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3381. Beeline to Spine | PSNet
      psnet.ahrq.gov/web-mm/beeline-spine
      March 01, 2014 - responsibility in this case for ensuring that the patient receives SSI and VTE prophylaxis would normally fall … So we fall back to the history: did the patient mention the mass or abdominal pain?

3382. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/73604/psn-pdf
      August 18, 2021 - The effect of providing staff training and enhanced support to care homes on care processes, safety climate and avoidable harms: evaluation of a care home quality improvement programme in England. August 18, 2021 Damery S, Flanagan S, Jones J, et al. The effect of providing staff training and enhanced support to c…

3383. Mark My Limb | PSNet
      psnet.ahrq.gov/web-mm/mark-my-limb
      February 10, 2015 - Most systems, even simple ones, operating in health care organizations today fall short of this characterization

3384. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33606/psn-pdf
      December 15, 2024 - improve the safety of opioids have primarily focused on reducing inappropriate opioid prescribing and fall

3385. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/860050/psn-pdf
      January 04, 2024 - Radiology Missed an Intracranial Bleed in a Lethargic Infant. January 4, 2024 Yuk J, Magana J. Radiology Missed an Intracranial Bleed in a Lethargic Infant. PSNet [internet]. 2024. https://psnet.ahrq.gov/web-mm/radiology-missed-intracranial-bleed-lethargic-infant The Case A 2-month-old full-term male infant was b…

3386. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49531/psn-pdf
      March 01, 2007 - The contributory factors in this event fall into the environmental category.

3387. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33736/psn-pdf
      September 01, 2012 - In Conversation With… Jack Needleman, PhD September 1, 2012 In Conversation With… Jack Needleman, PhD. PSNet [internet]. 2012. https://psnet.ahrq.gov/perspective/conversation-jack-needleman-phd Editor's note: Jack Needleman, PhD, is a Professor in the Department of Health Policy and Management at UCLA School of P…

3388. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49816/psn-pdf
      January 01, 2018 - After the fall, a CT scan revealed a fracture of the cervical spine, which required spinal fusion surgery

3389. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49705/psn-pdf
      January 01, 2020 - A "Reflexive" Diagnosis in Primary Care April 1, 2014 Betjemann J, Josephson AS. A "Reflexive" Diagnosis in Primary Care. PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/reflexive-diagnosis-primary-care Case Objectives Appreciate that primary care doctors may be caring for an increasing number of patients wi…

3390. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49712/psn-pdf
      June 01, 2014 - He noted that the diphenhydramine made him somewhat drowsy, but not enough to fall asleep.

3391. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49482/psn-pdf
      May 01, 2005 - In the present case, the patient would fall into Category V (medical complaint not related to pregnancy

3392. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39650/psn-pdf
      June 30, 2010 - Negotiating safety when staffing falls short. June 30, 2010 Zolnierek CD, Steckel CM. Negotiating Safety when Staffing Falls Short. Crit Care Nurs Clin North Am. 2010;22(2). doi:10.1016/j.ccell.2010.03.014. https://psnet.ahrq.gov/issue/negotiating-safety-when-staffing-falls-short This commentary describes strategi…

3393. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/37825/psn-pdf
      April 11, 2011 - The effect of bedrails on falls and injury: a systematic review of clinical studies. April 11, 2011 Healey F, Oliver D, Milne A, et al. The effect of bedrails on falls and injury: a systematic review of clinical studies. Age Ageing. 2008;37(4):368-78. doi:10.1093/ageing/afn112. https://psnet.ahrq.gov/issue/effect-…

3394. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44845/psn-pdf
      July 01, 2016 - Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls. July 1, 2016 Simon M, Maben J, Murrells T, et al. Is single room hospital accommodation associated with differences i…

3395. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/35808/psn-pdf
      June 19, 2007 - 100K Lives falling short. June 19, 2007 Robeznieks A. https://psnet.ahrq.gov/issue/100k-lives-falling-short This article reports on the progress of the 100,000 Lives Campaign and what has been learned thus far. https://psnet.ahrq.gov/issue/100k-lives-falling-short

3396. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39129/psn-pdf
      November 25, 2009 - How to avoid falling victim to a hospital mistake. November 25, 2009 Cohen E. https://psnet.ahrq.gov/issue/how-avoid-falling-victim-hospital-mistake This news story describes an incident of patient misidentification and offers tips to help patients confirm their care during a hospitalization. https://psnet.ahrq.g…

3397. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/850348/psn-pdf
      June 14, 2023 - Approaches to improving patient safety in integrated care: a scoping review. June 14, 2023 Lalani M, Wytrykowski S, Hogan H. Approaches to improving patient safety in integrated care: a scoping review. BMJ Open. 2023;13(4):e067441. doi:10.1136/bmjopen-2022-067441. https://psnet.ahrq.gov/issue/approaches-improving-…

3398. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39734/psn-pdf
      November 14, 2011 - Man falls off surgical table; St. Joseph's Hospital sued. November 14, 2011 Smith ML; Wolfe WA. https://psnet.ahrq.gov/issue/man-falls-surgical-table-st-josephs-hospital-sued This newspaper article reports on a lawsuit regarding a safety incident that led to injury and subsequent death of a patient. https://psnet…

3399. Nurses' perceptions of safety culture in long-term care settings. | PSNet
      psnet.ahrq.gov/issue/nurses-perceptions-safety-culture-long-term-care-settings
      April 06, 2011 - Study Nurses' perceptions of safety culture in long-term care settings. Citation Text: Wagner LM, Capezuti E, Rice JC. Nurses' perceptions of safety culture in long-term care settings. J Nurs Scholarsh. 2009;41(2):184-192. doi:10.1111/j.1547-5069.2009.01270.x. Copy Citation Format…

3400. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44641/psn-pdf
      October 26, 2016 - Resident Safety Practices in Nursing Home Settings. October 26, 2016 Simmons S, Schnelle J, Slagle J, et al. Technical Brief No. 24. Rockville, MD: Agency for Healthcare Research and Quality; May 2016. AHRQ Publication No. 16-EHC022-EF. https://psnet.ahrq.gov/issue/resident-safety-practices-nursing-home-settings E…