-
psnet.ahrq.gov/web-mm/looking-meds-all-wrong-places
June 16, 2021 - Many of the steps and techniques described above fall under the field of medication safety engineering
-
psnet.ahrq.gov/node/49427/psn-pdf
January 01, 2004 - team members to the task at hand and enable them to "speak up" or challenge something that
seems to fall
-
psnet.ahrq.gov/node/49782/psn-pdf
January 01, 2017 - starting vasopressors peripherally, or, alternatively, why
they allowed the patient's blood pressure to fall
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psnet.ahrq.gov/innovation/geisingers-outpatient-addiction-medicine-specialty-program-uses-data-driven-decision
October 30, 2024 - Behavioral health may not fall within traditional funding and reimbursement mechanisms within your facility
-
psnet.ahrq.gov/web-mm/wrong-route-nutrients
September 04, 2010 - Air
October 1, 2004
WebM&M Cases
Another Fall
-
psnet.ahrq.gov/node/49704/psn-pdf
March 01, 2014 - providers who all noted that the
hemoglobin remained stable at 12 g/dL, and the bilirubin continued to fall
-
psnet.ahrq.gov/node/33630/psn-pdf
March 01, 2006 - Fall 2002;Q4:20-24.
-
psnet.ahrq.gov/node/49683/psn-pdf
April 01, 2013 - potentially fatal conditions like pancreatitis, but with respect to communication and coordination, we
often fall
-
psnet.ahrq.gov/node/49802/psn-pdf
August 01, 2017 - addressed through a
thorough understanding of the barriers to adherence.(16) Sometimes a process will fall
-
psnet.ahrq.gov/web-mm/dnr-or-and-afterwards
July 01, 2003 - The Case An 85-year-old woman with dementia took a mechanical fall at her skilled nursing facility
-
psnet.ahrq.gov/node/33855/psn-pdf
April 01, 2018 - We need to be able to use
digital to make sure that people don't fall off during the time in between
-
psnet.ahrq.gov/node/33686/psn-pdf
August 01, 2009 - In Conversation with...Steven J. Spear, DBA, MS, MS
August 1, 2009
In Conversation with..Steven J. Spear, DBA, MS, MS . PSNet [internet]. 2009.
https://psnet.ahrq.gov/perspective/conversation-withsteven-j-spear-dba-ms-ms
Editor's note: Steven Spear, DBA, MS, MS, is Senior Lecturer at Massachusetts Institute of Tech…
-
psnet.ahrq.gov/sites/default/files/2023-03/march_2023_spotlight_agitated_delirium.pdf
January 01, 2023 - Microsoft PowerPoint - Spotlight Case_Agitated Delirium_FINAL.pptx
Spotlight
Agitated Delirium Contributes to Missed Testing and
Delayed Diagnosis of Gastric Perforation
Source and Credits
• This presentation is based on the March 2023 AHRQ WebM&M
Spotlight Case
o See the full article at https://psnet.ahrq.gov/…
-
psnet.ahrq.gov/web-mm/patient-safety-events-involving-opioid-dose-stacking
July 08, 2022 - male with a history of chronic opioid use, anxiety disorder, and major depression presented after a fall
-
psnet.ahrq.gov/web-mm/misplaced-nasogastric-tube-resulting-aspiration
August 01, 2009 - Journal Article
Study
Catching those who fall
-
psnet.ahrq.gov/web-mm/outbreak
January 29, 2015 - disaster plans, such as ensuring available critical care space and allocating mechanical ventilators, may fall
-
psnet.ahrq.gov/node/50927/psn-pdf
February 21, 2020 - referrals to ensure they are carried out in a timely way will likely minimize the number of patients who “fall
-
psnet.ahrq.gov/node/837658/psn-pdf
July 08, 2022 - In these situations, decisions for the unrepresented patient fall
to the medical provider.
-
psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.347_slideshow.ppt
May 01, 2015 - antibiotic administration
19
19
UCSF Sepsis Team (2)
Since the creation of UCSF sepsis team in fall
-
psnet.ahrq.gov/perspective/patient-safety-primary-care
January 31, 2020 - referrals to ensure they are carried out in a timely way will likely minimize the number of patients who “fall