergency medicine: balancing patient safety, resident wellness, and the resident training experience: a consensus response to the 2008 Institute of Medicine resident duty hours recommendations.
Citation Text:
Wagner MJ, Wolf S, Promes S, et al. Duty hours in e…
-
psnet.ahrq.gov/issue/evidence-nurses-need-participate-diagnosis-lessons-malpractice-claims
September 12, 2018 - Study
Evidence that nurses need to participate in diagnosis: lessons from malpractice claims.
Citation Text:
Gleason KT, Jones RM, Rhodes C, et al. Evidence that nurses need to participate in diagnosis: lessons from malpractice claims. J Patient Saf. 2021;17(8):e959-e963. doi:10.1097/pts…
-
psnet.ahrq.gov/issue/trainee-perceptions-resident-duty-hour-restrictions-qualitative-study-online-discussion
August 10, 2022 - Study
Trainee perceptions of resident duty hour restrictions: a qualitative study of online discussion forums.
Citation Text:
Dehmoobad Sharifabadi A, Clarkin C, Doja A. Trainee perceptions of resident duty hour restrictions: a qualitative study of online discussion forums. BMJ Open. 202…
-
psnet.ahrq.gov/issue/ethical-considerations-development-flexibility-duty-hour-requirements-surgical-trainees-trial
June 21, 2017 - Commentary
Ethical considerations in the development of the Flexibility in Duty Hour Requirements for Surgical Trainees trial.
Citation Text:
Minami CA, Odell DD, Bilimoria KY. Ethical Considerations in the Development of the Flexibility in Duty Hour Requirements for Surgical Trainees Tr…