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  1. psnet.ahrq.gov/issue/report-short-life-working-group-reducing-medication-related-harm
    September 09, 2015 - Book/Report The Report of the Short Life Working Group on Reducing Medication-related Harm. Citation Text: The Report of the Short Life Working Group on Reducing Medication-related Harm. Department of Health and Social Care. London, England: Crown Publishing; February 2018. Copy Citati…
  2. psnet.ahrq.gov/issue/openness-and-honesty-when-things-go-wrong-professional-duty-candour
    October 04, 2017 - Book/Report Openness and Honesty When Things Go Wrong: the Professional Duty of Candour. Citation Text: Openness and Honesty When Things Go Wrong: the Professional Duty of Candour. London, UK: General Medical Council and the Nursing and Midwifery Council; June 29, 2015. Copy Citation …
  3. psnet.ahrq.gov/issue/criminalization-mistakes-nursing
    June 13, 2011 - Commentary The criminalization of mistakes in nursing. Citation Text: Philipsen NC. The Criminalization of Mistakes in Nursing. J Nurs Pract. 2011;7(9):719-726. doi:10.1016/j.nurpra.2011.07.004. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNote 7 XML …
  4. psnet.ahrq.gov/issue/what-doctors-can-learn-factory-floor
    June 13, 2011 - Commentary What doctors can learn from the factory floor. Citation Text: Martyn C. What doctors can learn from the factory floor. BMJ. 2010;340(mar03 3). doi:10.1136/bmj.c1217. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged Pu…
  5. psnet.ahrq.gov/issue/unlabeled-containers-lead-patients-death
    September 26, 2017 - Commentary Unlabeled containers lead to patient's death. Citation Text: Cohen MR, Smetzer JL. Unlabeled containers lead to patient's death. Jt Comm J Qual Patient Saf. 2005;31(7):414-7. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote …
  6. psnet.ahrq.gov/issue/medical-mistakes-are-more-likely-women-and-minorities
    November 01, 2017 - Newspaper/Magazine Article Medical mistakes are more likely in women and minorities. Citation Text: Medical mistakes are more likely in women and minorities. Szabo L. NBC News. January 15, 2024. Copy Citation Save Save to your library Print Download PD…
  7. psnet.ahrq.gov/issue/please-dont-sleep-through-wake-call
    May 07, 2018 - Newspaper/Magazine Article Please don't sleep through this wake-up call. Citation Text: Please don't sleep through this wake-up call. ISMP Medication Safety Alert! Acute Care Edition. May 2, 2001.   Copy Citation Save Save to your library Print …
  8. psnet.ahrq.gov/issue/doctors-fear-criminalization-medical-mistakes
    March 28, 2012 - Newspaper/Magazine Article Doctors fear criminalization of medical mistakes. Citation Text: Doctors fear criminalization of medical mistakes. Sorrel AL. American Medical News. November 27, 2006. Copy Citation Save Save to your library Print Download…
  9. psnet.ahrq.gov/issue/battling-obstetric-malpractice-crisis-improving-patient-safety-part-1
    July 05, 2013 - Commentary Battling the obstetric malpractice crisis: improving patient safety, part 1. Citation Text: Battling the obstetric malpractice crisis: improving patient safety, part 1. Bernstein PS. Medscape Ob/Gyn. October 31, 2005. Copy Citation Save Save to your lib…
  10. psnet.ahrq.gov/issue/2011-annual-benchmarking-report-malpractice-risks-emergency-medicine
    July 18, 2018 - Book/Report 2011 Annual Benchmarking Report: Malpractice Risks in Emergency Medicine.  Citation Text: 2011 Annual Benchmarking Report: Malpractice Risks in Emergency Medicine.  Ruoff G, ed. Cambridge, MA: CRICO Strategies; 2012. Copy Citation Save Save to you…
  11. psnet.ahrq.gov/issue/field-guide-human-error-investigations-third-edition
    April 13, 2018 - Book/Report Classic The Field Guide to Human Error Investigations, Third Edition. Citation Text: The Field Guide to Human Error Investigations, Third Edition. Dekker S. Boca Baton, FL: CRC Press; 2017. Copy Citation Save Save to your libr…
  12. psnet.ahrq.gov/issue/er-doctors-misdiagnose-patients-unusual-symptoms
    August 05, 2008 - Newspaper/Magazine Article ER doctors misdiagnose patients with unusual symptoms. Citation Text: ER doctors misdiagnose patients with unusual symptoms. Abelson R. New York Times. December 15, 2022. Copy Citation Save Save to your library Print Download…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49412/psn-pdf
    September 01, 2003 - Shake Well September 1, 2003 Flynn EA. Shake Well. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/shake-well The Case A 35-year-old patient on the neurology service was receiving carbamazepine for a seizure disorder. Daily serum drug levels consistently fell below the therapeutic range, which led the physi…
  14. psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.188_slideshow.ppt
    November 01, 2008 - Spotlight Case [MONTH] 2003 Spotlight Case November 2008 Dangerous Shift Source and Credits This presentation is based on the November 2008 AHRQ WebM&M Spotlight Case See the full article at http://webmm.ahrq.gov CME credit is available Commentary by: Emily S. Patterson, PhD Institute for Ergonomics, Ohi…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49511/psn-pdf
    May 01, 2006 - Citrate Mix-Up May 1, 2006 Weber RJ. Citrate Mix-Up. PSNet [internet]. 2006. https://psnet.ahrq.gov/web-mm/citrate-mix The Case A 36-year-old woman with multiple sclerosis, diabetes, and chronic renal failure was transferred from a skilled nursing facility (SNF) to the hospital for treatment of an infection. On a…
  16. psnet.ahrq.gov/issue/development-national-reporting-and-learning-system-england-and-wales-2001-2005
    September 14, 2022 - Commentary The development of the National Reporting and Learning System in England and Wales, 2001-2005. Citation Text: Williams SK, Osborn SS. The development of the National Reporting and Learning System in England and Wales, 2001–2005. Med J Aust. 2019;184(S10) (S10):s65-s68. doi:1…
  17. psnet.ahrq.gov/issue/death-inside-lemuel-shattuck-hospital-case-study-medical-treatment-persons-mental-health
    May 03, 2023 - Book/Report Death Inside Lemuel Shattuck Hospital: A Case Study on Medical Treatment for Persons with Mental Health Disabilities. Citation Text: Death Inside Lemuel Shattuck Hospital: A Case Study on Medical Treatment for Persons with Mental Health Disabilities. Massachusetts Protection …
  18. psnet.ahrq.gov/issue/adverse-incidents-patient-flow-and-nursing-workforce-variables-acute-psychiatric-wards
    April 03, 2019 - Study Adverse incidents, patient flow and nursing workforce variables on acute psychiatric wards: the Tompkins Acute Ward Study. Citation Text: Bowers L, Allan T, Simpson A, et al. Adverse incidents, patient flow and nursing workforce variables on acute psychiatric wards: the Tompkins …
  19. psnet.ahrq.gov/issue/development-and-expression-high-reliability-organization
    November 03, 2021 - Commentary Development and expression of a high-reliability organization. Citation Text: Phillips RA, Schwartz RL, Sostman HD, et al. Development and expression of a high-reliability organization. NEJM Catal Innov Care Deliv. 2021;2(12). doi:10.1056/cat.21.0314. Copy Citation Forma…
  20. psnet.ahrq.gov/issue/time-out-analysis
    October 19, 2022 - Commentary Time out: an analysis. Citation Text: Dillon KA. Time out: an analysis. AORN J. 2008;88(3):437-442. doi:10.1016/j.aorn.2008.03.003. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Downloa…

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