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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.230_slideshow.ppt
December 01, 2010 - Spotlight Case July 2008
Spotlight Case
The Forgotten Turn
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Source and Credits
This presentation is based on the December 2010
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Susan Barbour, RN, FNP, University of California San Francisco …
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psnet.ahrq.gov/node/49563/psn-pdf
May 01, 2008 - Is It Safe to Be Direct?
May 1, 2008
Kulkarni NS, Williams M. Is It Safe to Be Direct? PSNet [internet]. 2008.
https://psnet.ahrq.gov/web-mm/it-safe-be-direct
The Case
A 92-year-old man with hypertension and heart failure (HF) was evaluated by his primary care physician
(PCP) for progressive shortness of breat…
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psnet.ahrq.gov/node/49721/psn-pdf
December 01, 2014 - Ebola: Are We Ready?
December 1, 2014
Barsuk JH, Barnard C. Ebola: Are We Ready? PSNet [internet]. 2014.
https://psnet.ahrq.gov/web-mm/ebola-are-we-ready
The Case
A 28-year-old man, well-appearing but pale, walked into the emergency department (ED) on a Wednesday
afternoon at 3 PM complaining of nausea, vomiting,…
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psnet.ahrq.gov/web-mm/patient-safety-events-involving-opioid-dose-stacking
July 08, 2022 - SPOTLIGHT CASE
Patient Safety Events Involving Opioid Dose Stacking
Citation Text:
Porras H, Lammers C. Patient Safety Events Involving Opioid Dose Stacking. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022.
Copy Cita…
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psnet.ahrq.gov/issue/quality-initiative-system-wide-reduction-serious-medication-events-through-targeted
April 10, 2024 - Study
A quality initiative: a system-wide reduction in serious medication events through targeted simulation training.
Citation Text:
Hebbar KB, Colman N, Williams L, et al. A Quality Initiative: A System-Wide Reduction in Serious Medication Events Through Targeted Simulation Training. S…
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psnet.ahrq.gov/issue/how-can-task-shifting-put-patient-safety-risk-qualitative-study-experiences-among-general
December 14, 2022 - Study
How can task shifting put patient safety at risk? A qualitative study of experiences among general practitioners in Norway.
Citation Text:
Malterud K, Aamland A, Fosse A. How can task shifting put patient safety at risk? A qualitative study of experiences among general practitioner…
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psnet.ahrq.gov/issue/what-does-safety-mental-healthcare-transitions-mean-service-users-and-other-stakeholder
February 02, 2022 - Study
What does safety in mental healthcare transitions mean for service users and other stakeholder groups: an open-ended questionnaire study.
Citation Text:
Tyler N, Wright N, Panagioti M, et al. What does safety in mental healthcare transitions mean for service users and other stakeho…
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psnet.ahrq.gov/issue/supporting-carers-improve-patient-safety-and-maintain-their-well-being-transitions-mental
May 31, 2023 - Study
Supporting carers to improve patient safety and maintain their well-being in transitions from mental health hospitals to the community: a prioritisation nominal group technique.
Citation Text:
McMullen S, Panagioti M, Planner C, et al. Supporting carers to improve patient safety an…
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psnet.ahrq.gov/issue/rapid-response-systems-antibiotic-stewardship-and-medication-reconciliation-scoping-review
March 18, 2020 - Review
Rapid response systems, antibiotic stewardship and medication reconciliation: a scoping review on implementation factors, activities and outcomes.
Citation Text:
Ohlsen JT, Søfteland E, Akselsen PE, et al. Rapid response systems, antibiotic stewardship and medication reconciliatio…
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psnet.ahrq.gov/issue/risk-covid-19-related-bullying-harassment-and-stigma-among-healthcare-workers-analytical
April 25, 2016 - Study
Risk of COVID-19-related bullying, harassment and stigma among healthcare workers: an analytical cross-sectional global study.
Citation Text:
Dye TD, Alcantara L, Siddiqi S, et al. Risk of COVID-19-related bullying, harassment and stigma among healthcare workers: an analytical cros…
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psnet.ahrq.gov/issue/healthcare-fragmentation-multimorbidity-potentially-inappropriate-medication-and-mortality
April 12, 2019 - Study
Healthcare fragmentation, multimorbidity, potentially inappropriate medication, and mortality: a Danish nationwide cohort study.
Citation Text:
Prior A, Vestergaard CH, Vedsted P, et al. Healthcare fragmentation, multimorbidity, potentially inappropriate medication, and mortality: …
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psnet.ahrq.gov/issue/interventions-reduce-adverse-drug-event-related-outcomes-older-adults-systematic-review-and
July 19, 2023 - Review
Emerging Classic
Interventions to reduce adverse drug event-related outcomes in older adults: a systematic review and meta-analysis.
Citation Text:
Tecklenborg S, Byrne C, Cahir C, et al. Interventions to Reduce Adverse Drug Event-Related Outcomes in Olde…
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psnet.ahrq.gov/issue/associations-person-related-environment-related-and-communication-related-factors-medication
January 19, 2022 - Study
Associations of person-related, environment-related and communication-related factors on medication errors in public and private hospitals: a retrospective clinical audit.
Citation Text:
Manias E, Street M, Lowe G, et al. Associations of person-related, environment-related and comm…
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psnet.ahrq.gov/issue/decreased-incidence-cesarean-surgical-site-infection-rate-hospital-wide-perioperative-bundle
September 08, 2021 - Study
Decreased incidence of cesarean surgical site infection rate with hospital-wide perioperative bundle.
Citation Text:
Sood N, Lee RE, To JK, et al. Decreased incidence of cesarean surgical site infection rate with hospital‐wide perioperative bundle. Birth. 2022;49(1):141-146. doi:10…
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psnet.ahrq.gov/issue/implementation-and-impact-rapid-response-team-childrens-hospital
April 24, 2018 - Study
Implementation and impact of a rapid response team in a children's hospital.
Citation Text:
Zenker P, Schlesinger A, Hauck M, et al. Implementation and impact of a rapid response team in a children's hospital. Jt Comm J Qual Patient Saf. 2007;33(7):418-425.
Copy Citation
Fo…
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psnet.ahrq.gov/issue/optimizing-patient-safety-clinical-trials-improving-transitions-care
October 16, 2024 - Study
Optimizing patient safety in clinical trials by improving transitions of care.
Citation Text:
Nair SC, Satish KP, Al Maini M, et al. Optimizing patient safety in clinical trials by improving transitions of care. Jt Comm J Qual Patient Saf. 2020;46(4). doi:10.1016/j.jcjq.2020.01.001…
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psnet.ahrq.gov/issue/provider-risk-factors-medication-administration-error-alerts-analyses-large-scale-closed-loop
September 01, 2016 - Study
Provider risk factors for medication administration error alerts: analyses of a large-scale closed-loop medication administration system using RFID and barcode.
Citation Text:
Hwang Y, Yoon D, Ahn EK, et al. Provider risk factors for medication administration error alerts: analyses…
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psnet.ahrq.gov/issue/learning-during-crisis-impact-covid-19-hospital-acquired-pressure-injury-incidence
August 25, 2021 - Study
Learning during crisis: the impact of COVID-19 on hospital-acquired pressure injury incidence.
Citation Text:
Polancich S, Hall AG, Miltner RS, et al. Learning during crisis: the impact of COVID-19 on hospital-acquired pressure injury incidence. J Healthc Qual. 2021;43(3):137-144. …
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psnet.ahrq.gov/web-mm/delirium-or-dementia
September 27, 2023 - Consequences of preventing delirium in hospitalized older adults on nursing home costs.
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psnet.ahrq.gov/node/49536/psn-pdf
May 01, 2007 - On the Other Hand
May 1, 2007
Henneman EA. On the Other Hand. PSNet [internet]. 2007.
https://psnet.ahrq.gov/web-mm/other-hand
The Case
A young woman with Takayasu's arteritis presented to the hospital with severe abdominal pain. The patient
had been diagnosed with Takayasu's a decade earlier. The disease results…