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psnet.ahrq.gov/web-mm/double-dose-transfer
November 01, 2012 - Double Dose at Transfer
Citation Text:
Hackman JL. Double Dose at Transfer. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2012.
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psnet.ahrq.gov/web-mm/patient-allergies-and-electronic-health-records
August 21, 2005 - Patient Allergies and Electronic Health Records
Citation Text:
Doyle MJ. Patient Allergies and Electronic Health Records. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
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Format:
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psnet.ahrq.gov/node/33735/psn-pdf
August 01, 2012 - Medication Safety in Nursing Homes: What's Wrong and
How to Fix It
August 1, 2012
Gurwitz JH. Medication Safety in Nursing Homes: What's Wrong and How to Fix It. PSNet [internet]. 2012.
https://psnet.ahrq.gov/perspective/medication-safety-nursing-homes-whats-wrong-and-how-fix-it
Perspective
At any point in time, …
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psnet.ahrq.gov/node/49581/psn-pdf
March 21, 2009 - Double Dosing, by the Rules
March 21, 2009
Cohen H. Double Dosing, by the Rules. PSNet [internet]. 2009.
https://psnet.ahrq.gov/web-mm/double-dosing-rules
The Case
A 65-year-old woman with rheumatoid arthritis and chronic obstructive pulmonary disease (COPD) was
admitted to a medical unit during the night with wo…
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psnet.ahrq.gov/node/49866/psn-pdf
June 01, 2019 - If You Say So: Taking a Syringe at Face Value in the
Operating Room
June 1, 2019
Lyndon A, Lim S. If You Say So: Taking a Syringe at Face Value in the Operating Room. PSNet [internet].
2019.
https://psnet.ahrq.gov/web-mm/if-you-say-so-taking-syringe-face-value-operating-room
The Case
A 43-year-old woman was admi…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.284_slideshow.ppt
November 01, 2012 - Spotlight Case July 2008
Spotlight Case
Transfusion Overload
1
2
Source and Credits
This presentation is based on the November 2012
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Manish S. Patel, MD, and Jeffrey L. Carson, MD, of UMDNJ−Robert Wood …
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psnet.ahrq.gov/node/49488/psn-pdf
August 21, 2005 - PCA Overdose
August 21, 2005
Doyle JD. PCA Overdose. PSNet [internet]. 2005.
https://psnet.ahrq.gov/web-mm/pca-overdose
The Case
A 49-year-old woman underwent an uneventful total abdominal hysterectomy bilateral salpingo-
oophorectomy. Postoperatively, the patient complained of severe pain and received intravenou…
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psnet.ahrq.gov/node/49420/psn-pdf
October 01, 2003 - To LP or Not LP
October 1, 2003
Landrigan CP. To LP or Not LP. PSNet [internet]. 2003.
https://psnet.ahrq.gov/web-mm/lp-or-not-lp
The Case
A 4-month-old male infant was seen in the office setting of a large multisite practice. He presented with
fever and irritability without an obvious source. He was referred to …
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www.ahrq.gov/hai/tools/ambulatory-surgery/sections/sustainability/management/visual-fac-notes.html
June 01, 2017 - Module 5: Visual Management - Facilitator Notes
Slide 1: Management Practices for Sustainability Module 5: Visual Management
Say:
As mentioned in the module on huddles, the frontline management system used to promote sustained, controlled standard work that ensures patient safety relies on several interlo…
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psnet.ahrq.gov/node/49477/psn-pdf
April 01, 2005 - Hold the tPA
April 1, 2005
Fagan SC. Hold the tPA. PSNet [internet]. 2005.
https://psnet.ahrq.gov/web-mm/hold-tpa
The Case
A 74-year-old woman with a history of atrial fibrillation on warfarin therapy came to the emergency
department (ED) 1 hour after the sudden onset of aphasia and right-sided weakness. A non-co…
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psnet.ahrq.gov/node/49634/psn-pdf
September 01, 2011 - Situational (Un)Awareness
September 1, 2011
Abramson EL, Kaushal R. Situational (Un)Awareness. PSNet [internet]. 2011.
https://psnet.ahrq.gov/web-mm/situational-unawareness
The Case
A 75-year-old man was admitted on a Tuesday evening with abdominal pain, jaundice, and elevated liver
function tests, including a bi…
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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/import/webmm.ahrq.gov.230_slideshow.ppt
December 01, 2010 - Spotlight Case July 2008
Spotlight Case
The Forgotten Turn
*
*
Source and Credits
This presentation is based on the December 2010
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Susan Barbour, RN, FNP, University of California San Francisco …
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www.uspreventiveservicestaskforce.org/uspstf/published-comment-and-response-comparing-uspstf-and-grade-approaches-recommendations
February 01, 2014 - Published Comment and Response: Comparing the USPSTF and GRADE Approaches to Recommendations
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Print
First published as a Letter to the Editor in Annals of Internal Medicine 151(5)…
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psnet.ahrq.gov/node/33579/psn-pdf
September 15, 2024 - Systems Approach
September 15, 2024
Systems Approach. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/systems-approach
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the patient safety field. Last reviewed in …
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/prostate-cancer-surveillance_disposition-comments.pdf
December 01, 2011 - An Evidence Review of Active Surveillance in Men with Localized Prostate Cancer
Source: http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-
reports/?productid=859&pageaction=displayproduct
Published Online: December 2011
Comparative Effectiveness Research Review Disposition …
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/cystic-fibrosis-hgh_surveillance.pdf
August 01, 2012 - CER # 23:
Effectiveness of Recombinant Human Growth Hormone (rhGH)
in the Treatment of Patients with Cystic Fibrosis
Original release date:
October 2010
Surveillance Report 1st Assessment: November, 2011
Surveillance Report 2nd Assessment: August 2012
Key Findings 1st Assessment:
• All conclusions for KQ…
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/3w8Wr9wwAyAqUJWmJo_bL-
February 01, 2014 - Risk Assessment, Genetic Counseling, and Genetic Testing for
BRCA-Related Cancer in Women: A Systematic Review to Update
the U.S. Preventive Services Task Force Recommendation
Heidi D. Nelson, MD, MPH; Miranda Pappas, MA; Bernadette Zakher, MBBS; Jennifer Priest Mitchell, BA; Leila Okinaka-Hu, MD;
and Rongwei Fu, PhD
…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressureulcertoolkit/putoolssect7.docx
February 16, 2011 - Section 7. Tools and Resources
0A: Introductory Executive Summary for Stakeholders
1A: Clinical Staff Attitudes Towards Pressure Ulcer Prevention
1B: Stakeholder Analysis
1C: Leadership Support Assessment
1D: Business Case Form
1E: Resource Needs Assessment
2A: Multidisciplinary Team
2B: Quality Improvement Process
2C…
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/k-btyK4W2-v9KnemTK8WDx
September 14, 2021 - Screening for Chlamydial and Gonococcal Infections: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
(Reprinted)
Clinical Review & Education
JAMA | US Preventive Services Task Force | EVIDENCE REPORT
Screening for Chlamydial and Gonococcal Infections
Updated Evidence Repor…