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psnet.ahrq.gov/web-mm/be-picky-about-your-piccs-fragmented-care-and-poor-communication-discharge-leads-picc
July 19, 2023 - availability of specialty vascular access teams, PICC lines carry the potential for increased mortality and morbidity
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psnet.ahrq.gov/web-mm/laceration-needed-proper-exam-not-x-ray
November 25, 2020 - thorough hand examination can lead to missed open or closed tendon injuries often resulting in serious morbidity
-
psnet.ahrq.gov/web-mm/one-got-away-elopement-suicidal-patient-emergency-department
September 27, 2023 - asystolic cardiac arrest secondary to carotid baroreceptor stimulation, all of which may lead to serious morbidity
-
psnet.ahrq.gov/node/72516/psn-pdf
November 25, 2020 - A surgical safety checklist to reduce morbidity and mortality
in a global population.
-
psnet.ahrq.gov/node/838221/psn-pdf
September 28, 2022 - we are designing an intervention that is evidence-based to address
those barriers and key causes of morbidity
-
psnet.ahrq.gov/perspective/conversation-gordon-schiff-md
February 26, 2025 - We have been holding special diagnostic error morbidity and mortality conferences where we're trying
-
psnet.ahrq.gov/perspective/conversation-richard-platt-md-msc
October 01, 2016 - On a societal level, the burden of morbidity is really greatest because the "normal" rate is higher than
-
psnet.ahrq.gov/node/865429/psn-pdf
April 24, 2024 - replacement (AVR) with coronary artery bypass grafting
(CABG) is associated with higher mortality and morbidity
-
psnet.ahrq.gov/node/33861/psn-pdf
July 01, 2018 - We have
been holding special diagnostic error morbidity and mortality conferences where we're trying
-
psnet.ahrq.gov/node/73906/psn-pdf
October 06, 2021 - I do think that one of the ways that we missed severe morbidity and
mortality in the postpartum period
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psnet.ahrq.gov/web-mm/getting-root-matter
September 01, 2005 - Such discussions could take place during an occasional morning report or a morbidity and mortality conference
-
psnet.ahrq.gov/web-mm/importance-following-safe-practices-infant-feeding-and-handling-expressed-breast-milk
January 31, 2024 - Women Should Not Die Giving Life": The lived experiences of Black women diagnosed with severe maternal morbidity
-
psnet.ahrq.gov/sites/default/files/2020-05/final_may-spotlight-fatal_pca_slides_05.01.2020_cme_review-revised.pdf
January 01, 2020 - Spotlight
Spotlight
Fatal PCA Opioid-Induced
Respiratory Depression
Source and Credits
• This presentation is based on the May 2020 AHRQ
WebM&M Spotlight Case
o See the full article at https://psnet.ahrq.gov/webmm
• Commentary by: Sarina Fazio, PhD, RN and Rachelle
Firestone, PharmD, BCCCP
o Editors in Chie…
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psnet.ahrq.gov/web-mm/challenging-case-multiple-suicide-attempts-complex-patient-psychiatric-comorbidities
September 27, 2023 - SPOTLIGHT CASE
Challenging Case of Multiple Suicide Attempts in a Complex Patient with Psychiatric Comorbidities.
Citation Text:
Bourgeois JA, Xiong G. Challenging Case of Multiple Suicide Attempts in a Complex Patient with Psychiatric Comorbidities.. PSNet [internet]. Rockville (MD): Agency for …
-
psnet.ahrq.gov/node/849679/psn-pdf
June 28, 2023 - Under Pressure: Tracheostomy Cuff Over Inflation
Leading to Tissue Necrosis and Cuff Rupture
June 28, 2023
Gould E, Carlsen K, Trask J, et al. Under Pressure: Tracheostomy Cuff Over Inflation Leading to Tissue
Necrosis and Cuff Rupture. PSNet [internet]. 2023.
https://psnet.ahrq.gov/web-mm/under-pressure-tracheost…
-
psnet.ahrq.gov/web-mm/duplicate-therapies-retail-pharmacy
August 05, 2022 - Duplicate Therapies in Retail Pharmacy
Citation Text:
Punatar N, Molla M, Lee S. Duplicate Therapies in Retail Pharmacy. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2023.
Copy Citation
Format:
Google Scholar BibTeX E…
-
psnet.ahrq.gov/perspective/conversation-rosemary-gibson-msc
September 01, 2014 - on patients when there are no blockages, or for most complex back surgeries that result in increased morbidity
-
psnet.ahrq.gov/sites/default/files/2021-02/final_feb_2021_spotlight_delay_in_appropriate_dx.pdf
January 01, 2021 - that require immediate action and
direct communication with providers to avoid death or significant
morbidity
-
psnet.ahrq.gov/node/853774/psn-pdf
September 27, 2023 - medications, such as beta blockers, blunt the response to inflammation and
infection.3 Not surprisingly, morbidity
-
psnet.ahrq.gov/sites/default/files/2025-03/PSNet%20Webinar%20Feb%202025_0.pdf
January 01, 2025 - ;
Simmes 2012; Bucknall 2013; Oglesby 2011; Adelstein 2011)
• This is associated with increased morbidity