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psnet.ahrq.gov/perspective/health-care-delivery-and-pharmacists-during-covid-19-pandemic
June 29, 2020 - community are working to develop vaccines and treatments, short-term solutions for immediate need have focused
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psnet.ahrq.gov/node/867428/psn-pdf
December 18, 2024 - In that study, called ASPIRE, we focused on three areas after doing a series of interviews and
looking
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psnet.ahrq.gov/web-mm/stroke-error
February 01, 2016 - The initial neurologic evaluation of a patient with suspected stroke necessitates a rapid and focused
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psnet.ahrq.gov/perspective/conversation-john-halamka-md-ms
March 27, 2024 - Suddenly you would find that if we focused on a few things deeply with the right incentives, we would
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psnet.ahrq.gov/sites/default/files/2022-04/final_spotlight_case_and_commentatry_io_line_extravasation-04.08.2022.pdf
January 01, 2022 - patients with lower extremity
injuries.
19
Background (10)
• Early research into the use of IO lines focused
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psnet.ahrq.gov/web-mm/syringe-swap-during-regional-block-case-medication-error-and-recovery
July 22, 2020 - well as frequently used technical skills. 18 An effectively designed simulation program specifically focused
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psnet.ahrq.gov/web-mm/unseen-perils-urinary-catheters
January 31, 2024 - In addition, we utilize a focused competency-based approach to review the microbiology of CAUTI, urinalysis
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psnet.ahrq.gov/web-mm/total-parenteral-nutrition-multifarious-errors
January 23, 2017 - Take-Home Points PN is a high-alert medication requiring safety-focused policies, procedures, and
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psnet.ahrq.gov/perspective/conversation-john-d-birkmeyer-md
January 31, 2024 - I think surgeons were a little surprised how, even where you're focused on comparatively high-volume
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psnet.ahrq.gov/node/865413/psn-pdf
March 27, 2024 - Staff may be busy, so they must have
focused attention on not only business continuity but clinical
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psnet.ahrq.gov/node/60790/psn-pdf
February 23, 2022 - develop recommendations.47Services provided as part of a
tele-dentistry visit may include problem-focused
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psnet.ahrq.gov/issue/doctor-dozed-during-surgery-report-says-beth-israel-faulted-case
June 06, 2018 - Newspaper/Magazine Article
Doctor dozed during surgery, report says Beth Israel faulted in case.
Citation Text:
Kowalczyk L. Boston Globe. March 25, 2009;Metro:1.
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Li…
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psnet.ahrq.gov/issue/manitoba-institute-patient-safety
March 06, 2005 - Multi-use Website
The Manitoba Institute for Patient Safety.
Citation Text:
The Manitoba Institute for Patient Safety; MIPS.
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…
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psnet.ahrq.gov/issue/attention-wanders-rethinking-autopilot
October 26, 2011 - Newspaper/Magazine Article
As attention wanders, rethinking the autopilot.
Citation Text:
Negroni C.
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June 2, 2010
Negroni…
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psnet.ahrq.gov/issue/ohio-patient-safety-institute-opsi
January 08, 2020 - Multi-use Website
Ohio Patient Safety Institute.
Citation Text:
Ohio Hospital Association, 155 East Broad St, Suite 301, Columbus, OH 43215-3620.
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psnet.ahrq.gov/issue/patient-safety-engaging-medical-staff-toward-common-goal
September 08, 2021 - Newspaper/Magazine Article
Patient safety: engaging medical staff toward a common goal.
Citation Text:
Sherman J.
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March 22, …
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.224_slideshow.ppt
October 01, 2010 - Spotlight Case July 2008
Spotlight Case October 2010
Dangerous Dialysis
*
*
Source and Credits
This presentation is based on the October 2010
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Jean L. Holley, MD, University of Illinois, Urbana-…
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psnet.ahrq.gov/node/49839/psn-pdf
August 01, 2018 - Mixup Beyond the Medication Label
August 1, 2018
Pervanas H, VanValkenburgh D. Mixup Beyond the Medication Label. PSNet [internet]. 2018.
https://psnet.ahrq.gov/web-mm/mixup-beyond-medication-label
The Case
An 80-year-old man was admitted to a hospital for recurrent hypoglycemia. He had been seen at another
hospi…
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psnet.ahrq.gov/sites/default/files/2020-09/final_slides_sept_spotlight_case_when_the_lytes_go_out_slides_08.25.2020-revised.pdf
January 01, 2020 - Microsoft PowerPoint - FINAL SLIDES Sept_Spotlight Case_When the Lytes Go Out_SLIDES_08.25.2020-revised.pptx
Spotlight
When the Lytes Go Out: A Case
of Inpatient Cardiac Arrest
Source and Credits
• This presentation is based on the September 2020 AHRQ WebM&M
Spotlight Case
o See the full article at https://psne…
-
psnet.ahrq.gov/node/49505/psn-pdf
March 01, 2006 - Collegiality vs. Competence
March 1, 2006
Sagin T. Collegiality vs. Competence. PSNet [internet]. 2006.
https://psnet.ahrq.gov/web-mm/collegiality-vs-competence
The Case
A 91-year-old man with coronary artery disease was taken to the operating room (OR) for semi-elective
repair of a 10-cm abdominal aortic aneurys…