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  1. psnet.ahrq.gov/perspective/conversation-rebecca-lawton-phd
    March 24, 2025 - In Conversation With… Rebecca Lawton, PhD September 1, 2018  Citation Text: In Conversation With… Rebecca Lawton, PhD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018. Copy Citation …
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49786/psn-pdf
    March 01, 2017 - Consequences of Medical Overuse March 1, 2017 Morgan DJ, Foy AJ. Consequences of Medical Overuse. PSNet [internet]. 2017. https://psnet.ahrq.gov/web-mm/consequences-medical-overuse Case Objectives Define overuse and overdiagnosis. State how much of all care is estimated to be overuse. Describe why the likelihood…
  3. psnet.ahrq.gov/web-mm/when-lytes-go-out-case-inpatient-cardiac-arrest
    February 01, 2023 - SPOTLIGHT CASE When the Lytes Go Out: A Case of Inpatient Cardiac Arrest Citation Text: Stripe B, Zuidema D. When the Lytes Go Out: A Case of Inpatient Cardiac Arrest . PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2020.…
  4. www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/103-how-to-integrate-cusp-approach-periop-fg.docx
    April 01, 2025 - AHRQ Safety Program for MRSA Prevention: Targeting SSI How To Integrate a Comprehensive Unit-based Safety Program (CUSP) Approach in the Perioperative Setting Surgical Services For: Cardiac, Hip and Knee Joint Replacement, and Spinal Fusion Surgeries Slide Title and Commentary Slide Number and Slide How To Integ…
  5. www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/sustainability-plan.pdf
    June 01, 2021 - Guide to Sustainability Planning: Long-Term Care Facilities AHRQ Safety Program for Improving Antibiotic Use Guide to Sustainability Planning: Long-Term Care Facilities Sustainability Planning 2 AHRQ Safety Program for Improving Antibiotic Use – Long-Term Care Introduction Johns Hopkins Medicine and NOR…
  6. www.ahrq.gov/hai/tools/mvp/modules/technical/head-bed-elevation-lit-review.html
    January 01, 2017 - Head of Bed Elevation or Semirecumbent Positioning Literature Review AHRQ Safety Program for Mechanically Ventilated Patients Summary The elevation of the head of bed (HOB) to a semirecumbent position (at least 30 degrees) is associated with a decreased incidence of aspiration and ventilator-ass…
  7. www.ahrq.gov/es/patient-safety/settings/hospital/resource/pressureulcer/tool/pu1.html
    October 01, 2014 - Preventing Pressure Ulcers in Hospitals 1. Are we ready for this change? Previous Page Next Page Table of Contents Preventing Pressure Ulcers in Hospitals Overview Key Subject Area Index 1. Are we ready for this change? 2. How will we manage change? 3. What are the best practices in pressu…
  8. Safemed Facguide (doc file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/medication/safemed_facguide.docx
    May 01, 2017 - AHRQ Safety Program for Perinatal Care Safe Medication Administration Safe Medication Administration SAY: The Safe Medication Administration bundle provides information on high-alert medications commonly used in labor and delivery (L&D) units, and discusses the importance of implementing safeguards for their administ…
  9. www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/medication/safe-medication-fac-guide.html
    July 01, 2023 - Safe Medication Administration: Facilitator Guide AHRQ Safety Program for Perinatal Care Slide 1: Safe Medication Administration Say: The Safe Medication Administration bundle provides information on high-alert medications commonly used in labor and delivery (L&D) units, and discusses the importance of …
  10. www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/156-what-are-4es.pptx
    October 01, 2024 - AHRQ Safety Program for MRSA Prevention AHRQ Safety Program for MRSA Prevention What Are the 4 Es? ICU/Non-ICU AHRQ Pub. No. 25-0007 October 2024 AHRQ Safety Program for MRSA Prevention | ICU & Non-ICU What Are The Four Es 1 Educational Objectives Define the 4 Es framework—Engage, Educate, Execute, Evaluate—and ex…
  11. psnet.ahrq.gov/web-mm/hemorrhagic-shock-after-elective-spine-surgery-failure-rescue-after-limited-response-nursing
    October 31, 2023 - SPOTLIGHT CASE Hemorrhagic Shock after Elective Spine Surgery: Failure to Rescue after Limited Response to Nursing Concerns. Citation Text: Zakaluzny S. Hemorrhagic Shock after Elective Spine Surgery: Failure to Rescue after Limited Response to Nursing Concerns.. PSNet [internet]. Rockville (MD):…
  12. effectivehealthcare.ahrq.gov/sites/default/files/pdf/breast-biopsy-update_espanol.pdf
    February 01, 2017 - Having a Breast Biopsy: A Review of the Research for Women and Their Families e Si tiene que hacerse una biopsia del seno: Revisión de las investigaciones para mujeres y sus familias � ¿Es esta información apropiada para mí? Esta información es apropiada para usted si: � Es mujer. La información de este r…
  13. meps.ahrq.gov/data_files/publications/st113/stat113.shtml
    January 01, 2006 - STATISTICAL BRIEF #113: Children's Dental Care: Periodicity of Checkups and Access to Care, 2003   Skip to main content An official website of the Department of Health & Human Services More …
  14. psnet.ahrq.gov/web-mm/medication-errors-retail-pharmacies-wrong-patient-wrong-instructions
    March 19, 2019 - Medication Errors in Retail Pharmacies: Wrong Patient, Wrong Instructions. Citation Text: Li C, Marquez K. Medication Errors in Retail Pharmacies: Wrong Patient, Wrong Instructions.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 202…
  15. psnet.ahrq.gov/web-mm/medication-safety-events-related-diagnostic-imaging
    January 26, 2022 - Medication Safety Events Related to Diagnostic Imaging Citation Text: Sanchez L, Porras H, Lammers C. Medication Safety Events Related to Diagnostic Imaging. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022. Copy Citation Fo…
  16. www.ahrq.gov/sites/default/files/2025-06/nishisaki3-report.pdf
    January 01, 2025 - Final Progress Report: Improving the safety of pediatric tracheal intubation in ICUs with apneic oxygenation and video laryngoscopes Title: Improving the safety of pediatric tracheal intubation in ICUs with apneic oxygenation and video laryngoscopes Principal Investigator: Akira Nishisaki, MD, MSCE Co-Investigator…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49519/psn-pdf
    September 01, 2006 - Triple Handoff September 1, 2006 Vidyarthi A. Triple Handoff. PSNet [internet]. 2006. https://psnet.ahrq.gov/web-mm/triple-handoff Case Objectives Appreciate the prevalence of handoffs and sign out related errors. Understand the key elements of a safe and effective written and verbal sign out. List Kotter’s 8 st…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73642/psn-pdf
    August 25, 2021 - Sudden Collapse During Upper Gastrointestinal Endoscopy: Expect the Unexpected August 25, 2021 Wieck M. Sudden Collapse During Upper Gastrointestinal Endoscopy: Expect the Unexpected. PSNet [internet]. 2021. https://psnet.ahrq.gov/web-mm/sudden-collapse-during-upper-gastrointestinal-endoscopy-expect- unexpected …
  19. psnet.ahrq.gov/web-mm/deaths-not-foretold-are-unexpected-deaths-useful-patient-safety-signals
    March 01, 2004 - Deaths Not Foretold: Are Unexpected Deaths Useful Patient Safety Signals? Citation Text: Shojania KG. Deaths Not Foretold: Are Unexpected Deaths Useful Patient Safety Signals?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007. C…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/840174/psn-pdf
    August 28, 2024 - Missed CANDOR Implementation Opportunities. November 16, 2022 Schweitzer L. Missed CANDOR Implementation Opportunities. PSNet [internet]. 2022. https://psnet.ahrq.gov/web-mm/missed-candor-implementation-opportunities The Case A 58-year-old man with a history of type 2 diabetes mellitus, hypertension, morbid obesit…