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psnet.ahrq.gov/node/49504/psn-pdf
March 01, 2006 - Is there significant recovery monitoring equipment?
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psnet.ahrq.gov/web-mm/missing-ecg-and-missed-diagnosis-lead-dangerous-delay
March 01, 2015 - She was subsequently admitted to the inpatient telemetry floor for overnight monitoring.
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psnet.ahrq.gov/node/836978/psn-pdf
May 16, 2022 - psnet.ahrq.gov/web-mm/complications-ecmo-during-transport
as unintended discontinuation of pulse oximetry monitoring
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psnet.ahrq.gov/node/33693/psn-pdf
February 01, 2010 - They
also recommended improvements to the culture of safety through error detection, reporting, and
monitoring
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psnet.ahrq.gov/node/49625/psn-pdf
May 01, 2011 - the
OR, with preparation being made to move the patient to the transport gurney, disconnection of monitoring
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psnet.ahrq.gov/web-mm/finding-fault-default-alert
August 28, 2024 - to Reduce Alert Fatigue To ensure that computerized alerts remain relevant and effective, ongoing monitoring
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psnet.ahrq.gov/web-mm/situational-awareness-and-patient-safety
May 01, 2012 - Beyond monitoring: distributed situation awareness in anaesthesia. Br J Anaesth. 2010;105:83-90.
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psnet.ahrq.gov/perspective/handoffs-and-transitions
February 01, 2007 - most commonly due to nonadherence or underuse, untreated medical problems, and lack of therapeutic monitoring
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psnet.ahrq.gov/web-mm/medication-reconciliation-pitfalls
May 01, 2006 - October 26, 2010
Assessing and monitoring override medications in automated dispensing
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psnet.ahrq.gov/web-mm/inadvertent-castration
October 27, 2010 - supreme commander,' with sole responsibility for the safe functioning of the team, with some indirect monitoring
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psnet.ahrq.gov/web-mm/waiting-too-long
February 01, 2013 - Shortly afterward, fetal heart rate monitoring suggested fetal distress and the patient was transferred
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psnet.ahrq.gov/web-mm/superficial-report-leads-deep-problem
July 01, 2012 - January 11, 2023
Monitoring the diagnostic process on an inpatient neurology service.
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psnet.ahrq.gov/perspective/role-graduate-medical-education-gme-improving-patient-safety
February 01, 2010 - They also recommended improvements to the culture of safety through error detection, reporting, and monitoring
-
psnet.ahrq.gov/perspective/conversation-withthomas-j-nasca-md
February 01, 2010 - They also recommended improvements to the culture of safety through error detection, reporting, and monitoring
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psnet.ahrq.gov/webmm-case-studies
March 25, 2025 - Events
(157)
Administration Errors
(64)
Dispensing Errors
(27)
Monitoring
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psnet.ahrq.gov/sites/default/files/2024-05/spotlight_case_hindsight_is_2020_slides_final_revised_05.03.2024.pdf
January 01, 2024 - • The patient was admitted to the intensive care unit (ICU) for close
monitoring.
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psnet.ahrq.gov/perspective/health-care-data-science-quality-improvement-and-patient-safety
October 01, 2016 - Related Resources
Perspective
Surveillance Monitoring
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psnet.ahrq.gov/node/33757/psn-pdf
October 01, 2013 - Safety in Radiology
October 1, 2013
Pinto A. Safety in Radiology. PSNet [internet]. 2013.
https://psnet.ahrq.gov/perspective/safety-radiology
Perspective
The use of medical imaging to depict and to help diagnose illness and injury as well as to guide therapeutic
interventions has expanded greatly during the past …
-
psnet.ahrq.gov/node/49416/psn-pdf
September 01, 2003 - Check the Bags
September 1, 2003
Caldwell M, Dracup KA. Check the Bags. PSNet [internet]. 2003.
https://psnet.ahrq.gov/web-mm/check-bags
The Case
A 50-year-old man with new atrial fibrillation was placed on a diltiazem drip in the emergency department
for rate control. After arriving at the cardiac care unit (CCU…
-
psnet.ahrq.gov/node/49410/psn-pdf
July 01, 2003 - A Little Shuteye
July 1, 2003
Farion KJ. A Little Shuteye. PSNet [internet]. 2003.
https://psnet.ahrq.gov/web-mm/little-shuteye
The Case
A 3-year-old boy was seen in urgent care for a superficial laceration above the left eyebrow. The
pediatrician had heard of the availability of topical skin adhesive that can be…