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3881. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/60328/psn-pdf
      May 27, 2020 - Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression May 27, 2020 Fazio S, Firestone R. Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression. PSNet [internet]. 2020. https://psnet.ahrq.gov/web-mm/fatal-patient-controlled-analgesia-pca-opioid-induced-respiratory- …

3882. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49733/psn-pdf
      May 01, 2015 - Transitions in Adolescent Medicine May 1, 2015 Okumura MJ, Williams RG. Transitions in Adolescent Medicine. PSNet [internet]. 2015. https://psnet.ahrq.gov/web-mm/transitions-adolescent-medicine The Case A 21-year-old woman with a history of Marfan syndrome complicated by aortic root dilation presented to the emer…

3883. Order Interrupted by Text: Multitasking Mishap | PSNet
      psnet.ahrq.gov/web-mm/order-interrupted-text-multitasking-mishap
      August 21, 2015 - The Case A 56-year-old man with dementia was admitted to an academic medical center from a nursing … home for replacement of a percutaneous endoscopic gastrostomy (PEG) tube, which had become dislodged … The patient survived the operation and ultimately was discharged back to the nursing home after a 3-week

3884. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49519/psn-pdf
      September 01, 2006 - Triple Handoff September 1, 2006 Vidyarthi A. Triple Handoff. PSNet [internet]. 2006. https://psnet.ahrq.gov/web-mm/triple-handoff Case Objectives Appreciate the prevalence of handoffs and sign out related errors. Understand the key elements of a safe and effective written and verbal sign out. List Kotter’s 8 st…

3885. Triple Handoff | PSNet
      psnet.ahrq.gov/web-mm/triple-handoff
      March 01, 2004 - SPOTLIGHT CASE Triple Handoff Citation Text: Vidyarthi A. Triple Handoff. 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 XML EndNote 7 XML Endnote …

3886. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/854897/psn-pdf
      October 31, 2023 - Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose October 31, 2023 Jain NP, Dakwa D. Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/weight-and-…

3887. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/838855/psn-pdf
      October 27, 2022 - False Assumptions Result in a Missed Pneumothorax after Bronchoscopy with Transbronchial Biopsy. October 27, 2022 Kuhn BT, Chau-Etchepare F. False Assumptions Result in a Missed Pneumothorax after Bronchoscopy with Transbronchial Biopsy. PSNet [internet]. 2022. https://psnet.ahrq.gov/web-mm/false-assumptions-resul…

3888. Low on the Totem Pole | PSNet
      psnet.ahrq.gov/web-mm/low-totem-pole
      October 01, 2003 - SPOTLIGHT CASE Low on the Totem Pole Citation Text: Wachter R. Low on the Totem Pole. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 …

3889. Medical Devices in the "Wild" | PSNet
      psnet.ahrq.gov/web-mm/medical-devices-wild
      March 27, 2024 - Medical Devices in the "Wild" Citation Text: Gurses AP, Doyle PA. Medical Devices in the "Wild". 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 …

3890. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49664/psn-pdf
      January 01, 2013 - Empty Handoff September 1, 2012 Goldman A, Catchpole K. Empty Handoff. PSNet [internet]. 2012. https://psnet.ahrq.gov/web-mm/empty-handoff The Case A 29-year-old man with "brittle diabetes" was admitted to the surgery service for incision and drainage of a leg wound. The patient's medical history included chronic…

3891. Consumer Safe Medicine. | PSNet
      psnet.ahrq.gov/issue/ismps-safe-medicine
      January 26, 2023 - Newsletter/Journal Consumer Safe Medicine. Citation Text: Consumer Safe Medicine. Plymouth Meeting, PA; Institute for Safe Medication Practices. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Li…

3892. National Review of Maternity Services in England 2022 to 2024. | PSNet
      psnet.ahrq.gov/issue/national-review-maternity-services-england-2022-2024
      November 13, 2024 - Book/Report National Review of Maternity Services in England 2022 to 2024. Citation Text: National Review Of Maternity Services In England 2022 To 2024. Newcastle Upon Tyne, UK: Care Quality Commission; September 2024. Copy Citation Format: Google Scholar BibTeX EndNote X3 …

3893. How-to Guide: Prevent Obstetrical Adverse Events. | PSNet
      psnet.ahrq.gov/issue/how-guide-prevent-obstetrical-adverse-events
      August 08, 2012 - Book/Report How-to Guide: Prevent Obstetrical Adverse Events. Citation Text: How-to Guide: Prevent Obstetrical Adverse Events. Cambridge, MA: Institute for Healthcare Improvement; 2012. Copy Citation Save Save to your library Print Download PDF …

3894. Harmed Patient Alliance. | PSNet
      psnet.ahrq.gov/issue/harmed-patient-alliance
      October 31, 2018 - Multi-use Website Harmed Patient Alliance. Citation Text: Harmed Patient Alliance. United Kingdom. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL Februar…

3895. Frederick mother's burning inspires daughter's activism. | PSNet
      psnet.ahrq.gov/issue/frederick-mothers-burning-inspires-daughters-activism
      June 24, 2020 - Newspaper/Magazine Article Frederick mother's burning inspires daughter's activism. Citation Text: Frederick mother's burning inspires daughter's activism. Levine S. Copy Citation Save Save to your library Print Download PDF Share Faceboo…

3896. Safety. | PSNet
      psnet.ahrq.gov/issue/safety-0
      March 07, 2018 - Multi-use Website Safety. Citation Text: Safety. Center for Health Design. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL June 15, 2016 Center for Heal…

3897. Evidence of respiratory infection transmission within physician offices could inform outpatient infection control. | PSNet
      psnet.ahrq.gov/issue/evidence-respiratory-infection-transmission-within-physician-offices-could-inform-outpatient
      June 30, 2021 - Study Evidence of respiratory infection transmission within physician offices could inform outpatient infection control. Citation Text: Neprash HT, Sheridan B, Jena AB, et al. Evidence of respiratory infection transmission within physician offices could inform outpatient infection contro…

3898. A "Do No Harm" novel safety checklist and research approach to determine whether to launch an artificial intelligence-based medical technology: introducing the Biological-Psychological, Economic, and Social (BPES) Framework. | PSNet
      psnet.ahrq.gov/issue/do-no-harm-novel-safety-checklist-and-research-approach-determine-whether-launch-artificial
      September 23, 2020 - Commentary A "Do No Harm" novel safety checklist and research approach to determine whether to launch an artificial intelligence-based medical technology: introducing the Biological-Psychological, Economic, and Social (BPES) Framework. Citation Text: Khan WU, Seto E. "Do No Harm" novel s…

3899. Transparency, public reporting, and a culture of change to quality and safety in cardiac surgery. | PSNet
      psnet.ahrq.gov/issue/transparency-public-reporting-and-culture-change-quality-and-safety-cardiac-surgery
      February 17, 2021 - Commentary Transparency, public reporting, and a culture of change to quality and safety in cardiac surgery. Citation Text: Ibrahim M, Szeto WY, Gutsche J, et al. Transparency, public reporting, and a culture of change to quality and safety in cardiac surgery. Ann Thorac Surg. 2022;114(3…

3900. Association between in-clinic opioid administration and discharge opioid prescription in urgent care: a retrospective cohort study. | PSNet
      psnet.ahrq.gov/issue/association-between-clinic-opioid-administration-and-discharge-opioid-prescription-urgent
      May 19, 2021 - Study Association between in-clinic opioid administration and discharge opioid prescription in urgent care: a retrospective cohort study. Citation Text: Calcaterra SL, Lou Y, Everhart RM, et al. Association between in-clinic opioid administration and discharge opioid prescription in urge…