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psnet.ahrq.gov/issue/when-doing-wrong-feels-so-right-normalization-deviance
September 03, 2011 - Review
When doing wrong feels so right: normalization of deviance.
Citation Text:
Price MR, Williams TC. When Doing Wrong Feels So Right: Normalization of Deviance. J Patient Saf. 2018;14(1):1-2. doi:10.1097/PTS.0000000000000157.
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DOI Google Scholar Pub…
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psnet.ahrq.gov/issue/impact-age-anaesthesiologists-competence-narrative-review
December 15, 2014 - Review
Impact of age on anaesthesiologists' competence: a narrative review.
Citation Text:
Giacalone M, Zaouter C, Mion S, et al. Impact of age on anaesthesiologists' competence: A narrative review. Eur J Anaesthesiol. 2016;33(11):787-793.
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Google Schol…
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www.ahrq.gov/patient-safety/reports/candor-demo-program/plan-grants/findings.html
August 01, 2022 - the establishment of the Massachusetts Alliance for Communication and Resolution following Medical Injury … evidence-based medical guidelines addressing clinical situations that result in significant numbers of patient injuries
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/misuse-prescription-protocol.pdf
September 13, 2024 - applicable
• Outcome
o Short-term
Overdoses, fatal and non-fatal
Health measures (cardiovascular, injuries … certainty on the association of prescription stimulant
misuse with each consequence (i.e., overdose injury
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psnet.ahrq.gov/web-mm/lack-sepsis-recognition-leads-delay-care-following-cesarean-delivery
November 30, 2021 - Her subsequent, lengthy hospitalization was notable for multiple wound debridements, rehabilitation, … The precipitating causes include breaches of skin or mucosa, non-penetrating soft tissue injuries, and … infections: absence of fever, absence of cutaneous manifestations, attributing severe pain to a recent injury … had a knowledge deficit with respect to NF, as this diagnosis is much more common in the setting of trauma
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psnet.ahrq.gov/web-mm/spotlight-overdiagnosis-and-delay-challenges-sepsis-diagnosis
October 28, 2020 - Laboratory test results revealed a mildly elevated white count, acute kidney injury, and elevated liver … elevated white blood cell count) and end-organ dysfunction (elevated liver function tests, acute kidney injury … Sight
August 1, 2009
WebM&M Cases
Missing Trauma
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psnet.ahrq.gov/web-mm/copy-and-paste-notes-and-autopopulated-text-electronic-health-record
May 26, 2021 - On hospital day 2, the primary trauma surgery team ordered magnetic resonance imaging (MRI) of the brain … These studies, completed on hospital day 6, showed no evidence of traumatic or hypoxic brain injury and … no vertebral or ligamentous injury; the radiologist noted “minimal cervical spine epidural blood or
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psnet.ahrq.gov/node/49609/psn-pdf
October 01, 2010 - The quality indicators include identification of medical
injuries and medical errors. … Falls and fall-related injuries in older dialysis patients.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/engage/engagement.pptx
May 01, 2017 - Program for Perinatal Care
Patient & Family
16
Engaging After Adverse Events
An adverse event is an injury … Victim: Health Care Workers7
Health care workers involved in an adverse event experience their own trauma … Many hospitals have developed employee assistance programs and medically induced trauma support services
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digital.ahrq.gov/sites/default/files/docs/resource/PCC_Lapane_Q2_Focus_Groups_Consent_Form.pdf
June 16, 2021 - If you have any questions pertinent to this study, or this study causes you any injury, you
should call
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effectivehealthcare.ahrq.gov/sites/default/files/toc.pdf
January 01, 2007 - Evaluation and Overview
of the National Electronic Injury Surveillance System- Cooperative Adverse
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.25_slideshow.ppt
July 01, 2003 - with uncertain outcomes
i.e., successful cardiac resuscitation with resultant severe anoxic brain injury
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.2_slideshow.ppt
February 01, 2003 - Neuromuscular blockade overdose
Aminoglycosides or intravenous magnesium
Neurological impairment or injury
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www.ahrq.gov/news/newsletters/e-newsletter/920.html
July 01, 2024 - Epidemiology and clinical outcomes of community-acquired acute kidney injury in the emergency department
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digital.ahrq.gov/2020-year-review/research-summary/supporting-clinicians-improve-decision-making-and-patients-care
January 01, 2020 - applied to other conditions commonly seen in the PICU, such as venous thromboembolism and traumatic brain injury
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digital.ahrq.gov/ahrq-funded-projects/development-clinical-decision-support-tool-facilitating-naturalistic-decision
January 01, 2023 - conditions in the PICU, such as venous thromboembolism, acute respiratory distress syndrome, traumatic brain injury
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www.ahrq.gov/news/newsletters/e-newsletter/955.html
April 01, 2025 - of on-pump versus off-pump coronary surgical revascularization related to postoperative acute kidney injury
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psnet.ahrq.gov/node/33588/psn-pdf
March 15, 2025 - health care providers who are involved in an unanticipated
adverse event, medical error, or patient injury
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psnet.ahrq.gov/node/33578/psn-pdf
September 15, 2024 - anesthesia were integral to the redesign of anesthesia equipment, significantly reducing the risk of injury
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www.uspreventiveservicestaskforce.org/uspstf/document/draft-research-plan/cognitive-impairment-older-adults
March 06, 2025 - diagnosed with depression or psychosis, alcohol use disorder, HIV/AIDS, Down syndrome, posttraumatic brain injury