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psnet.ahrq.gov/node/46184/psn-pdf
January 01, 2018 - A prospective risk assessment of informal carers'
medication administration errors within the domiciliary
setting.
December 19, 2017
Parand A, Faiella G, Franklin BD, et al. A prospective risk assessment of informal carers' medication
administration errors within the domiciliary setting. Ergonomics. 2018;61(1):104…
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psnet.ahrq.gov/node/844777/psn-pdf
September 18, 2019 - Adapting cognitive task analysis to investigate clinical
decision making and medication safety incidents.
September 18, 2019
Russ AL, Militello LG, Glassman PA, et al. Adapting Cognitive Task Analysis to Investigate Clinical
Decision Making and Medication Safety Incidents. J Patient Saf. 2019;15(3):191-197.
doi:10…
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psnet.ahrq.gov/node/848089/psn-pdf
April 26, 2023 - Patient Safety Advisory: fentanyl counterfeit prescription
medications that contain fentanyl and patient safety.
April 26, 2023
Jewell ML, Jewell HL, Singer R, et al. Patient Safety Advisory: fentanyl counterfeit prescription medications
that contain fentanyl and patient safety. Aesthetic Plast Surg. 2023;47(3):123…
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psnet.ahrq.gov/node/852287/psn-pdf
August 09, 2023 - Electronic health record usability contributions to patient
safety and clinician burnout: a path forward.
August 9, 2023
Schwappach DLB, Ratwani RM. Electronic health record usability contributions to patient safety and
clinician burnout: a path forward. J Patient Saf. 2023;19(5):38-39. doi:10.1097/pts.000000000000…
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psnet.ahrq.gov/node/46911/psn-pdf
May 02, 2018 - Errors in electronic health record–based data query of
statin prescriptions in patients with coronary artery
disease in a large, academic, multispecialty clinic
practice.
May 2, 2018
Shin EY, Ochuko P, Bhatt K, et al. Errors in Electronic Health Record-Based Data Query of Statin
Prescriptions in Patients With Cor…
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psnet.ahrq.gov/node/38310/psn-pdf
June 03, 2010 - The relationship between early emergency team calls and
serious adverse events.
June 3, 2010
Chen J, Bellomo R, Flabouris A, et al. The relationship between early emergency team calls and serious
adverse events. Crit Care Med. 2009;37(1):148-53. doi:10.1097/CCM.0b013e3181928ce3.
https://psnet.ahrq.gov/issue/relati…
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psnet.ahrq.gov/node/35544/psn-pdf
March 29, 2010 - How surgeons disclose medical errors to patients: a
study using standardized patients.
March 29, 2010
Chan DK, Gallagher TH, Reznick R, et al. How surgeons disclose medical errors to patients: a study using
standardized patients. Surgery. 2005;138(5):851-8.
https://psnet.ahrq.gov/issue/how-surgeons-disclose-medi…
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psnet.ahrq.gov/node/38157/psn-pdf
October 22, 2008 - Contributing factors identified by hospital incident report
narratives.
October 22, 2008
Nuckols TK, Bell DS, Paddock SM, et al. Contributing factors identified by hospital incident report
narratives. Qual Saf Health Care. 2008;17(5):368-72. doi:10.1136/qshc.2007.023721.
https://psnet.ahrq.gov/issue/contributing-f…
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psnet.ahrq.gov/node/867015/psn-pdf
October 23, 2024 - Supporting perioperative safety during a disaster through
clinical crisis education.
October 23, 2024
Kirkman A, Tripp H, Ward L, et al. Supporting perioperative safety during a disaster through clinical crisis
education. AORN J. 2024;120(4):226-237. doi:10.1002/aorn.14217.
https://psnet.ahrq.gov/issue/supporting-…
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psnet.ahrq.gov/node/45726/psn-pdf
December 14, 2016 - National Cancer Institute–American Society of Clinical
Oncology Teams in Cancer Care Project.
December 14, 2016
J Oncol Pract. 2016;12(11):955-1194.
https://psnet.ahrq.gov/issue/national-cancer-institute-american-society-clinical-oncology-teams-cancer-
care-project
Team-based care has been adopted in various spec…
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psnet.ahrq.gov/node/34055/psn-pdf
March 07, 2005 - What is driving hospitals' patient-safety efforts?
March 7, 2005
Devers KJ, Pham HH, Liu G. What is driving hospitals' patient-safety efforts? Health Aff (Millwood).
2004;23(2):103-15.
https://psnet.ahrq.gov/issue/what-driving-hospitals-patient-safety-efforts
This study evaluated the role professionalism, regulati…
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psnet.ahrq.gov/node/865967/psn-pdf
May 29, 2024 - Impact of diagnostic management team on patient time to
diagnosis and percent of accurate and clinically
actionable diagnoses.
May 29, 2024
Brashear J, Mize R, Laposata M, et al. Impact of diagnostic management team on patient time to diagnosis
and percent of accurate and clinically actionable diagnoses. Diagnosis…
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psnet.ahrq.gov/node/73659/psn-pdf
September 01, 2021 - Using a patient safety/quality improvement model to
assess telehealth for psychiatry and behavioral health
services among special populations during COVID-19 and
beyond.
September 1, 2021
Li L, Childs AW. J Psychiatr Pract. 2021;27(4):245-253.
https://psnet.ahrq.gov/issue/using-patient-safetyquality-improvement-m…
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psnet.ahrq.gov/perspective/conversation-kaveh-shojania-md
February 26, 2025 - You're not doing anyone a favor by rigorously evaluating something that's not going to work.
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psnet.ahrq.gov/web-mm/listen-family
April 15, 2015 - Listen to the Family
Citation Text:
Campbell D. Listen to the Family. 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…
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psnet.ahrq.gov/node/49394/psn-pdf
April 01, 2003 - Premature or Overdue?
April 1, 2003
Thomas J, Hannah M. Premature or Overdue? PSNet [internet]. 2003.
https://psnet.ahrq.gov/web-mm/premature-or-overdue
The Case
A 32-year-old woman, gravida 3, para 1, presented for prenatal care at 24 weeks. Her past medical history
was unremarkable, and results of her prenatal …
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psnet.ahrq.gov/node/49788/psn-pdf
March 01, 2017 - Correct Treatment Plan for Incorrect Diagnosis: A
Pharmacist Intervention
March 1, 2017
Nelson SD. Correct Treatment Plan for Incorrect Diagnosis: A Pharmacist Intervention. PSNet [internet].
2017.
https://psnet.ahrq.gov/web-mm/correct-treatment-plan-incorrect-diagnosis-pharmacist-intervention
The Case
A 48-year…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.344_slideshow.ppt
April 01, 2015 - PowerPoint Presentation
Spotlight
Dissecting the Presentation
*
This presentation is based on the April 2015
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Shirley Beng Suat Ooi, MBBS (S'pore), Emergency Medicine Department, National Univers…
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psnet.ahrq.gov/web-mm/anesthesia-weighty-issue
September 01, 2006 - Anesthesia: A Weighty Issue
Citation Text:
Sinha AC. Anesthesia: A Weighty Issue. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2013.
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Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tag…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.161_slideshow.ppt
October 01, 2007 - Spotlight Case [MONTH] 2003
Spotlight Case October 2007
Do Not Disturb!
Source and Credits
This presentation is based on the October 2007
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available online
Commentary by: F. Daniel Duffy, MD, University of Oklahoma, and…