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  1. psnet.ahrq.gov/curated-library/diagnostic-safety-improvement
    September 01, 2025 - Breadcrumb Home The PSNet Collection Curated Libraries Subscribed Diagnostic Safety Improvement  Download  Share Facebook Twitter Linkedin Copy URL Subscribe Created By: Lorri Zipperer, Cybrarian, AHRQ PSNe…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49392/psn-pdf
    April 01, 2003 - Another Fall April 1, 2003 Bogardus SG. Another Fall. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/another-fall Case Objectives List risk factors for falls in hospitalized patients Understand appropriate use of restraints Identify system issues contributing to falls in hospitalized patients Case & Comm…
  3. psnet.ahrq.gov/web-mm/nurse-staffing-ratios-crucible-money-policy-research-and-patient-care
    June 01, 2003 - SPOTLIGHT CASE Nurse Staffing Ratios: The Crucible of Money, Policy, Research, and Patient Care Citation Text: Rich V. Nurse Staffing Ratios: The Crucible of Money, Policy, Research, and Patient Care. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of H…
  4. psnet.ahrq.gov/web-mm/challenging-case-multiple-suicide-attempts-complex-patient-psychiatric-comorbidities
    September 27, 2023 - SPOTLIGHT CASE Challenging Case of Multiple Suicide Attempts in a Complex Patient with Psychiatric Comorbidities. Citation Text: Bourgeois JA, Xiong G. Challenging Case of Multiple Suicide Attempts in a Complex Patient with Psychiatric Comorbidities.. PSNet [internet]. Rockville (MD): Agency for …
  5. psnet.ahrq.gov/perspective/conversation-witheric-g-poon-md-mph
    September 01, 2008 - In Conversation with…Eric G. Poon, MD, MPH September 1, 2008  Also Read an Essay Citation Text: In Conversation with…Eric G. Poon, MD, MPH. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 20…
  6. psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.68_slideshow.ppt
    July 01, 2004 - Spotlight Case [MONTH] 2003 Spotlight Case July 2004 Preventing Inappropriate Use of Novel Therapeutic Agents Source and Credits This presentation is based on the July 2004 AHRQ WebM&M Spotlight Case in Critical Care Medicine See the full article at http://webmm.ahrq.gov CME credit is available through the W…
  7. psnet.ahrq.gov/web-mm/late-anemia-following-rh-disease-newborn
    June 17, 2010 - Late Anemia Following Rh Disease in a Newborn Citation Text: Newman TB, Maisels JM. Late Anemia Following Rh Disease in a Newborn. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2014. Copy Citation Format: Google Schola…
  8. psnet.ahrq.gov/web-mm/discontinued-medications-are-they-really-discontinued
    January 05, 2017 - Discontinued Medications: Are They Really Discontinued? Citation Text: Mankey CG, Varkey P. Discontinued Medications: Are They Really Discontinued?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2014. Copy Citation Format: …
  9. psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.152_slideshow.ppt
    June 01, 2007 - Spotlight Case [MONTH] 2003 Spotlight Case June 2007 Beeline to Spine Source and Credits This presentation is based on June 2007 AHRQ WebM&M Spotlight Case See full article at http://webmm.ahrq.gov CME credit is available online Commentary by: Gerald W. Smetana, MD, Harvard Medical School, Beth Israel D…
  10. Spotlight (pdf file)

    psnet.ahrq.gov/sites/default/files/2022-10/spotlight_case_missed_pneumothorax_10.09.2022_-_final.pdf
    January 01, 2022 - Spotlight Spotlight False Assumptions Result in a Missed Pneumothorax after Bronchoscopy with Transbronchial Biopsy Source and Credits • This presentation is based on the September 2022 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahrq.gov/webmm o CME credit is available o Commentary by:…
  11. psnet.ahrq.gov/sites/default/files/2024-06/spotlight_case_hemorrhagic_shock_slides_final.pptx
    January 01, 2024 - Spotlight Spotlight Hemorrhagic Shock after Elective Spine Surgery: Failure to Rescue after Limited Response to Nursing Concerns 1 Source and Credits This presentation is based on the July 2024 AHRQ WebM&M Spotlight Case See the full article at https://psnet.ahrq.gov/webmm  CME credit is available  Commentary …
  12. psnet.ahrq.gov/web-mm/wrongful-resuscitation
    October 12, 2012 - The Wrongful Resuscitation Citation Text: Teno JM. The Wrongful Resuscitation. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2008. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged…
  13. psnet.ahrq.gov/web-mm/fluidity-diagnostic-wet-reads
    April 24, 2018 - The Fluidity of Diagnostic "Wet Reads" Citation Text: Lee CS, Hess CP. The Fluidity of Diagnostic "Wet Reads". PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016. Copy Citation Format: Google Scholar BibTeX EndNote X3 …
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/848037/psn-pdf
    April 26, 2023 - A cluster randomized trial of two implementation strategies to deliver audit and feedback in the EQUIPPED medication safety program. April 26, 2023 Vaughan CP, Burningham Z, Kelleher JL, et al. A cluster?randomized trial of two implementation strategies to deliver audit and feedback in the EQUIPPED medication safe…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43161/psn-pdf
    December 12, 2014 - Burnout in the NICU setting and its relation to safety culture. December 12, 2014 Profit J, Sharek PJ, Amspoker AB, et al. Burnout in the NICU setting and its relation to safety culture. BMJ Qual Saf. 2014;23(10):806-813. doi:10.1136/bmjqs-2014-002831. https://psnet.ahrq.gov/issue/burnout-nicu-setting-and-its-rela…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41223/psn-pdf
    March 21, 2012 - High-profile investigations into hospital safety problems in England did not prompt patients to switch providers. March 21, 2012 Laverty AA, Smith PC, Pape UJ, et al. High-profile investigations into hospital safety problems in England did not prompt patients to switch providers. Health Aff (Millwood). 2012;31(3):5…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46068/psn-pdf
    July 09, 2018 - A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites. July 9, 2018 Adelman JS, Berger MA, Rai A, et al. A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites. J Am Med In…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38612/psn-pdf
    May 06, 2009 - Assessing controlled substance prescribing errors in a pediatric teaching hospital: an analysis of the safety of analgesic prescription practice in the transition from the hospital to home. May 6, 2009 Lee BH, Lehmann CU, Jackson E, et al. Assessing controlled substance prescribing errors in a pediatric teaching …
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46178/psn-pdf
    December 22, 2017 - Evaluating serial strategies for preventing wrong-patient orders in the NICU. December 22, 2017 Adelman JS, Aschner JL, Schechter CB, et al. Evaluating Serial Strategies for Preventing Wrong-Patient Orders in the NICU. Pediatrics. 2017;139(5). doi:10.1542/peds.2016-2863. https://psnet.ahrq.gov/issue/evaluating-ser…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42946/psn-pdf
    January 07, 2015 - Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two 'early adopter' hospitals. January 7, 2015 Cresswell K, Bates DW, Williams R, et al. Evaluation of medium-term consequences of implementing commercial compu…

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