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psnet.ahrq.gov/node/44324/psn-pdf
September 09, 2015 - Prevalence, nature, severity and risk factors for
prescribing errors in hospital inpatients: prospective
study in 20 UK hospitals.
September 9, 2015
Ashcroft DM, Lewis PJ, Tully MP, et al. Prevalence, Nature, Severity and Risk Factors for Prescribing
Errors in Hospital Inpatients: Prospective Study in 20 UK Hospit…
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psnet.ahrq.gov/node/47671/psn-pdf
January 01, 2019 - Racial, ethnic, and socioeconomic disparities in patient
safety events for hospitalized children.
December 19, 2018
Stockwell DC, Landrigan CP, Toomey SL, et al. Racial, Ethnic, and Socioeconomic Disparities in Patient
Safety Events for Hospitalized Children. Hosp Pediatr. 2019;9(1):1-5. doi:10.1542/hpeds.2018-0131…
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psnet.ahrq.gov/perspective/strengthening-business-case-patient-safety
May 01, 2013 - Has pay-for-performance decreased access for minority patients? Health Serv Res. 2010;45:6-23. … Here we see much clearer evidence that minority patients and poor patients are much more likely to be … Institutions located in communities with a high proportion of minority and poor patients are much more … are some pretty reasonable fixes there, including accounting for the proportion of poor patients or minority
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psnet.ahrq.gov/perspective/conversation-ashish-k-jha-md-mph
May 01, 2013 - Here we see much clearer evidence that minority patients and poor patients are much more likely to be … Institutions located in communities with a high proportion of minority and poor patients are much more … are some pretty reasonable fixes there, including accounting for the proportion of poor patients or minority … Has pay-for-performance decreased access for minority patients? Health Serv Res. 2010;45:6-23.
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psnet.ahrq.gov/node/33586/psn-pdf
December 15, 2024 - Alert Fatigue
December 15, 2024
Alert Fatigue. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/alert-fatigue
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the patient safety field. Last reviewed in 2024.
Bac…
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psnet.ahrq.gov/node/43865/psn-pdf
May 01, 2015 - Computerised physician order entry-related medication
errors: analysis of reported errors and vulnerability
testing of current systems.
May 1, 2015
Schiff GD, Amato MG, Eguale T, et al. Computerised physician order entry-related medication errors:
analysis of reported errors and vulnerability testing of current sy…
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psnet.ahrq.gov/node/73873/psn-pdf
September 29, 2021 - There is an app for that: mobile technology improves
complication reporting and resident perception of their
role in patient safety
September 29, 2021
Johnson CR, Noorzad A, Pujari A, et al. There is an app for that: mobile technology improves complication
reporting and resident perception of their role in patient…
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psnet.ahrq.gov/web-mm/translating-normal-abnormal
October 02, 2019 - federal funding must provide meaningful language assistance to LEP populations.( 3 ) The Office of Minority … Rockville, MD: US Department of Health and Human Services, Office of Minority Health.
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psnet.ahrq.gov/node/49444/psn-pdf
May 01, 2004 - Do Me a Favor
May 1, 2004
Williamson A. Do Me a Favor. PSNet [internet]. 2004.
https://psnet.ahrq.gov/web-mm/do-me-favor
The Case
A 26-year-old gravida 4 para 1 woman reported that her last menstrual period was 5 weeks prior, and she
had a positive home pregnancy test. With a history of one ectopic pregnancy, one…
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psnet.ahrq.gov/issue/investigators-find-hospital-error-caused-mothers-death-brooklyn
February 01, 2023 - Newspaper/Magazine Article
Investigators find hospital error caused mother’s death in Brooklyn.
Citation Text:
Investigators find hospital error caused mother’s death in Brooklyn. Goldstein J. New York Times. January 14, 2024.
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psnet.ahrq.gov/issue/early-warnings-weak-signals-and-learning-healthcare-disasters
February 28, 2024 - Commentary
Early warnings, weak signals and learning from healthcare disasters.
Citation Text:
Macrae C. Early warnings, weak signals and learning from healthcare disasters. BMJ Qual Saf. 2014;23(6):440-5. doi:10.1136/bmjqs-2013-002685.
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DOI Google Scho…
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psnet.ahrq.gov/issue/science-interruption
September 04, 2024 - Commentary
The science of interruption.
Citation Text:
Coiera E. The science of interruption. BMJ Qual Saf. 2012;21(5):357-60. doi:10.1136/bmjqs-2012-000783.
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Format:
DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS
…
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psnet.ahrq.gov/issue/cyberattack-unitedhealth-still-impacting-prescription-access-these-are-threats-life
March 21, 2024 - Newspaper/Magazine Article
Cyberattack on UnitedHealth still impacting prescription access: "These are threats to life".
Citation Text:
Cyberattack on UnitedHealth still impacting prescription access: "These are threats to life". Sganga N, Triay A. CBS Evening News. February 29, 2024.
…
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psnet.ahrq.gov/primer/alert-fatigue
March 15, 2025 - Alert Fatigue
Citation Text:
Alert Fatigue. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS
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psnet.ahrq.gov/web-mm/hidden-heparins-hit-happens
March 27, 2024 - Although HIT antibodies are detectable in most of these patients, thrombocytopenia is present in only a minority … Skin lesions occur in a minority of patients with HIT but increase the probability of the diagnosis in
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.191_slideshow.ppt
January 01, 2009 - Spotlight Case July 2008
Spotlight Case January 2009
To Transfer or Not to Transfer
Source and Credits
This presentation is based on the January 2009
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Jesse M. Pines, MD, MBA, MSCE
University o…
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psnet.ahrq.gov/node/49869/psn-pdf
July 02, 2019 - Failure to Rescue the Mother
July 2, 2019
Vivero A, Klapper EB, Gregory KD, et al. Failure to Rescue the Mother. PSNet [internet]. 2019.
https://psnet.ahrq.gov/web-mm/failure-rescue-mother
The Case
A 27-year-old woman, G5 P2 A2, was first admitted to the hospital at 25 weeks of pregnancy for vaginal
bleeding. An …
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psnet.ahrq.gov/issue/dr-google-meets-its-match-dr-chatgpt
May 24, 2023 - Newspaper/Magazine Article
‘Dr. Google’ meets its match: Dr. ChatGPT.
Citation Text:
‘Dr. Google’ meets its match: Dr. ChatGPT. Leonard A. KFF Health News. September 12, 2023.
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psnet.ahrq.gov/issue/survey-ohio-regulator-shows-stress-fatigue-among-pharmacists-chain-stores
November 09, 2022 - Newspaper/Magazine Article
Survey by Ohio regulator shows stress, fatigue among pharmacists at chain stores.
Citation Text:
Survey by Ohio regulator shows stress, fatigue among pharmacists at chain stores. Kaplan A. NBC News. April 21, 2021.
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psnet.ahrq.gov/issue/walgreens-will-stop-judging-its-pharmacy-staffers-how-fast-they-work
May 05, 2021 - Newspaper/Magazine Article
Walgreens will stop judging its pharmacy staffers by how fast they work.
Citation Text:
Walgreens will stop judging its pharmacy staffers by how fast they work. Kaplan A. NBC News. October 27, 2022.
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