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psnet.ahrq.gov/node/49407/psn-pdf
July 01, 2003 - Take-Home Points
Oral warfarin is safe and effective in the treatment and prevention of many thromboembolic
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psnet.ahrq.gov/web-mm/deadly-duo
April 28, 2021 - Suicide prevention and primary care. In: Hawton K, Heeringen K, eds. … Hyponatremia
January 29, 2020
Evaluation of clinical practice guidelines on fall … prevention and management for older adults: a systematic review.
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psnet.ahrq.gov/web-mm/difficult-encounters-cmo-and-cno-respond
March 01, 2018 - Often, individuals feel that their complaints fall into a black hole, are not taken seriously, or will … February 27, 2019
Guidelines for prevention, diagnosis and treatment of ventilator-associated
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psnet.ahrq.gov/periodic-issue/periodic-issue-318
November 30, 2021 - This funding announcement calls for program applications to motivate suicide prevention strategy implementation … The patient subsequently presented to Emergency Department after a fall at home and was found to have
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psnet.ahrq.gov/curated-article-libraries
March 05, 2025 - Curated Libraries
Curated Libraries are groupings of PSNet content, curated by AHRQ and by other experts in the patient safety field.
Watch the video to learn more about how this new feature works and how it can be of benefit to you.
Latest PSNet…
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psnet.ahrq.gov/node/49623/psn-pdf
March 01, 2011 - Report of Findings from the Practice and Professional
Survey, Fall 2004.
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psnet.ahrq.gov/web-mm/ruptured-heterotopic-pregnancy
August 16, 2023 - Unfortunately, ß-hCG levels alone are not diagnostic as they may fall and rise in some situations, such
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psnet.ahrq.gov/node/49443/psn-pdf
May 01, 2004 - Privacy Gone Awry
May 1, 2004
Pauker SG, Pauker SP. Privacy Gone Awry. PSNet [internet]. 2004.
https://psnet.ahrq.gov/web-mm/privacy-gone-awry
The Case
A 3-year-old child underwent bilateral myringotomies and tube insertion with adenoidectomy.
Preoperatively, she had an upper respiratory infection, but was eating…
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psnet.ahrq.gov/node/837748/psn-pdf
August 05, 2022 - readmitted 10 days later with another episode of severe
hypoglycemia and a humeral fracture caused by a fall … Hypoglycemia among patients with
Type 2 diabetes: epidemiology, risk factors, and prevention strategies
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psnet.ahrq.gov/web-mm/challenges-diabetes-management-and-medication-reconciliation
March 15, 2023 - readmitted 10 days later with another episode of severe hypoglycemia and a humeral fracture caused by a fall … Hypoglycemia among patients with Type 2 diabetes: epidemiology, risk factors, and prevention strategies
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psnet.ahrq.gov/web-mm/one-toxic-drug-not-another
October 02, 2019 - Innovations
Preventing Falls Through Patient and Family Engagement to Create Customized Prevention
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psnet.ahrq.gov/web-mm/missed-connection-case-inadequate-ecg-oversight-cardiac-surgery
March 25, 2020 - SPOTLIGHT CASE
CME/MOC
Missed Connection: A Case of Inadequate ECG Oversight in Cardiac Surgery
Citation Text:
Bohringer C, Fierro M, Venugopal S. Missed Connection: A Case of Inadequate ECG Oversight in Cardiac Surgery. PSNet [internet]. Rockville (MD): Agency for Healthcar…
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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…
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psnet.ahrq.gov/primer/coronavirus-disease-2019-covid-19-and-safety-older-adults
April 10, 2024 - [Free full text] Centers for Disease Control and Prevention. … Baltimore, MD: US Centers for Disease Control and Prevention; April 30, 2020. … Centers for Disease Control and Prevention. Accessed March 11,2022. … Centers for Disease Control and Prevention. Accessed March 11, 2022. … Centers for Disease Control and Prevention. Accessed December 2021.
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psnet.ahrq.gov/web-mm/cyp450-drugs-expect-unexpected
October 19, 2022 - CYP450 Drugs: Expect the Unexpected
Citation Text:
Gonzalez CJ. CYP450 Drugs: Expect the Unexpected. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2014.
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Format:
Google Scholar BibTeX EndNote X3 XML EndNot…
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psnet.ahrq.gov/node/49594/psn-pdf
December 01, 2009 - Standard Deviations
December 1, 2009
Sabin JE. Standard Deviations. PSNet [internet]. 2009.
https://psnet.ahrq.gov/web-mm/standard-deviations
Case Objectives
Understand the safety risks associated with patients being discharged against medical advice
(AMA).
Recognize safety risks associated with being part of a …
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psnet.ahrq.gov/web-mm/do-not-disturb
February 03, 2011 - SPOTLIGHT CASE
Do Not Disturb!
Citation Text:
Duffy DF, Cassel C. Do Not Disturb!. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007.
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Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML…
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psnet.ahrq.gov/perspective/conversation-kaveh-shojania-md
February 26, 2025 - In Conversation With… Kaveh Shojania, MD
November 1, 2015
Citation Text:
In Conversation With… Kaveh Shojania, MD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015.
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For…
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psnet.ahrq.gov/web-mm/hypoxemia-after-emergency-intubation
March 24, 2019 - tube (ETT) placement was confirmed by auscultation of breath sounds and observation of chest rise and fall
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psnet.ahrq.gov/perspective/advancing-patient-safety-through-state-reporting-systems
June 01, 2007 - while being cared for in a health care facility
Patient death or serious disability associated with a fall … February 25, 2015
Exploring the causes of adverse events in hospitals and potential prevention