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Total Results: 3,729 records

Showing results for "reason".

3301. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49484/psn-pdf
      June 01, 2005 - Two Pills, Same Drug June 1, 2005 Horsky J, Patel VL. Two Pills, Same Drug. PSNet [internet]. 2005. https://psnet.ahrq.gov/web-mm/two-pills-same-drug The Case A 34-year-old woman with AIDS developed a fever and hypotension due to suspected pneumonia. Her past medical history included several AIDS-related complica…

3302. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49694/psn-pdf
      October 01, 2013 - Are You Mrs. A? An Issue of Identification Over Telephone October 1, 2013 Adelman JS. Are You Mrs. A? An Issue of Identification Over Telephone. PSNet [internet]. 2013. https://psnet.ahrq.gov/web-mm/are-you-mrs-issue-identification-over-telephone The Case Mr. A was a 78-year-old man admitted with non-ST elevation…

3303. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49835/psn-pdf
      January 01, 2020 - Don't Pick the PICC July 1, 2018 McGill RL. Don't Pick the PICC. PSNet [internet]. 2018. https://psnet.ahrq.gov/web-mm/dont-pick-picc The Case A 63-year-old man with diabetes mellitus complicated by retinopathy, neuropathy, and nephropathy; glaucoma; and stage IV chronic kidney disease was admitted to the hospita…

3304. 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…

3305. Spotlight Case July 2008 (ppt file)
      psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.272_slideshow.ppt
      July 01, 2012 - Spotlight Case July 2008 Spotlight Case Not-So-Therapeutic Tap * * Source and Credits This presentation is based on the July 2012 AHRQ WebM&M Spotlight Case See the full article at http://webmm.ahrq.gov CME credit is available Commentary by: Jeffrey H. Barsuk, MD, MS; Northwestern University Feinberg Scho…

3306. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49397/psn-pdf
      May 01, 2003 - The Dropped Lung May 1, 2003 Heffner JR. The Dropped Lung. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/dropped-lung The Case A 79-year-old woman was admitted for hypoxia and shortness of breath. Two weeks prior she had been hospitalized for dyspnea and was found to have multiple bilateral pulmonary nodu…

3307. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33823/psn-pdf
      January 01, 2017 - Workplace Safety in Health Care January 1, 2017 Simon RW, Canacari EG. Workplace Safety in Health Care. PSNet [internet]. 2017. https://psnet.ahrq.gov/perspective/workplace-safety-health-care Perspective The patient safety movement has highlighted the risks that patients face when receiving health care. But, impo…

3308. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49538/psn-pdf
      June 01, 2007 - Abnormal Volunteer Results June 1, 2007 Fernandez C. Abnormal Volunteer Results. PSNet [internet]. 2007. https://psnet.ahrq.gov/web-mm/abnormal-volunteer-results The Case A healthy 52-year-old woman volunteered to participate in a radiology study in which she underwent magnetic resonance imaging (MRI) of her abdo…

3309. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49722/psn-pdf
      December 01, 2014 - Medical Devices in the "Wild" December 1, 2014 Gurses AP, Doyle PA. Medical Devices in the "Wild". PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/medical-devices-wild The Case A 75-year-old man with a history of congestive heart failure (CHF), coronary artery disease, diabetes, chronic pain, arthritis, and…

3310. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50842/psn-pdf
      January 29, 2020 - Patient Identification Errors: A Systems Challenge January 29, 2020 Choudhury LS, Vu CT. Patient Identification Errors: A Systems Challenge. PSNet [internet]. 2020. https://psnet.ahrq.gov/web-mm/patient-identification-errors-systems-challenge The Cases The following four events involving five patients all involved…

3311. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/851158/psn-pdf
      June 28, 2023 - Ventricular Wall Injury during a Diagnostic Cardiac Catheterization June 28, 2023 Pham TH, Atreja S. Ventricular Wall Injury during a Diagnostic Cardiac Catheterization. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/ventricular-wall-injury-during-diagnostic-cardiac-catheterization The Case A patient was …

3312. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49815/psn-pdf
      December 01, 2017 - Over-the-Counter Oversight December 1, 2017 Janamanchi V, Modha K, Whinney C. Over-the-Counter Oversight. PSNet [internet]. 2017. https://psnet.ahrq.gov/web-mm/over-counter-oversight The Case A 56-year-old man was evaluated in the burn clinic for a second-degree burn on his chest. Although portions of his skin we…

3313. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49718/psn-pdf
      January 01, 2015 - Too Much, Too Fast September 1, 2014 Tuot D. Too Much, Too Fast. PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/too-much-too-fast The Case A 68-year-old man with amyotrophic lateral sclerosis (ALS) was admitted to the intensive care unit (ICU) for fever, tachycardia, and increased respiratory secretions. H…

3314. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49610/psn-pdf
      October 01, 2010 - "Recurrent" Appendicitis October 1, 2010 Greenberg CC. "Recurrent" Appendicitis. PSNet [internet]. 2010. https://psnet.ahrq.gov/web-mm/recurrent-appendicitis The Case An 85-year-old man presented to the emergency department (ED) with right lower quadrant pain. On physical examination, the patient showed rebound t…

3315. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49776/psn-pdf
      November 01, 2016 - Continuity Errors in Resident Clinic November 1, 2016 Warm EJ. Continuity Errors in Resident Clinic. PSNet [internet]. 2016. https://psnet.ahrq.gov/web-mm/continuity-errors-resident-clinic The Case A 32-year-old woman presented to internal medicine clinic for evaluation of headaches and difficulty concentrating. …

3316. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49604/psn-pdf
      June 01, 2010 - Tacit Handover, Overt Mishap June 1, 2010 Cooper JB, Kamdar BB. Tacit Handover, Overt Mishap. PSNet [internet]. 2010. https://psnet.ahrq.gov/web-mm/tacit-handover-overt-mishap The Case A 61-year-old man was admitted for management of an infected aortic stent, which had been placed 3 years earlier to treat an abdo…

3317. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49569/psn-pdf
      September 01, 2008 - Where's the Feeding Tube? September 1, 2008 Metheny NA, Meert KL. Where's the Feeding Tube? PSNet [internet]. 2008. https://psnet.ahrq.gov/web-mm/wheres-feeding-tube The Case A 13-year-old boy was involved in a motor vehicle collision and experienced a traumatic brain injury. Because of the injuries, he was unabl…

3318. Reflecting on diagnostic errors: taking a second look is not enough. | PSNet
      psnet.ahrq.gov/issue/reflecting-diagnostic-errors-taking-second-look-not-enough
      September 26, 2016 - Study Reflecting on diagnostic errors: taking a second look is not enough. Citation Text: Monteiro SD, Sherbino J, Patel A, et al. Reflecting on Diagnostic Errors: Taking a Second Look is Not Enough. J Gen Intern Med. 2015;30(9):1270-4. doi:10.1007/s11606-015-3369-4. Copy Citation …

3319. Does time pressure have a negative effect on diagnostic accuracy? | PSNet
      psnet.ahrq.gov/issue/does-time-pressure-have-negative-effect-diagnostic-accuracy
      January 16, 2019 - Study Does time pressure have a negative effect on diagnostic accuracy? Citation Text: ALQahtani DA, Rotgans JI, Mamede S, et al. Does Time Pressure Have a Negative Effect on Diagnostic Accuracy? Acad Med. 2016;91(5):710-716. doi:10.1097/ACM.0000000000001098. Copy Citation Format: …

3320. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/42871/psn-pdf
      September 13, 2016 - Diagnosis. September 13, 2016 Graber ML, Plebani M, eds. Berlin, Germany: Society to Improve Diagnosis in Medicine and DeGruyter. ISSN: 2194-802X. https://psnet.ahrq.gov/issue/diagnosis This journal offers multidisciplinary research and commentary covering such topics as diagnostic error, clinical reasoning, and …