-
psnet.ahrq.gov/web-mm/techno-trip
May 01, 2005 - Techno Trip
Citation Text:
Cook RI. Techno Trip. 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 XML Endnote tagged PubMedId RIS
Downlo…
-
psnet.ahrq.gov/web-mm/dont-dismiss-dangerous-obstetric-hemorrhage
August 21, 2024 - SPOTLIGHT CASE
Don't Dismiss the Dangerous: Obstetric Hemorrhage
Citation Text:
Main EK. Don't Dismiss the Dangerous: Obstetric Hemorrhage. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016.
Copy Citation
Format:
…
-
psnet.ahrq.gov/node/857258/psn-pdf
November 30, 2023 - Always Check the Muscle Twitch: Residual
Neuromuscular Block After Removal of a Gastric Balloon
November 30, 2023
Bohringer C, Ashley S. Always Check the Muscle Twitch: Residual Neuromuscular Block After Removal of
a Gastric Balloon. PSNet [internet]. 2023.
https://psnet.ahrq.gov/web-mm/always-check-muscle-twitch-…
-
psnet.ahrq.gov/node/49591/psn-pdf
October 01, 2009 - Difficult Encounters: A CMO and CNO Respond
October 1, 2009
Ring EJ, Hirsch JE. Difficult Encounters: A CMO and CNO Respond. PSNet [internet]. 2009.
https://psnet.ahrq.gov/web-mm/difficult-encounters-cmo-and-cno-respond
Case Objectives
Appreciate the risk of disruptive behavior and understand institutional respons…
-
psnet.ahrq.gov/web-mm/sudden-collapse-during-upper-gastrointestinal-endoscopy-expect-unexpected
September 25, 2024 - Sudden Collapse During Upper Gastrointestinal Endoscopy: Expect the Unexpected
Citation Text:
Wieck M. Sudden Collapse During Upper Gastrointestinal Endoscopy: Expect the Unexpected. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 202…
-
psnet.ahrq.gov/node/865489/psn-pdf
April 03, 2024 - Safety is the preservation of value.
April 3, 2024
Vandeskog B. Safety is the preservation of value. J Safety Res. 2024;89:105-115.
doi:10.1016/j.jsr.2024.02.004.
https://psnet.ahrq.gov/issue/safety-preservation-value
Safety is at the heart of safety science, and yet “safety” lacks a consensus definition among saf…
-
psnet.ahrq.gov/node/36429/psn-pdf
March 28, 2011 - Governing the surgical count through communication
interactions: implications for patient safety.
March 28, 2011
Riley R, Manias E, Polglase A. Governing the surgical count through communication interactions:
implications for patient safety. Qual Saf Health Care. 2006;15(5):369-374.
https://psnet.ahrq.gov/issue/go…
-
psnet.ahrq.gov/node/44789/psn-pdf
April 25, 2016 - Guideline for prevention of retained surgical items.
April 25, 2016
Putnam K. Guideline for prevention of retained surgical items. AORN J. 2015;102(6):P11-P13.
https://psnet.ahrq.gov/issue/guideline-prevention-retained-surgical-items
Retained surgical items are considered a sentinel event in perioperative care. Thi…
-
psnet.ahrq.gov/node/74759/psn-pdf
February 09, 2022 - The challenge of competency assessment of the late-
career practitioner.
February 9, 2022
Steffany M. The challenge of competency assessment of the late?career practitioner. J Healthc Risk
Manag. 2022;41(3):31-38. doi:10.1002/jhrm.21492.
https://psnet.ahrq.gov/issue/challenge-competency-assessment-late-career-prac…
-
psnet.ahrq.gov/node/867145/psn-pdf
November 13, 2024 - Technology, Education and Safety.
November 13, 2024
Technology, Education and Safety. Harbell MW, ed. Curr Opin Anaesthesiol. 2024;37(6):666-742.
https://psnet.ahrq.gov/issue/technology-education-and-safety-3
Despite consummate efforts to improve safety, errors still occur in anesthesiology. This special collection…
-
psnet.ahrq.gov/node/36148/psn-pdf
March 03, 2011 - Surgical crisis management skills training and
assessment: a stimulation-based approach to enhancing
operating room performance.
March 3, 2011
Moorthy K, Munz Y, Forrest D, et al. Surgical Crisis Management Skills Training and Assessment. Ann
Surg. 2006;244(1). doi:10.1097/01.sla.0000217618.30744.61.
https://psne…
-
psnet.ahrq.gov/node/840494/psn-pdf
November 30, 2022 - Safety of anesthetic and perioperative medication
practices.
November 30, 2022
Meyer TA. Anesthesiology News. October 31, 2022.
https://psnet.ahrq.gov/issue/safety-anesthetic-and-perioperative-medication-practices
Medication use in the surgical environment is complex and high-risk. This article describes steps tow…
-
psnet.ahrq.gov/node/40836/psn-pdf
October 12, 2011 - Exploring varieties of knowledge in safe work
practices—an ethnographic study of surgical teams.
October 12, 2011
Høyland S, Aase K, Hollund JG. Exploring varieties of knowledge in safe work practices - an ethnographic
study of surgical teams. Patient Saf Surg. 2011;5:21. doi:10.1186/1754-9493-5-21.
https://psnet.…
-
psnet.ahrq.gov/node/42282/psn-pdf
October 08, 2013 - Flow disruptions in trauma care handoffs.
October 8, 2013
Catchpole K, Gangi A, Blocker RC, et al. Flow disruptions in trauma care handoffs. J Surg Res.
2013;184(1):586-91. doi:10.1016/j.jss.2013.02.038.
https://psnet.ahrq.gov/issue/flow-disruptions-trauma-care-handoffs
Higher acuity trauma patients were more like…
-
psnet.ahrq.gov/node/35976/psn-pdf
August 10, 2010 - Guidelines for prevention, diagnosis and treatment of
ventilator-associated pneumonia (VAP) in the trauma
patient.
August 10, 2010
Minei JP, Nathens AB, West M, et al. Guidelines for prevention, diagnosis and treatment of ventilator-
associated pneumonia (VAP) in the trauma patient. J Trauma. 2006;60(5):1106-1113.…
-
psnet.ahrq.gov/node/43152/psn-pdf
May 07, 2014 - The trainee's voice: recognising the importance of
preoperative briefings for surgical trainees.
May 7, 2014
Bethune R, Blencowe NS. The trainee's voice: recognising the importance of preoperative briefings for
surgical trainees. J Perioper Pract. 2014;24(3):56-58.
https://psnet.ahrq.gov/issue/trainees-voice-recog…
-
psnet.ahrq.gov/node/865820/psn-pdf
May 08, 2024 - Breaking the silence on medical mistakes.
May 8, 2024
Scott M. The Pulse. New York Public Radio; April 26, 2024.
https://psnet.ahrq.gov/issue/breaking-silence-medical-mistakes
Individuals involved in medical errors need time and support to process the incident and its consequences.
This moderated podcast examines …
-
psnet.ahrq.gov/node/42591/psn-pdf
July 16, 2015 - Underreporting of robotic surgery complications.
July 16, 2015
Cooper M, Ibrahim AM, Lyu H, et al. Underreporting of robotic surgery complications. J Healthc Qual.
2015;37(2):133-8. doi:10.1111/jhq.12036.
https://psnet.ahrq.gov/issue/underreporting-robotic-surgery-complications
By cross-referencing court records a…
-
psnet.ahrq.gov/node/43603/psn-pdf
October 15, 2014 - Coaching to improve the quality of communication during
briefings and debriefings.
October 15, 2014
Kleiner C, Link T, Maynard T, et al. Coaching to improve the quality of communication during briefings and
debriefings. AORN J. 2014;100(4):358-68. doi:10.1016/j.aorn.2014.03.012.
https://psnet.ahrq.gov/issue/coachi…
-
psnet.ahrq.gov/node/39556/psn-pdf
May 26, 2010 - Adherence to a medication safety protocol: current
practice for labeling medications and solutions on the
sterile field.
May 26, 2010
Brown-Brumfield D, DeLeon A. Adherence to a medication safety protocol: current practice for labeling
medications and solutions on the sterile field. AORN J. 2010;91(5):610-7. doi:1…