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psnet.ahrq.gov/node/49689/psn-pdf
August 21, 2013 - Anesthesia: A Weighty Issue
August 21, 2013
Sinha AC. Anesthesia: A Weighty Issue. PSNet [internet]. 2013.
https://psnet.ahrq.gov/web-mm/anesthesia-weighty-issue
The Case
A 77-year-old woman was evaluated preoperatively in anticipation of an elective left hip arthroplasty. She
reported having a history of hyperte…
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psnet.ahrq.gov/node/33757/psn-pdf
October 01, 2013 - Safety in Radiology
October 1, 2013
Pinto A. Safety in Radiology. PSNet [internet]. 2013.
https://psnet.ahrq.gov/perspective/safety-radiology
Perspective
The use of medical imaging to depict and to help diagnose illness and injury as well as to guide therapeutic
interventions has expanded greatly during the past …
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psnet.ahrq.gov/node/49425/psn-pdf
November 01, 2003 - Misread Label
November 1, 2003
Franklin BD. Misread Label. PSNet [internet]. 2003.
https://psnet.ahrq.gov/web-mm/misread-label
The Case
An infant was born with sluggish respirations. During labor the infant’s mother had received meperidine
[Demerol, a pain medication], a narcotic with a half-life of 2.5-4.0 hours…
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psnet.ahrq.gov/primer/second-victims-support-clinicians-involved-errors-and-adverse-events
December 15, 2024 - Second Victims: Support for Clinicians Involved in Errors and Adverse Events
Citation Text:
Second Victims: Support for Clinicians Involved in Errors and Adverse Events. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
Copy Cit…
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psnet.ahrq.gov/web-mm/room-without-orders
September 01, 2011 - SPOTLIGHT CASE
A Room Without Orders
Citation Text:
Vogelsmeier A, Despins L. A Room Without Orders. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016.
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Format:
Google Scholar BibTeX EndNote X3…
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psnet.ahrq.gov/perspective/conversation-maureen-bisognano
February 26, 2025 - In Conversation With… Maureen Bisognano
June 1, 2015
Citation Text:
In Conversation With… Maureen Bisognano. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015.
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Format:
…
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psnet.ahrq.gov/node/867359/psn-pdf
December 18, 2024 - Importance of Following Safe Practices for Infant Feeding
and Handling Expressed Breast Milk
December 18, 2024
Shauer M, Perez DG, Chagolla B. Importance of Following Safe Practices for Infant Feeding and Handling
Expressed Breast Milk. PSNet [internet]. 2024.
https://psnet.ahrq.gov/web-mm/importance-following-saf…
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psnet.ahrq.gov/node/33789/psn-pdf
August 01, 2015 - In Conversation With… Robert M. Wachter, MD
August 1, 2015
In Conversation With… Robert M. Wachter, MD. PSNet [internet]. 2015.
https://psnet.ahrq.gov/perspective/conversation-robert-m-wachter-md
Editor's note: Dr. Wachter is Professor and the Interim Chairman of the Department of Medicine at UCSF,
where he also …
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psnet.ahrq.gov/node/867497/psn-pdf
February 26, 2025 - Retained Surgical Items: Causation and Prevention
February 26, 2025
Gibbs V, Romano P. Retained Surgical Items: Causation and Prevention. PSNet [internet]. 2025.
https://psnet.ahrq.gov/primer/retained-surgical-items-causation-and-prevention
Background
A retained surgical item (RSI) is a surgical patient safety pro…
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psnet.ahrq.gov/perspective/becoming-certified-professional-patient-safety-registered-nurses-perspective
June 01, 2016 - Becoming a Certified Professional in Patient Safety—A Registered Nurse's Perspective
Karen Frank, DNP, RN, MSHA | June 1, 2016
Also Read a Conversation
View more articles from the same authors.
Citation Text:
Frank K. Becoming a Certified Professional in Patien…
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psnet.ahrq.gov/web-mm/importance-following-safe-practices-infant-feeding-and-handling-expressed-breast-milk
January 31, 2024 - Importance of Following Safe Practices for Infant Feeding and Handling Expressed Breast Milk
Citation Text:
Shauer M, Perez DG, Chagolla B. Importance of Following Safe Practices for Infant Feeding and Handling Expressed Breast Milk. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quali…
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psnet.ahrq.gov/web-mm/medication-handling-and-compounding-errors-operating-room
May 16, 2022 - pharmacy oversight. 4,5 This commentary focuses on immediate-use compounding and how the process creates situations
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psnet.ahrq.gov/periodic-issue/periodic-issue-293
May 26, 2021 - Study
Communication of preclinical emergency teams in critical situations: a nationwide
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psnet.ahrq.gov/periodic-issue/periodic-issue-281
March 15, 2021 - improving the organization of care, (3) control of risks, and (4) enhancing responses to hazardous situations
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psnet.ahrq.gov/periodic-issue/periodic-issue-286
April 28, 2021 - condition was eventually discovered through communication with a physician whose experience with similar situations
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psnet.ahrq.gov/periodic-issue/periodic-issue-317
November 30, 2021 - experience into the health care domain to improve communication and resolve conflicts in stressful situations
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psnet.ahrq.gov/periodic-issue/periodic-issue-338
April 27, 2022 - This news article highlights situations where resident autonomy should be disclosed to patients (such
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psnet.ahrq.gov/periodic-issue/periodic-issue-404
August 30, 2023 - of team-based care, communication, and a culture of safety can improve care in complex health care situations
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psnet.ahrq.gov/periodic-issue/periodic-issue-378
February 01, 2023 - Emergent care situations are vulnerable to a range of factors that reduce care safety and access.
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psnet.ahrq.gov/node/837791/psn-pdf
August 05, 2022 - For
example, clinician peer input can affect diagnostic accuracy and confidence, particularly in situations