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  1. psnet.ahrq.gov/web-mm/hidden-heparins-hit-happens
    March 27, 2024 - SPOTLIGHT CASE Hidden Heparins: HIT Happens Citation Text: Fogarty PF. Hidden Heparins: HIT Happens. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2006. Copy Citation Format: Google Scholar BibTeX EndNote X3…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60542/psn-pdf
    May 27, 2020 - Life-Threatening Infant Overdose of Sodium Chloride May 27, 2020 Hamline M, McGlynn G, Lee A, et al. Life-Threatening Infant Overdose of Sodium Chloride. PSNet [internet]. 2020. https://psnet.ahrq.gov/web-mm/life-threatening-infant-overdose-sodium-chloride The Case  An infant with trisomy 21 underwent repair of a…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49597/psn-pdf
    February 01, 2010 - Adolescent Diabetes: A Routine Visit? February 1, 2010 Slap GB. Adolescent Diabetes: A Routine Visit? PSNet [internet]. 2010. https://psnet.ahrq.gov/web-mm/adolescent-diabetes-routine-visit Case Objectives Appreciate the increasing prevalence of obesity and type 2 diabetes mellitus (T2DM) among adolescents in the…
  4. psnet.ahrq.gov/perspective/conversation-bernardo-perea-perez-md-dds-phd
    August 01, 2016 - In Conversation With… Bernardo Perea-Pérez, MD, DDS, PhD August 1, 2016  Also Read an Essay Citation Text: In Conversation With… Bernardo Perea-Pérez, MD, DDS, PhD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Heal…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49566/psn-pdf
    July 01, 2008 - What Was in Those Platelets? July 1, 2008 Yomtovian R. What Was in Those Platelets? . PSNet [internet]. 2008. https://psnet.ahrq.gov/web-mm/what-was-those-platelets The Case A 47-year-old woman was admitted to the hospital for complex spinal surgery. The surgery went well without complications, and postoperativel…
  6. psnet.ahrq.gov/web-mm/wrong-patients-blood-evaluating-near-miss-wrong-transfusion-event
    July 01, 2017 - SPOTLIGHT CASE “This is the wrong patient's blood!”: Evaluating a Near-Miss Wrong Transfusion Event Citation Text: Barnhard S. “This is the wrong patient's blood!”: Evaluating a Near-Miss Wrong Transfusion Event. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Dep…
  7. psnet.ahrq.gov/web-mm/fatal-twist-pseudohyperkalemia
    February 10, 2021 - SPOTLIGHT CASE A Fatal Twist in Pseudohyperkalemia Citation Text: Devera JL, Barnes DK, Lewis WR. A Fatal Twist in Pseudohyperkalemia. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2024. Copy Citation Format: …
  8. psnet.ahrq.gov/innovation/ambulatory-safety-nets-reduce-missed-and-delayed-diagnoses-cancer
    February 26, 2025 - Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL July 31, 2023 Innovation Contact …
  9. psnet.ahrq.gov/web-mm/ebola-are-we-ready
    July 01, 2012 - Ebola: Are We Ready? Citation Text: Barsuk JH, Barnard C. Ebola: Are We Ready?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2014. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagge…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867022/psn-pdf
    October 30, 2024 - Delayed Symptomatic Subdural Hematoma Following an Initially Normal CT Head October 30, 2024 Martin R, Shahlaie K. Delayed Symptomatic Subdural Hematoma Following an Initially Normal CT Head. PSNet [internet]. 2024. https://psnet.ahrq.gov/web-mm/delayed-symptomatic-subdural-hematoma-following-initially-normal-ct-h…
  11. psnet.ahrq.gov/issue/role-communication-paediatric-drug-safety
    July 08, 2008 - Review The role of communication in paediatric drug safety. Citation Text: Stebbing C, Wong ICK, Kaushal R, et al. The role of communication in paediatric drug safety. Arch Dis Child. 2007;92(5):440-5. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndN…
  12. psnet.ahrq.gov/issue/diagnostic-errors-primary-care-lessons-learned
    September 12, 2011 - Study Diagnostic errors in primary care: lessons learned. Citation Text: Ely JW, Kaldjian LC, D'Alessandro DM. Diagnostic errors in primary care: lessons learned. J Am Board Fam Med. 2012;25(1):87-97. doi:10.3122/jabfm.2012.01.110174. Copy Citation Format: DOI Google Scho…
  13. psnet.ahrq.gov/issue/communication-and-resolution-after-adverse-health-care-incident
    August 01, 2014 - Legislation/Regulation Communication and Resolution After an Adverse Health Care Incident. Citation Text: Communication and Resolution After an Adverse Health Care Incident. Pettersen B, Tate J, Tipper K, McKean H. Colorado Senate Bill 19-201. Copy Citation Save S…
  14. psnet.ahrq.gov/issue/health-care-leader-action-guide-reduce-avoidable-readmissions
    March 14, 2018 - Book/Report Health Care Leader Action Guide to Reduce Avoidable Readmissions. Citation Text: Health Care Leader Action Guide to Reduce Avoidable Readmissions. Osei-Anto A, Joshi M, Audet AJ, Berman A, Jencks SF. New York, NY: The Commonwealth Fund, The John Hartford Foundation, Healt…
  15. psnet.ahrq.gov/issue/beyond-organisational-accident-need-error-wisdom-frontline
    November 18, 2015 - Commentary Beyond the organisational accident: the need for "error wisdom" on the frontline. Citation Text: Reason J. Beyond the organisational accident: the need for "error wisdom" on the frontline. Qual Saf Health Care. 2004;13 Suppl 2:ii28-33. Copy Citation Format: Goo…
  16. psnet.ahrq.gov/issue/national-report-findings-2016-issue-brief-no-2-patient-safety
    November 18, 2020 - Book/Report National Report of Findings 2016: Issue Brief No. 2: Patient Safety. Citation Text: National Report of Findings 2016: Issue Brief No. 2: Patient Safety. Clinical Learning Environment Review. Chicago, IL: Accreditation Council for Graduate Medical Education; 2016. Copy Citat…
  17. psnet.ahrq.gov/issue/junior-doctors-shifts-and-sleep-deprivation
    October 16, 2012 - Commentary Junior doctors' shifts and sleep deprivation. Citation Text: Murray A, Pounder R, Mather H, et al. Junior doctors' shifts and sleep deprivation. BMJ. 2005;330(7505):1404. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote ta…
  18. psnet.ahrq.gov/issue/medication-safety-issue-brief-bar-code-implementation-strategies
    June 17, 2014 - Fact Sheet/FAQs Medication safety issue brief. Bar code implementation strategies. Citation Text: Association AH, Pharmacists AS of H-S, Networks H and H. Medication Safety Issue Brief. Bar Code implementation strategies. Hospitals & health networks. 2005;79(7):65-6. Copy Citation …
  19. psnet.ahrq.gov/issue/insulin-pumps-have-most-reported-problems-fda-database
    October 03, 2018 - Newspaper/Magazine Article Insulin pumps have most reported problems in FDA database. Citation Text: Insulin pumps have most reported problems in FDA database. Mohr H, Weiss M. Associated Press. November 27, 2018. Copy Citation Save Save to your library Prin…
  20. psnet.ahrq.gov/issue/vaught-says-some-system-practices-contributed-fatal-mistake
    September 29, 2021 - Newspaper/Magazine Article RaDonda Vaught says some system practices contributed to fatal mistake. Citation Text: RaDonda Vaught says some system practices contributed to fatal mistake. Clark C. MedPage Today. March 14, 2024. Copy Citation Save Save to…

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