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4601. Mobility Lost in the ICU | PSNet
      psnet.ahrq.gov/web-mm/mobility-lost-icu
      August 01, 2018 - SPOTLIGHT CASE Mobility Lost in the ICU Citation Text: Smith J. Mobility Lost in the ICU. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNot…

4602. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/867359/psn-pdf
      December 18, 2024 - Importance of Following Safe Practices for Infant Feeding and Handling Expressed Breast Milk December 18, 2024 Shauer M, Perez DG, Chagolla B. Importance of Following Safe Practices for Infant Feeding and Handling Expressed Breast Milk. PSNet [internet]. 2024. https://psnet.ahrq.gov/web-mm/importance-following-saf…

4603. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49849/psn-pdf
      January 01, 2019 - Spotlight: Mistaken Attribution, Diagnostic Misstep January 1, 2019 Kreider TR, Young JQ. Spotlight: Mistaken Attribution, Diagnostic Misstep. PSNet [internet]. 2019. https://psnet.ahrq.gov/web-mm/spotlight-mistaken-attribution-diagnostic-misstep Case Objectives List the patient safety events that are unique to in…

4604. Awareness of human factors in the operating theatres during the COVID-19 pandemic | PSNet
      psnet.ahrq.gov/innovation/awareness-human-factors-operating-theatres-during-covid-19-pandemic
      January 13, 2021 - EMERGING INNOVATIONS Awareness of human factors in the operating theatres during the COVID-19 pandemic Citation Text: Britton CR, Hayman G, Stroud N. Awareness of Human Factors in the operating theatres during the COVID-19 pandemic. Journal of Perioperative Practice. 2020;31(1-2). doi:10.1177/1750…

4605. States Targeting Reduction in Infections via Engagement (STRIVE). | PSNet
      psnet.ahrq.gov/issue/states-targeting-reduction-infections-engagement-strive
      June 12, 2024 - Special or Theme Issue States Targeting Reduction in Infections via Engagement (STRIVE). Citation Text: States Targeting Reduction in Infections via Engagement (STRIVE). Ann Intern Med. 2019;171(7_Suppl):s1-s82. Copy Citation Save Save to your library Prin…

4606. There is an app for that: mobile technology improves complication reporting and resident perception of their role in patient safety | PSNet
      psnet.ahrq.gov/innovation/there-app-mobile-technology-improves-complication-reporting-and-resident-perception
      November 28, 2012 - EMERGING INNOVATIONS There is an app for that: mobile technology improves complication reporting and resident perception of their role in patient safety Citation Text: Johnson CR, Noorzad A, Pujari A, et al. There is an app for that: mobile technology improves complication reporting and resident p…

4607. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49392/psn-pdf
      April 01, 2003 - Guideline for the prevention of falls in older persons.

4608. Mismanagement of Acute Decompensated Heart Failure with Hypertensive Emergency | PSNet
      psnet.ahrq.gov/web-mm/mismanagement-acute-decompensated-heart-failure-hypertensive-emergency
      May 01, 2018 - Optimizing guideline-directed medical therapies for heart failure with reduced ejection fraction during

4609. Hospital-Acquired Diabetic Ketoacidosis. | PSNet
      psnet.ahrq.gov/web-mm/hospital-acquired-diabetic-ketoacidosis
      October 28, 2020 - The management of diabetic ketoacidosis in adults- an updated guideline from the Joint British Diabetes

4610. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/849679/psn-pdf
      June 28, 2023 - AARC clinical practice guideline: management of adult patients with tracheostomy in the acute care setting

4611. Spotlight (ppt file)
      psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.458_slideshow.ppt
      October 01, 2018 - Spotlight Spotlight Overdiagnosis and Delay: Challenges in Sepsis Diagnosis 1 Source and Credits This presentation is based on the October 2018 AHRQ WebM&M Spotlight Case See the full article at https://psnet.ahrq.gov/webmm CME credit is available Commentary by: Ifedayo Kuye, MD, MBA, and Chanu Rhee, MD, MPH, …

4612. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/73998/psn-pdf
      October 27, 2021 - The Hidden Danger of Unseen Intravenous Catheters October 27, 2021 Vadi MG, Malkin MR. The Hidden Danger of Unseen Intravenous Catheters. PSNet [internet]. 2021. https://psnet.ahrq.gov/web-mm/hidden-danger-unseen-intravenous-catheters The Case A 6-week-old infant underwent a craniotomy and excision of abnormal bra…

4613. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49490/psn-pdf
      September 01, 2005 - The Wrong Channel September 1, 2005 Gosbee JW. The Wrong Channel . PSNet [internet]. 2005. https://psnet.ahrq.gov/web-mm/wrong-channel The Case A 28-year-old woman in labor began receiving treatment with magnesium sulfate for preeclampsia. Initial dosing started at 50 mL/hour using a multi-channel medication pump…

4614. Pharmacist Role in Patient Safety | PSNet
      psnet.ahrq.gov/perspective/pharmacist-role-patient-safety
      June 29, 2020 - Annual Perspective Pharmacist Role in Patient Safety February 21, 2020  View more articles from the same authors. Citation Text: Dopp AL, Hall KK. Pharmacist Role in Patient Safety. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality,…

4615. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/60330/psn-pdf
      May 05, 2020 - Telehealth and Patient Safety During the COVID-19 Response May 14, 2020 Sikka N, Willis JS, Fitall E, et al. Telehealth and Patient Safety During the COVID-19 Response. PSNet [internet]. 2020. https://psnet.ahrq.gov/perspective/telehealth-and-patient-safety-during-covid-19-response Introduction   Telehealth typ…

4616. Wrong-Time Error With High-Alert Medication | PSNet
      psnet.ahrq.gov/web-mm/wrong-time-error-high-alert-medication
      February 01, 2014 - Wrong-Time Error With High-Alert Medication Citation Text: Yang A, Nelson LS. Wrong-Time Error With High-Alert Medication. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016. Copy Citation Format: Google Scholar BibTeX…

4617. Managing Ascites: Hazards of Fluid Removal | PSNet
      psnet.ahrq.gov/web-mm/managing-ascites-hazards-fluid-removal
      June 01, 2018 - Managing Ascites: Hazards of Fluid Removal Citation Text: Moore K. Managing Ascites: Hazards of Fluid Removal. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015. Copy Citation Format: Google Scholar BibTeX EndNote X3 …

4618. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33675/psn-pdf
      October 01, 2008 - Identifying Adverse Events Not Present on Admission: Can We Do It? October 1, 2008 Naessens JM. Identifying Adverse Events Not Present on Admission: Can We Do It? PSNet [internet]. 2008. https://psnet.ahrq.gov/perspective/identifying-adverse-events-not-present-admission-can-we-do-it Perspective Interest is growi…

4619. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49583/psn-pdf
      April 01, 2009 - Eptifibatide Epilogue April 1, 2009 Churchill WW, Fiumara K. Eptifibatide Epilogue. PSNet [internet]. 2009. https://psnet.ahrq.gov/web-mm/eptifibatide-epilogue The Case A 62-year-old man was admitted at 11:00 PM on a Saturday night with the provisional diagnosis of acute coronary syndrome. Serial testing for mark…

4620. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49562/psn-pdf
      May 01, 2008 - The Inside of a Time Out May 1, 2008 Feldman DL. The Inside of a Time Out. PSNet [internet]. 2008. https://psnet.ahrq.gov/web-mm/inside-time-out The Case A 65-year-old man was scheduled for an elective endovascular repair of an abdominal aortic aneurysm. The patient had an allergy to "IV contrast dye" that was no…