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8261. 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…

8262. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49775/psn-pdf
      November 01, 2016 - Unexpected Drawbacks of Electronic Order Sets November 1, 2016 McGreevey JD. Unexpected Drawbacks of Electronic Order Sets. PSNet [internet]. 2016. https://psnet.ahrq.gov/web-mm/unexpected-drawbacks-electronic-order-sets The Case A 70-year-old man with stage 4 prostate cancer presented to the emergency department …

8263. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49512/psn-pdf
      May 01, 2006 - Right? Left? Neither! May 1, 2006 Chassin MR, Howell EA. Right? Left? Neither!. PSNet [internet]. 2006. https://psnet.ahrq.gov/web-mm/right-left-neither Case Objectives Appreciate the role of Reason's Swiss Cheese Model in medical errors Understand the process of analyzing a single error Provide suggestions for …

8264. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33618/psn-pdf
      September 01, 2005 - Playing Well with Others: "Translocational Research" in Patient Safety September 1, 2005 Wachter R. Playing Well with Others: "Translocational Research" in Patient Safety. PSNet [internet]. 2005. https://psnet.ahrq.gov/perspective/playing-well-others-translocational-research-patient-safety Perspective Translation…

8265. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/846127/psn-pdf
      March 15, 2023 - Sepsis Resulting from Delays in Treatment and Miscommunication among Specialists March 15, 2023 Shi L, Noren E. Sepsis Resulting from Delays in Treatment and Miscommunication among Specialists. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/sepsis-resulting-delays-treatment-and-miscommunication-among- spec…

8266. 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…

8267. Pressure Ulcer Prevention Toolkit (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module4/putoolkit_module4_tools.docx
      January 01, 1995 - Pressure Ulcer Prevention Toolkit Pressure Ulcer Prevention Toolkit Module 4 Tools 2G: Pieper Pressure Ulcer Knowledge Test 4A: Assigning Responsibilities for Using Best Practice Bundle with the left column completed (by the Implementation Team Leader/co-leaders and best practices decided upon earlier by the team 4B:…

8268. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49706/psn-pdf
      January 01, 2015 - Clostridium Difficile Relapse Secondary to Medication Access Issue April 1, 2014 Walker PC, Nagel J. Clostridium Difficile Relapse Secondary to Medication Access Issue. PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/clostridium-difficile-relapse-secondary-medication-access-issue The Case A 24-year-old wom…

8269. Webinar 6: Enhance Services for High-Risk Patients | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/hospital/resource/guide/web6.html
      December 01, 2017 - Webinar 6: Enhance Services for High-Risk Patients Designing & Delivering Whole-Person Transitional Care: The Hospital Guide to Reducing Medicaid Readmissions Text version of Webinar slide presentation. Slide 1: Designing & Delivering Whole-Person Transitional Care Designing & Delivering Whole-Person Tr…

8270. Electronic Student Health Questionnaire (eSHQ) enhances risk assessment for adolescents: Special Innovation Feature, August 2015 (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/co-nm-specialinnovation.pdf
      January 01, 2020 - Electronic Student Health Questionnaire (eSHQ) enhances risk assessment for adolescents: Special Innovation Feature, August 2015 Page 1 The National Evaluation of the CHIPRA Quality Demonstration Grant Program SUMMARY The electronic Student Health Questionnaire (eSHQ) improved early identification of health ris…

8271. Elements of an Evaluation Plan | Agency for Healthcare Research and Quality
      www.ahrq.gov/talkingquality/assess/evaluation-plan.html
      January 01, 2023 - Elements of an Evaluation Plan An evaluation plan should be an integral part of your overall written plan for a quality reporting project. To support the planning of an evaluation, this page covers the following topics: Purpose of the Evaluation Evaluation Questions Evaluation Criteria Timetable and W…

8272. Presentation: Program Overview
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/vae/vaesurveillance-slides.pptx
      January 01, 2017 - Presentation: Program Overview Ventilator-Associated Event Surveillance AHRQ Safety Program for Mechanically Ventilated Patients AHRQ Pub. No. 16(17)-0018-41-EF January 2017 VAE Surveillance ‹#› AHRQ Safety Program for Mechanically Ventilated Patients 1 Learning Objectives After this session, you will be able…

8273. Assess Patient Safety Culture Using the Hospital Survey on Patient Safety: Facilitator Guide | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/tools/mvp/modules/cusp/assess-psc-hsop-fac-guide.html
      February 01, 2017 - Assess Patient Safety Culture Using the Hospital Survey on Patient Safety: Facilitator Guide AHRQ Safety Program for Mechanically Ventilated Patients Slide 1: Assess Patient Safety Culture Using the Hospital Survey on Patient Safety Say: In this module, we will introduce the Hospital Survey on Patient S…

8274. Final Progress Report: Electronic Communications Across Provider Settings (pdf file)
      www.ahrq.gov/sites/default/files/2024-07/morrison-report.pdf
      January 01, 2024 - Final Progress Report: Electronic Communications Across Provider Settings AHRQ Grant Final Progress Report Electronic Communications Across Provider Settings Deane Morrison - Principal Investigator Wendy Angelo, MD - Project Co-Director Josie Bendiks - Project Co-Director Dan Venecek - Project Manager …

8275. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49620/psn-pdf
      February 01, 2011 - Silent Pain in the Neck February 1, 2011 Bittner EA. Silent Pain in the Neck. PSNet [internet]. 2011. https://psnet.ahrq.gov/web-mm/silent-pain-neck The Case A 60-year-old man with no significant past medical history underwent an elective anterior cervical discectomy for persistent right arm weakness due to cervi…

8276. Final Progress Report: Patient Safety: Physician Assistant Responsibilities and Opportunities (pdf file)
      www.ahrq.gov/sites/default/files/2024-02/crane-report.pdf
      January 01, 2024 - Final Progress Report: Patient Safety: Physician Assistant Responsibilities and Opportunities Final Report Patient Safety: Physician Assistant Responsibilities and Opportunities An educational conference program of the American Academy of Physician Assistants This program was funded by a grant from the Agency fo…

8277. PowerPoint Presentation
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/teach-back-slides-final508.pptx
      June 02, 2025 - PowerPoint Presentation Teach-Back AHRQ Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families The Agency for Healthcare Research and Quality, or AHRQ, funded the development of a Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families. A…

8278. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49398/psn-pdf
      May 01, 2003 - Bloody BP Cuff May 1, 2003 Madan AK. Bloody BP Cuff. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/bloody-bp-cuff The Case Patient #1, a 28-year-old male, was a trauma patient following a motor vehicle collision into a cement pillar. Patient #1 was in the trauma bay with massive injuries and profuse bleed…

8279. The Science of Improving Patient Safety and Identifying Defects: Facilitator Notes | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/tools/surgery/modules/on-boarding/science-of-safety-fac-notes.html
      December 01, 2017 - The Science of Improving Patient Safety and Identifying Defects: Facilitator Notes AHRQ Safety Program for Surgery Slide 1: The Science of Improving Patient Safety and Identifying Defects Say: The topic of this module is the science of patient safety. The discussion will include the importance of unders…

8280. AHRQ Safety Program for Perinatal Care: Sample Scenario or Uterine Tachysystole In Site Simulation (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/situ/simulation_ut-tachysystole.docx
      May 01, 2017 - AHRQ Safety Program for Perinatal Care: Sample Scenario or Uterine Tachysystole In Site Simulation AHRQ Safety Program for Perinatal Care Sample Scenario for Uterine Tachysystole In Situ Simulation Sample Scenario for Uterine Tachysystole In Situ Simulation Purpose of the tool: The Uterine Tachysystole In Situ Simul…