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  1. Potential inaccuracy of electronically transmitted medication history information used for medication reconciliation. | PSNet

    psnet.ahrq.gov/issue/potential-inaccuracy-electronically-transmitted-medication-history-information-used
    December 15, 2021 - Press Release/Announcement Potential inaccuracy of electronically transmitted medication history information used for medication reconciliation. Citation Text: Potential inaccuracy of electronically transmitted medication history information used for medication reconciliation. Nati…

  2. Building a Culture of Patient Safety: Report of the Commission on Patient Safety and Quality Assurance. | PSNet

    psnet.ahrq.gov/issue/building-culture-patient-safety-report-commission-patient-safety-and-quality-assurance
    November 10, 2011 - Book/Report Building a Culture of Patient Safety: Report of the Commission on Patient Safety and Quality Assurance. Citation Text: Building a Culture of Patient Safety: Report of the Commission on Patient Safety and Quality Assurance. Dublin, Ireland: Department of Health & Childre…

  3. Medical Residents and Burnout | PSNet

    psnet.ahrq.gov/issue/medical-residents-and-burnout
    June 01, 2022 - Special or Theme Issue Medical Residents and Burnout Citation Text: Medical Residents and Burnout Coverdale J, West CP, Roberts LW, eds. Acad Med. 2021;96(5):611-769;e14-e21. Copy Citation Save Save to your library Print Download PDF Share…

  4. The vanishing nonforensic autopsy. | PSNet

    psnet.ahrq.gov/issue/vanishing-nonforensic-autopsy
    February 09, 2011 - Commentary The vanishing nonforensic autopsy. Citation Text: Shojania KG, Burton EC. The vanishing nonforensic autopsy. N Engl J Med. 2008;358(9):873-5. doi:10.1056/NEJMp0707996. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote …

  5. Obstetric Care Consensus No. 5: Severe Maternal Morbidity: Screening and Review. | PSNet

    psnet.ahrq.gov/issue/obstetric-care-consensus-no-5-severe-maternal-morbidity-screening-and-review
    August 20, 2018 - Organizational Policy/Guidelines Obstetric Care Consensus No. 5: Severe Maternal Morbidity: Screening and Review. Citation Text: Obstetric Care Consensus No. 5: Severe Maternal Morbidity: Screening and Review. Obstet Gynecol. 2016;128(3):e54-60. doi:10.1097/AOG.0000000000001642. Copy C…

  6. Electronically Generated Medication Administration and Electronic Medication Administration Records for the Prevention of Medication Transcription Errors: Review of Clinical Effectiveness and Safety. | PSNet

    psnet.ahrq.gov/issue/electronically-generated-medication-administration-and-electronic-medication-administration
    May 25, 2016 - Book/Report Electronically Generated Medication Administration and Electronic Medication Administration Records for the Prevention of Medication Transcription Errors: Review of Clinical Effectiveness and Safety. Citation Text: Electronically Generated Medication Administration and Electr…

  7. Perfusion safety: new initiatives and enduring principles. | PSNet

    psnet.ahrq.gov/issue/perfusion-safety-new-initiatives-and-enduring-principles
    July 19, 2023 - Commentary Perfusion safety: new initiatives and enduring principles. Citation Text: Kurusz M. Perfusion safety: new initiatives and enduring principles. Perfusion. 2011;26 Suppl 1:6-14. doi:10.1177/0267659110393389. Copy Citation Format: DOI Google Scholar PubMed BibTeX …

  8. Independent double checks: worth the effort if used judiciously and properly. | PSNet

    psnet.ahrq.gov/issue/independent-double-checks-worth-effort-if-used-judiciously-and-properly
    January 23, 2019 - Newspaper/Magazine Article Independent double checks: worth the effort if used judiciously and properly. Citation Text: Independent double checks: worth the effort if used judiciously and properly. ISMP Medication Safety Alert! Acute Care Edition. June 6, 2019;24:1-7. Copy Citation …

  9. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. 2nd ed. | PSNet

    psnet.ahrq.gov/issue/improvement-guide-practical-approach-enhancing-organizational-performance-2nd-ed
    November 29, 2017 - Book/Report Classic The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. 2nd ed. Citation Text: The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. 2nd ed. Langley GJ, Moen R, Nolan KM, et al. Ho…

  10. Structural and organizational issues in patient safety: a comparison of health care to other high-hazard industries. | PSNet

    psnet.ahrq.gov/issue/structural-and-organizational-issues-patient-safety-comparison-health-care-other-high-hazard
    February 09, 2011 - Commentary Classic Structural and organizational issues in patient safety: a comparison of health care to other high-hazard industries. Citation Text: Structural and organizational issues in patient safety: a comparison of health care to other high-hazard indust…

  11. Microsoft PowerPoint - Spotlight Case_The Risks of a Malpositioned Gastrostomy Tube_FINAL.pptx (pdf file)

    psnet.ahrq.gov/sites/default/files/2023-11/spotlight_case_the_risk_of_malpositioned.pdf
    January 01, 2023 - Microsoft PowerPoint - Spotlight Case_The Risks of a Malpositioned Gastrostomy Tube_FINAL.pptx Spotlight The Risks of a Malpositioned Gastrostomy Tube and Poor Communication Source and Credits • This presentation is based on the November 2023 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahr…

  12. Engaging Seriously Ill Older Patients in Advance Care Planning | PSNet

    psnet.ahrq.gov/web-mm/engaging-seriously-ill-older-patients-advance-care-planning
    December 22, 2018 - SPOTLIGHT CASE Engaging Seriously Ill Older Patients in Advance Care Planning Citation Text: Heyland DK. Engaging Seriously Ill Older Patients in Advance Care Planning. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017. …

  13. Webmm Spotlight Suicide Risk Assessment (pdf file)

    psnet.ahrq.gov/sites/default/files/2019-11/webmm_spotlight_suicide_risk_assessment.pdf
    January 01, 2019 - Spotlight Missed Opportunities for Suicide Risk Assessment Source and Credits • This presentation is based on the November 2019 AHRQ WebM&M Spotlight Case ○ See the full article at https://psnet.ahrq.gov/webmm ○ CME credit is available • Commentary by: Glen Xiong, MD & Debra Kahn, MD ○ Editors in Chief, AHRQ We…

  14. Who Nose Where the Airway Is? | PSNet

    psnet.ahrq.gov/web-mm/who-nose-where-airway
    May 01, 2016 - Who Nose Where the Airway Is? Citation Text: Lee CR. Who Nose Where the Airway Is?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2009. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote t…

  15. Clostridium Difficile Relapse Secondary to Medication Access Issue | PSNet

    psnet.ahrq.gov/web-mm/clostridium-difficile-relapse-secondary-medication-access-issue
    October 01, 2015 - Clostridium Difficile Relapse Secondary to Medication Access Issue Citation Text: Walker PC, Nagel J. Clostridium Difficile Relapse Secondary to Medication Access Issue. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2014. Copy Cit…

  16. Liver Biopsy: Proceed With Caution | PSNet

    psnet.ahrq.gov/web-mm/liver-biopsy-proceed-caution
    March 07, 2012 - Liver Biopsy: Proceed With Caution Citation Text: Rockey DC. Liver Biopsy: Proceed With Caution. 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 …

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49816/psn-pdf
    January 01, 2018 - A Painful Medication Reconciliation Mishap January 1, 2018 Chou R. A Painful Medication Reconciliation Mishap. PSNet [internet]. 2018. https://psnet.ahrq.gov/web-mm/painful-medication-reconciliation-mishap Case Objectives Recognize that substance use disorders are common in patients with acute pain. Understand th…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49550/psn-pdf
    December 01, 2007 - Deaths Not Foretold: Are Unexpected Deaths Useful Patient Safety Signals? December 1, 2007 Shojania KG. Deaths Not Foretold: Are Unexpected Deaths Useful Patient Safety Signals? PSNet [internet]. 2007. https://psnet.ahrq.gov/web-mm/deaths-not-foretold-are-unexpected-deaths-useful-patient-safety-signals The Case …

  19. Getting the Diagnosis Both Right and Wrong | PSNet

    psnet.ahrq.gov/web-mm/getting-diagnosis-both-right-and-wrong
    May 29, 2024 - Getting the Diagnosis Both Right and Wrong Citation Text: Olson AP. Getting the Diagnosis Both Right and Wrong. 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…

  20. Preventing Falls Through Patient and Family Engagement to Create Customized Prevention Plans | PSNet

    psnet.ahrq.gov/innovation/preventing-falls-through-patient-and-family-engagement-create-customized-prevention
    July 23, 2024 - Preventing Falls Through Patient and Family Engagement to Create Customized Prevention Plans Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL May 31, 2023 Innovation Contact …
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