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psnet.ahrq.gov/node/49793/psn-pdf
May 01, 2017 - Hemolysis Holdup
May 1, 2017
Lehman CM. Hemolysis Holdup. PSNet [internet]. 2017.
https://psnet.ahrq.gov/web-mm/hemolysis-holdup
The Case
A 72-year-old man with congestive heart failure due to nonischemic cardiomyopathy, stage 3 chronic
kidney disease, atrial fibrillation, and type 2 diabetes mellitus presented t…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.107_slideshow.ppt
November 01, 2005 - Spotlight Case [MONTH] 2003
Spotlight Case November 2005
Reconciling Doses
Source and Credits
This presentation is based on the November 2005 Spotlight Case in Emergency Medicine
See the full article at http://webmm.ahrq.gov
CME credit is available through the Web site
Commentary by: Frank Federico, RPh,…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.398_slideshow.ppt
February 01, 2017 - PowerPoint Presentation
Spotlight
The Hazards of Distraction: Ticking All the EHR Boxes
*
Source and Credits
This presentation is based on the February 2017
AHRQ WebM&M Spotlight Case
See the full article at https://psnet.ahrq.gov/webmm
CME credit is available
Commentary by: Anthony C. Easty, PhD, Adjunct Pr…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.335_slideshow.ppt
December 01, 2014 - PowerPoint Presentation
Spotlight
A Stroke of Error
This presentation is based on the December 2014
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Kevin M. Barrett, MD, MSc, Consultant, Associate Professor of Neurology, Director, Neurohospitalist F…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.17_slideshow.ppt
June 01, 2003 - PowerPoint Presentation
Spotlight Case June 2003
Missed Appendicitis
webmm.ahrq.gov
Source and Credits
This presentation is based on June 2003
AHRQ WebM&M Spotlight Case in Surgery
See the full article at http://webmm.ahrq.gov
CME credit is available through the Web site
Commentary by: James Adams, MD, Fei…
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psnet.ahrq.gov/primer/human-factors-engineering
December 15, 2024 - Human Factors Engineering
Citation Text:
Human Factors Engineering. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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psnet.ahrq.gov/node/49682/psn-pdf
April 01, 2013 - From Possible to Probable to Sure to Wrong—Premature
Closure and Anchoring in a Complicated Case
April 1, 2013
Newman-Toker DE. From Possible to Probable to Sure to Wrong—Premature Closure and Anchoring in a
Complicated Case. PSNet [internet]. 2013.
https://psnet.ahrq.gov/web-mm/possible-probable-sure-wrong-premat…
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psnet.ahrq.gov/web-mm/great-pretender-syphilis-still-stumping-healthcare-providers
January 07, 2022 - The “Great Pretender” (Syphilis) is Still Stumping Healthcare Providers
Citation Text:
Glaser K, Vongspanich-Dray J. The “Great Pretender” (Syphilis) is Still Stumping Healthcare Providers. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Servic…
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psnet.ahrq.gov/perspective/promising-areas-patient-safety-research
November 02, 2016 - Promising Areas for Patient Safety Research
P. Jeffrey Brady, MD, MPH; William B. Munier, MD, MBA; Irim Azam, MPH | December 1, 2003
View more articles from the same authors.
Citation Text:
Brady JP, Munier WB, Azam I. Promising Areas for Patient Safety Research. …
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psnet.ahrq.gov/issue/patient-death-after-inadvertent-infusion-prn-medication-hanging-bedside-intravenous-iv-pole
April 17, 2024 - Newspaper/Magazine Article
Patient death after inadvertent infusion of PRN medication hanging on bedside intravenous (IV) pole.
Citation Text:
Patient death after inadvertent infusion of PRN medication hanging on bedside intravenous (IV) pole. ISMP Medication Safety Alert! Acute Care. 20…
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psnet.ahrq.gov/issue/simulation-obstetric-anesthesia
January 12, 2011 - Review
Simulation in obstetric anesthesia.
Citation Text:
Pratt SD. Focused review: simulation in obstetric anesthesia. Anesth Analg. 2012;114(1):186-90. doi:10.1213/ANE.0b013e3182377bbc.
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DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML …
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psnet.ahrq.gov/issue/designing-strategy-promote-safe-innovative-label-use-medications
May 06, 2009 - Commentary
Designing a strategy to promote safe, innovative off-label use of medications.
Citation Text:
Ansani N, Sirio CA, Smitherman T, et al. Designing a strategy to promote safe, innovative off-label use of medications. Am J Med Qual. 2006;21(4):255-261.
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psnet.ahrq.gov/issue/roundtable-public-policy-affecting-patient-safety
June 15, 2016 - Commentary
Roundtable on public policy affecting patient safety.
Citation Text:
Crane RM, Raymond B. Roundtable on Public Policy Affecting Patient Safety. J Patient Saf. 2011;7(1):5-10. doi:10.1097/pts.0b013e31820c98cd.
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psnet.ahrq.gov/issue/medical-audible-alarms-review
August 11, 2021 - Review
Medical audible alarms: a review.
Citation Text:
Edworthy J. Medical audible alarms: a review. J Am Med Inform Assoc. 2013;20(3):584-9. doi:10.1136/amiajnl-2012-001061.
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psnet.ahrq.gov/issue/bundaberg-and-beyond-duty-disclose-adverse-events-patients
January 12, 2022 - Commentary
Bundaberg and beyond: duty to disclose adverse events to patients.
Citation Text:
Madden B, Cockburn T. Bundaberg and beyond: duty to disclose adverse events to patients. J Law Med. 2007;14(4):501-27.
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psnet.ahrq.gov/issue/safe-prescribing-educational-intervention-medical-students
September 24, 2010 - Study
Safe prescribing: an educational intervention for medical students.
Citation Text:
Garbutt J, DeFer TM, Highstein G, et al. Safe prescribing: an educational intervention for medical students. Teach Learn Med. 2006;18(3):244-50.
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psnet.ahrq.gov/issue/special-section-iea-health-care-2021
August 02, 2010 - Special or Theme Issue
Special Section: IEA Health Care 2021.
Citation Text:
Special Section: IEA Health Care 2021. Hum Factors. 2024;66(3):633-769.
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psnet.ahrq.gov/issue/evaluating-teamwork-simulated-obstetric-environment
November 04, 2009 - Study
Evaluating teamwork in a simulated obstetric environment.
Citation Text:
Morgan PJ, Pittini R, Regehr G, et al. Evaluating teamwork in a simulated obstetric environment. Anesthesiology. 2007;106(5):907-915.
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psnet.ahrq.gov/issue/nurses-sleep-work-hours-and-patient-care-quality-and-safety
April 23, 2012 - Study
Nurses' sleep, work hours, and patient care quality, and safety
Citation Text:
Nurses' sleep, work hours, and patient care quality, and safety Stimpfel AW, Fatehi F, Kovner C. Sleep Health. 2020;6(3):314-320.
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psnet.ahrq.gov/issue/how-series-errors-led-recurrent-hypoglycemia
April 23, 2014 - Commentary
How a series of errors led to recurrent hypoglycemia.
Citation Text:
Singh R. How a series of errors led to recurrent hypoglycemia. J Fam Pract. 2006;55(6):489-97.
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