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  1. Saline Flush Leads to Acute Paralysis of an Awake Patient: Risks of Improper Medication Labeling in an Operating Room | PSNet

    psnet.ahrq.gov/web-mm/saline-flush-leads-acute-paralysis-awake-patient-risks-improper-medication-labeling
    February 01, 2019 - Saline Flush Leads to Acute Paralysis of an Awake Patient: Risks of Improper Medication Labeling in an Operating Room Citation Text: Kriss RS. Saline Flush Leads to Acute Paralysis of an Awake Patient: Risks of Improper Medication Labeling in an Operating Room. PSNet [internet]. Rockville (MD): Agency for H…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72693/psn-pdf
    January 29, 2021 - Unintentional Ketamine Overdose in the Operating Room – Mixing Up the Ampules January 29, 2021 Bohringer C. Unintentional Ketamine Overdose in the Operating Room – Mixing Up the Ampules. PSNet [internet]. 2021. https://psnet.ahrq.gov/web-mm/unintentional-ketamine-overdose-operating-room-mixing-ampules The Case A…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50927/psn-pdf
    February 21, 2020 - Patient Safety in Primary Care February 21, 2020 Schiff G, Hall KK, Fitall E. Patient Safety in Primary Care. PSNet [internet]. 2020. https://psnet.ahrq.gov/perspective/patient-safety-primary-care Introduction A strong primary care system is foundational to achieving high-quality, accessible, efficient healthcare …

  4. Febrile Neutropenia and an Almost Fatal Medication Error | PSNet

    psnet.ahrq.gov/web-mm/febrile-neutropenia-and-almost-fatal-medication-error
    February 01, 2012 - Febrile Neutropenia and an Almost Fatal Medication Error Citation Text: Faig J, Zerillo JA. Febrile Neutropenia and an Almost Fatal Medication Error. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018. Copy Citation Format: …

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49719/psn-pdf
    September 01, 2014 - No BP During NIBP September 1, 2014 Görges M, Ansermino MJ. No BP During NIBP. PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/no-bp-during-nibp The Case An otherwise healthy 49-year-old man with atrial fibrillation was scheduled for ablation in the catheterization laboratory under general endotracheal anes…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/846975/psn-pdf
    March 28, 2023 - Specialized departments, like emergency departments and pediatrics, may not focus on the mother, conduct

  7. EHR Copy and Paste and Patient Safety | PSNet

    psnet.ahrq.gov/perspective/ehr-copy-and-paste-and-patient-safety
    January 01, 2018 - Dean, MD Chief Medical Information Officer–UW Health Associate Professor of Pediatrics University of … Wisconsin School of Medicine and Public Health Department of Pediatrics Division of Hospital Medicine

  8. Intubation Mishap | PSNet

    psnet.ahrq.gov/web-mm/intubation-mishap
    April 26, 2023 - SPOTLIGHT CASE Intubation Mishap Citation Text: Weinger MB, Blike G. Intubation Mishap. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote …

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49800/psn-pdf
    July 01, 2017 - The Hidden Harms of Hand Sanitizer July 1, 2017 Stewart S. The Hidden Harms of Hand Sanitizer. PSNet [internet]. 2017. https://psnet.ahrq.gov/web-mm/hidden-harms-hand-sanitizer The Case A 57-year-old woman with a history of alcohol abuse and severe depression was admitted to the hospital for community-acquired pn…

  10. Medical liability and patient safety: setting the proper course. | PSNet

    psnet.ahrq.gov/issue/medical-liability-and-patient-safety-setting-proper-course
    January 12, 2011 - Commentary Medical liability and patient safety: setting the proper course. Citation Text: Pearlman MD, Gluck PA. Medical liability and patient safety: setting the proper course. Obstet Gynecol. 2005;105(5 Pt 1):941-943. Copy Citation Format: Google Scholar PubMed BibTeX …

  11. Excusable neglect in malpractice suits against radiologists: a proposed jury instruction to recognize the human condition. | PSNet

    psnet.ahrq.gov/issue/excusable-neglect-malpractice-suits-against-radiologists-proposed-jury-instruction-recognize
    April 11, 2011 - Commentary Excusable neglect in malpractice suits against radiologists: a proposed jury instruction to recognize the human condition. Citation Text: Excusable neglect in malpractice suits against radiologists: a proposed jury instruction to recognize the human condition. Caldwell C; …

  12. Medication errors. | PSNet

    psnet.ahrq.gov/issue/medication-errors
    August 21, 2018 - Commentary Medication errors. Citation Text: Medication errors. Hartigan-Go K. Int J Risk Safety Med. 2006;18(3):181-186. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy UR…

  13. ARV medication errors: experience of a community-based HIV specialty clinic and review of the literature. | PSNet

    psnet.ahrq.gov/issue/arv-medication-errors-experience-community-based-hiv-specialty-clinic-and-review-literature
    March 29, 2010 - Study ARV medication errors: experience of a community-based HIV specialty clinic and review of the literature. Citation Text: ARV medication errors: experience of a community-based HIV specialty clinic and review of the literature. Cocohoba J; Dong BJ. Copy Citation S…

  14. Contemporary View of Medication-Related Harm. A New Paradigm. | PSNet

    psnet.ahrq.gov/issue/contemporary-view-medication-related-harm-new-paradigm
    July 20, 2012 - Tools/Toolkit Contemporary View of Medication-Related Harm. A New Paradigm. Citation Text: Contemporary View of Medication-Related Harm. A New Paradigm. National Coordinating Council for Medication Error Reporting and Prevention; NCCMERP. Copy Citation Save Save t…

  15. Patient Safety Indicators Overview. | PSNet

    psnet.ahrq.gov/issue/patient-safety-indicators-overview
    December 24, 2008 - Measurement Tool/Indicator Classic Patient Safety Indicators Overview. Citation Text: Patient Safety Indicators Overview. Agency for Healthcare Research and Quality Copy Citation Save Save to your library Print Download PDF …

  16. IHI Global Trigger Tool for Measuring Adverse Events. 2nd Edition. | PSNet

    psnet.ahrq.gov/issue/ihi-global-trigger-tool-measuring-adverse-events-2nd-edition
    January 09, 2019 - Measurement Tool/Indicator Classic IHI Global Trigger Tool for Measuring Adverse Events. 2nd Edition. Citation Text: IHI Global Trigger Tool for Measuring Adverse Events. 2nd Edition. Griffin FA, Resar RK. IHI Innovation Series white paper. Cambridge, MA: Instit…

  17. Inadvertent Administration of an Oral Liquid Medicine into a Vein. | PSNet

    psnet.ahrq.gov/issue/inadvertent-administration-oral-liquid-medicine-vein
    January 22, 2020 - Book/Report Inadvertent Administration of an Oral Liquid Medicine into a Vein. Citation Text: Inadvertent Administration of an Oral Liquid Medicine into a Vein. Farnborough, UK; Healthcare Safety Investigation Branch: April 2019. Copy Citation Save Save to your …

  18. Blame: what does it look like? | PSNet

    psnet.ahrq.gov/issue/blame-what-does-it-look
    February 02, 2022 - Commentary Blame: what does it look like? Citation Text: Duthie EA. Blame: What does it look like? Nurs Manage. 2018;49(11):18-21. doi:10.1097/01.NUMA.0000547256.76967.9e. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged Pub…

  19. Polypharmacy. | PSNet

    psnet.ahrq.gov/issue/polypharmacy-0
    October 09, 2013 - Special or Theme Issue Polypharmacy. Citation Text: Polypharmacy. Schneider E, Koretz BK, eds. Clin Geriatr Med. 2022;38(4):621-732. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin …

  20. Profiles in patient safety: authority gradients in medical error. | PSNet

    psnet.ahrq.gov/issue/profiles-patient-safety-authority-gradients-medical-error
    August 28, 2019 - Review Profiles in patient safety: authority gradients in medical error. Citation Text: Cosby K, Croskerry P. Profiles in patient safety: authority gradients in medical error. Acad Emerg Med. 2004;11(12):1341-5. Copy Citation Format: Google Scholar PubMed BibTeX EndNote …
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