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psnet.ahrq.gov/node/35749/psn-pdf
May 09, 2014 - Chemotherapy dose limits set by users of a computer
order entry system.
May 9, 2014
DuBeshter B; Griggs J; Angel C; Loughner J.
https://psnet.ahrq.gov/issue/chemotherapy-dose-limits-set-users-computer-order-entry-system
To avoid excessive dosing of chemotherapeutic agents, standardized dose limits must be agreed u…
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psnet.ahrq.gov/node/40214/psn-pdf
March 30, 2011 - Can teaching medical students to investigate medication
errors change their attitudes towards patient safety?
March 30, 2011
Dudas RA, Bundy DG, Miller MR, et al. Can teaching medical students to investigate medication errors
change their attitudes towards patient safety? BMJ Qual Saf. 2011;20(4):319-25.
doi:10.11…
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psnet.ahrq.gov/node/38114/psn-pdf
June 29, 2011 - Analysis of overridden alerts in a drug–drug interaction
detection system.
June 29, 2011
Mille F, Schwartz C, Brion F, et al. Analysis of overridden alerts in a drug-drug interaction detection system.
Int J Qual Health Care. 2008;20(6):400-5. doi:10.1093/intqhc/mzn038.
https://psnet.ahrq.gov/issue/analysis-overrid…
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psnet.ahrq.gov/node/45915/psn-pdf
July 19, 2017 - Half the time, nursing homes scrutinized on safety by
Medicare are still treacherous.
July 19, 2017
Rau J. Kaiser Health News. July 6, 2017.
https://psnet.ahrq.gov/issue/half-time-nursing-homes-scrutinized-safety-medicare-are-still-treacherous
System failures contribute to recurring problems in health care environ…
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psnet.ahrq.gov/node/46837/psn-pdf
March 21, 2018 - Drug shortages: effect on parenteral nutrition therapy.
March 21, 2018
Holcombe B, Mattox TW, Plogsted S. Drug Shortages: Effect on Parenteral Nutrition Therapy. Nutr Clin
Pract. 2018;33(1):53-61. doi:10.1002/ncp.10052.
https://psnet.ahrq.gov/issue/drug-shortages-effect-parenteral-nutrition-therapy
Shortages of me…
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/communication-slides.pptx
June 01, 2021 - PowerPoint Presentation
Improving Teamwork and Communication
Long-Term Care
AHRQ Safety Program for Improving Antibiotic Use
AHRQ Pub. No. 17(21)-0029
June 2021
Improving Teamwork
1
Objectives
Recognize the importance of seeking input from all team members when making antibiotic prescribing decisions
Summarize ho…
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digital.ahrq.gov/sites/default/files/docs/page/length-of-stay-quick-reference-guide.pdf
March 01, 2009 - Length of Stay
Length of Stay
This measure allows organizations to systematically
assess the impact of implementing health
information technology (health IT) with the intent
to decrease inpatient length of stay (LOS).
Measure Category: Clinical Outcomes
Quality Domain: Patient Safety; Efficiency
Current Fi…
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psnet.ahrq.gov/node/846170/psn-pdf
March 15, 2023 - The retail
pharmacist recognized that two physicians, a general internist and a cardiologist, had prescribed
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017067-kaushal-final-report-2011.pdf
January 01, 2011 - patients 18-56 years of age who were identified as having persistent
asthma and who were appropriately prescribed … 5 Percentage of patients with HF who also have paroxysmal or chronic atrial fibrillation
who were prescribed … central dual-energy X-ray absorptiometry (DXA) measurement
ordered or performed or pharmacologic therapy prescribed … Repeat Cardiac Studies
4 Generic Prescribing
Of all medications prescribed by a given provider and … 5
Of all medications prescribed by a given provider and filled by patients over a three-month period
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integrationacademy.ahrq.gov/products/playbooks/opioid-use-disorder/implement-mat-for-oud/screening-and-diagnosis
January 01, 2018 - An official website of the Department of Health & Human Services
Search All AHRQ Sites
Careers
Contact Us
Español
FAQs
Email Updates
The Academy
Integrating Behavioral Health & Primary Care
Expand Navi…
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integrationacademy.ahrq.gov/about/initiatives/opioid/grantees/north_carolina
June 01, 2024 - An official website of the Department of Health & Human Services
Search All AHRQ Sites
Careers
Contact Us
Español
FAQs
Email Updates
The Academy
Integrating Behavioral Health & Primary Care
Expand Navi…
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psnet.ahrq.gov/web-mm/citrate-mix
February 01, 2010 - Citrate Mix-Up
Citation Text:
Weber RJ. Citrate Mix-Up. 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 tagged PubMedId RIS
…
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psnet.ahrq.gov/node/49395/psn-pdf
April 01, 2003 - Medication Overdose
April 1, 2003
Kaushal R. Medication Overdose. PSNet [internet]. 2003.
https://psnet.ahrq.gov/web-mm/medication-overdose
The Case
A 15-year-old boy with end-stage AIDS was admitted to the pediatric ICU with mental status changes. He
was diagnosed with status epilepticus and started on a loading…
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psnet.ahrq.gov/node/73102/psn-pdf
July 01, 2022 - is that it puts a trained health coach into the patient’s
home to observe and compile a list of all prescribed
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psnet.ahrq.gov/web-mm/duplicate-insulin-order
May 04, 2012 - Duplicate Insulin Order
Citation Text:
Acquisto NM, Cobaugh DJ. Duplicate Insulin Order. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
Copy Citation
Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endn…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide76.html
October 01, 2014 - 76. For the Patient Who Has Recently Quit (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Addressing problems encountered by former smokers
A patient who previously smoked might identify a problem that negatively affects health or quality of life. Specifi…
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digital.ahrq.gov/ahrq-funded-projects/cancelrx-health-it-tool-decrease-medication-discrepancies-outpatient-setting/final-report
January 01, 2023 - CancelRx: A Health IT Tool to Decrease Medication Discrepancies in the Outpatient Setting - Final Report
Citation
Chui M. CancelRx: A Health IT Tool to Decrease Medication Discrepancies in the Outpatient Setting - Final Report. (Prepared by University of Wisconsin - Madison under Grant No. R21 HS02579…
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psnet.ahrq.gov/node/867754/psn-pdf
March 12, 2025 - Decision fatigue in hospital settings: a scoping review.
March 12, 2025
Perry K, Jones S, Stumpff JC, et al. Decision fatigue in hospital settings: a scoping review. J Hosp Med.
2024;Epub Nov 11. doi:10.1002/jhm.13550.
https://psnet.ahrq.gov/issue/decision-fatigue-hospital-settings-scoping-review
Production pressu…
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psnet.ahrq.gov/node/60186/psn-pdf
April 01, 2020 - Eleven basic procedures/practices for dental patient
safety.
April 1, 2020
Perea-Pérez B, Labajo-González E, Acosta-Gío AE, et al. Eleven basic procedures/practices for dental
patient safety. J Patient Saf. 2020;16(1). doi:10.1097/pts.0000000000000234.
https://psnet.ahrq.gov/issue/eleven-basic-procedurespractices-…
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digital.ahrq.gov/ahrq-funded-projects/health-information-technology-center-education-and-research-therapeutics/final-report
January 01, 2023 - Health Information Technology Center for Education and Research on Therapeutics - Final Report
Citation
Bates D. Health Information Technology Center for Education and Research on Therapeutics - Final Report. (Prepared by Brigham and Women's Hospital under Grant No. U19 HS021094. Rockville, MD: Agency…