-
psnet.ahrq.gov/node/49648/psn-pdf
March 01, 2012 - large telephone follow-up program at a tertiary care medical center with
medical–surgical patients led
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psnet.ahrq.gov/node/33690/psn-pdf
December 01, 2009 - These findings led to a series of studies that
demonstrated that individuals at high risk are more challenged
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psnet.ahrq.gov/node/841305/psn-pdf
January 27, 2023 - About 10 years ago, I was privileged to attend one of the early Resilient Health Care
Network meetings led
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psnet.ahrq.gov/node/74691/psn-pdf
January 01, 2021 - Feedback
following use of the instrument in several settings led to revisions to the tool.
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psnet.ahrq.gov/node/863308/psn-pdf
February 28, 2024 - #18
https://psnet.ahrq.gov//#19
patient suffered from a severe aspiration event, which most likely led
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psnet.ahrq.gov/web-mm/open-wider-failure-use-interpreter-results-fractured-teeth-and-hypoxia-during-simple
January 29, 2021 - The increasing linguistic and cultural diversity of our country has led to the potential for communication
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psnet.ahrq.gov/primer/nursing-and-patient-safety
September 15, 2024 - The strength of these data has led several states, beginning with California in 2004, to establish legislatively
-
psnet.ahrq.gov/node/49807/psn-pdf
October 01, 2017 - The miscommunication led to
patient distress, frustration, and unnecessary visits to the urgent care
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psnet.ahrq.gov/node/49636/psn-pdf
October 01, 2011 - This led to a prolonged intensive care unit (ICU) stay
for respiratory failure from an ischemic cardiac
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psnet.ahrq.gov/web-mm/paroxysmal-supraventricular-tachycardia-masquerading-panic-attacks
September 01, 2017 - disease persists over many years. 17 In this case, premature closure on the diagnosis of “panic attack” led
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psnet.ahrq.gov/web-mm/bad-writing-wrong-medication
March 01, 2015 - In this case, the medication error, a preventable ADE, led to patient harm.
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psnet.ahrq.gov/node/865610/psn-pdf
April 24, 2024 - effectiveness, and
the standard use of the new procedures and interventions from ED-SAFE 1.3 This led
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psnet.ahrq.gov/web-mm/moving-pains
August 17, 2017 - during intrahospital transport of critically ill patients is well described in the literature and has led
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psnet.ahrq.gov/web-mm/delay-treatment-failure-contact-patient-leads-significant-complications
February 01, 2004 - SPOTLIGHT CASE
Delay in Treatment: Failure to Contact Patient Leads to Significant Complications
Citation Text:
Shapiro DS. Delay in Treatment: Failure to Contact Patient Leads to Significant Complications. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Departmen…
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psnet.ahrq.gov/periodic-issue/periodic-issue-291
May 26, 2021 - medically stable, chronic conditions undergoing blood transfusion in a home setting provided by a nurse-led
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psnet.ahrq.gov/periodic-issue/periodic-issue-298
June 30, 2021 - near misses in radiation oncology, a major change in the use of the electronic health record (EHR) led
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psnet.ahrq.gov/web-mm/back-again
November 18, 2016 - attention to the patient's history of fever and injection drug use at the first two visits might well have led
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psnet.ahrq.gov/web-mm/duty-disclose-someone-elses-error
June 01, 2004 - revealed a diagnosis of venous sinus thromboses (blood clots in the veins of the brain), which had led
-
psnet.ahrq.gov/node/846564/psn-pdf
March 29, 2023 - alerts were overridden, only 9.3% of those were
inappropriately overridden, and very few overrides led
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psnet.ahrq.gov/web-mm/lost-start-date-unknown-risk-e-prescribing
December 02, 2020 - difficulty ordering complex medication regimens, inflexible systems, and excessive alerts — these challenges led