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  1. A piece of my mind. Mistakes. | PSNet

    psnet.ahrq.gov/issue/piece-my-mind-mistakes
    March 19, 2008 - Commentary A piece of my mind. Mistakes. Citation Text: Lesnewski R. A piece of my mind. Mistakes. JAMA. 2006;296(11):1327-8. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Download Citation …

  2. When does quality improvement count as research? Human subject protection and theories of knowledge. | PSNet

    psnet.ahrq.gov/issue/when-does-quality-improvement-count-research-human-subject-protection-and-theories-knowledge
    July 10, 2019 - Commentary When does quality improvement count as research? Human subject protection and theories of knowledge. Citation Text: Lynn J. When does quality improvement count as research? Human subject protection and theories of knowledge. Qual Saf Health Care. 2004;13(1):67-70. Copy Cit…

  3. Diagnostic errors in medicine: a case of neglect. | PSNet

    psnet.ahrq.gov/issue/diagnostic-errors-medicine-case-neglect
    July 15, 2015 - Study Diagnostic errors in medicine: a case of neglect. Citation Text: Graber ML. Diagnostic errors in medicine: a case of neglect. Jt Comm J Qual Patient Saf. 2005;31(2):106-13. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged …

  4. Up Next for Patient Safety. | PSNet

    psnet.ahrq.gov/issue/next-patient-safety
    September 11, 2019 - Audiovisual Presentation Up Next for Patient Safety. Citation Text: National Patient Safety Board. 2021-2023. Copy Citation Save Save to your library Print Share Facebook Twitter Linkedin Copy URL June 9, 2023 …

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33673/psn-pdf
    September 01, 2008 - The Role of Bar Coding and Smart Pumps in Safety September 1, 2008 Rothschild JM, Keohane C. The Role of Bar Coding and Smart Pumps in Safety. PSNet [internet]. 2008. https://psnet.ahrq.gov/perspective/role-bar-coding-and-smart-pumps-safety Perspective Medication safety in hospitals depends on the successful execu…

  6. Procedural Mishap: Learning Curve? | PSNet

    psnet.ahrq.gov/web-mm/procedural-mishap-learning-curve
    April 28, 2021 - Procedural Mishap: Learning Curve? Citation Text: Gibbs VC, Leape L. Procedural Mishap: Learning Curve?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML En…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49736/psn-pdf
    June 01, 2015 - Inflicting Confusion June 1, 2015 Scott FI, Lichtenstein GR. Inflicting Confusion. PSNet [internet]. 2015. https://psnet.ahrq.gov/web-mm/inflicting-confusion The Case A 26-year-old man with recently diagnosed Crohn disease presented to the emergency department with acute-onset abdominal pain, nausea, vomiting, an…

  8. Turn the Other Cheek | PSNet

    psnet.ahrq.gov/web-mm/turn-other-cheek
    October 26, 2010 - Turn the Other Cheek Citation Text: Starling J. Turn the Other Cheek. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2012. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId…

  9. An Untimely End Despite End-of-Life Care Planning | PSNet

    psnet.ahrq.gov/web-mm/untimely-end-despite-end-life-care-planning
    February 01, 2012 - An Untimely End Despite End-of-Life Care Planning Citation Text: Elia G, Barbour S, Anderson WG. An Untimely End Despite End-of-Life Care Planning. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018. Copy Citation Format: …

  10. Too Hot For Comfort | PSNet

    psnet.ahrq.gov/web-mm/too-hot-comfort
    May 19, 2015 - Too Hot For Comfort Citation Text: Cleland H, Wasiak J. Too Hot For Comfort. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged P…

  11. Bowel Prep | PSNet

    psnet.ahrq.gov/web-mm/bowel-prep
    March 01, 2017 - Bowel Prep Citation Text: Nelson D. Bowel Prep. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2004. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Downloa…

  12. Is the Admission Drug Dose Too Low? | PSNet

    psnet.ahrq.gov/web-mm/admission-drug-dose-too-low
    September 01, 2011 - Is the Admission Drug Dose Too Low? Citation Text: Kaushal R, Abramson EL. Is the Admission Drug Dose Too Low?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2009. Copy Citation Format: Google Scholar BibTeX EndNote X3…

  13. Transition to Nowhere | PSNet

    psnet.ahrq.gov/web-mm/transition-nowhere
    March 21, 2009 - Transition to Nowhere Citation Text: Farrell TW. Transition to Nowhere. 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 XML EndNote 7 XML Endnote tagged PubMed…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33832/psn-pdf
    April 01, 2017 - In Conversation With… Kathleen Sutcliffe, MN, PhD April 1, 2017 In Conversation With… Kathleen Sutcliffe, MN, PhD. PSNet [internet]. 2017. https://psnet.ahrq.gov/perspective/conversation-kathleen-sutcliffe-mn-phd Editor's note: Professor Sutcliffe is a Bloomberg Distinguished Professor of Business and Medicine at …

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49397/psn-pdf
    May 01, 2003 - The Dropped Lung May 1, 2003 Heffner JR. The Dropped Lung. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/dropped-lung The Case A 79-year-old woman was admitted for hypoxia and shortness of breath. Two weeks prior she had been hospitalized for dyspnea and was found to have multiple bilateral pulmonary nodu…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73335/psn-pdf
    May 26, 2021 - Hyponatremia Secondary to Home Parenteral Nutrition Error May 26, 2021 Haas K, Lee A. Hyponatremia Secondary to Home Parenteral Nutrition Error. PSNet [internet]. 2021. https://psnet.ahrq.gov/web-mm/hyponatremia-secondary-home-parenteral-nutrition-error The Case A 4-year-old (former 33-week premature) boy with a …

  17. Spotlight (pdf file)

    psnet.ahrq.gov/sites/default/files/2022-12/spotlight_case_strongyloides_final_11.21.22.pdf
    January 01, 2022 - Spotlight Spotlight Strongyloides: A Hidden Traveler and Potentially Lethal Missed Diagnosis Source and Credits • This presentation is based on the November 2022 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahrq.gov/webmm o CME credit is available o Commentary by: Narath Carlile MD MPH,…

  18. PowerPoint Presentation (ppt file)

    psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.347_slideshow.ppt
    May 01, 2015 - PowerPoint Presentation Spotlight Errors in Sepsis Management This presentation is based on the May 2015 AHRQ WebM&M Spotlight Case See the full article at http://webmm.ahrq.gov CME credit is available Commentary by: David Shimabukuro, MD, University of California, San Francisco (UCSF) Editor, AHRQ WebM&M: Rober…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837658/psn-pdf
    July 08, 2022 - Preventable Transfer to the Hospital July 8, 2022 Agrawal G, Kashkouli P, Bakerjian D. Preventable Transfer to the Hospital. PSNet [internet]. 2022. https://psnet.ahrq.gov/web-mm/preventable-transfer-hospital The Case A 78-year-old veteran with dementia-associated aggressive behavior and multiple comorbidities had…

  20. Adverse events from cough and cold medications after a market withdrawal of products labeled for infants. | PSNet

    psnet.ahrq.gov/issue/adverse-events-cough-and-cold-medications-after-market-withdrawal-products-labeled-infants
    August 02, 2015 - Study Adverse events from cough and cold medications after a market withdrawal of products labeled for infants. Citation Text: Shehab N, Schaefer MK, Kegler SR, et al. Adverse events from cough and cold medications after a market withdrawal of products labeled for infants. Pediatrics. 20…
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