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psnet.ahrq.gov/periodic-issue/periodic-issue-457
September 25, 2024 - September 25, 2024 Weekly Issue
PSNet highlights the latest patient safety literature, news, and expert commentary, including Weekly
Updates, WebM&M, and Perspectives on Safety. The current issue highlights what's new this week in patient
safety literature, news, conferences, repo…
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psnet.ahrq.gov/periodic-issue/periodic-issue-455
September 25, 2024 - September 11, 2024 Weekly Issue
PSNet highlights the latest patient safety literature, news, and expert commentary, including Weekly
Updates, WebM&M, and Perspectives on Safety. The current issue highlights what's new this week in patient
safety literature, news, conferences, repo…
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psnet.ahrq.gov/webmm-case-studies
March 25, 2025 - WebM&M: Case Studies
WebM&M (Morbidity & Mortality Rounds on the Web) features expert analysis of medical errors reported anonymously by our readers. Spotlight Cases include interactive learning modules available for CME/CPE . Commentaries are written by patient safety experts and published monthly. Have you encou…
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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.
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Format:
Google Schola…
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psnet.ahrq.gov/periodic-issue/periodic-issue-456
September 25, 2024 - September 18, 2024 Weekly Issue
PSNet highlights the latest patient safety literature, news, and expert commentary, including Weekly
Updates, WebM&M, and Perspectives on Safety. The current issue highlights what's new this week in patient
safety literature, news, conferences, repo…
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psnet.ahrq.gov/web-mm/lost-sign-out-and-documentation
January 31, 2011 - While being evaluated by the emergency physician, he suddenly went into cardiac arrest.
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psnet.ahrq.gov/perspective/conversation-erik-hollnagel-phd
February 26, 2025 - But in the longer term it will be there because people suddenly understand what they do, they understand
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psnet.ahrq.gov/perspective/what-do-we-know-about-emergency-department-safety
June 01, 2010 - nature of error in medicine that I really wasn't aware of what was going on in the department until suddenly … We often cannot predict what the flow will be like; there are lots of surges—suddenly you have six ambulances
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psnet.ahrq.gov/web-mm/production-pressures
November 16, 2022 - Production Pressures
Citation Text:
Carayon P. Production Pressures. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007.
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Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId …
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psnet.ahrq.gov/sites/default/files/2024-03/delayed_diagnosis_and_treatment_of_sle.pdf
January 01, 2024 - Despite the
possibility of targeted treatment, the patient died suddenly of organ failure.
22
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psnet.ahrq.gov/node/73398/psn-pdf
June 30, 2021 - But with COVID-19, the issues have also suddenly become about staff
safety.
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psnet.ahrq.gov/web-mm/worst-headache
July 01, 2016 - The Worst Headache
Citation Text:
Edlow JA. The Worst Headache. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2004.
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Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS
…
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psnet.ahrq.gov/periodic-issue/periodic-issue-320
November 30, 2021 - During labor, the fetal heart rate dropped suddenly and the obstetric provider diagnosed umbilical cord
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psnet.ahrq.gov/periodic-issue/periodic-issue-316
November 30, 2021 - During labor, the fetal heart rate dropped suddenly and the obstetric provider diagnosed umbilical cord
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psnet.ahrq.gov/web-mm/complaints-safety-surveillance
May 05, 2021 - She said the pain came on suddenly that morning after binge-drinking vodka.
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psnet.ahrq.gov/perspective/conversation-joel-willis-do-pa-ma-mphil-and-neal-sikka-md
May 14, 2020 - I am on the ground, at a facility that wasn’t using telemedicine 6 months ago and is now suddenly using … Everything was moving along at a slow pace, and suddenly there is COVID.
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psnet.ahrq.gov/perspective/telehealth-and-patient-safety-during-covid-19-response
May 14, 2020 - I am on the ground, at a facility that wasn’t using telemedicine 6 months ago and is now suddenly using … Everything was moving along at a slow pace, and suddenly there is COVID.
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psnet.ahrq.gov/web-mm/undetected-foreign-object
April 24, 2018 - Undetected Foreign Object
Citation Text:
Cima RR. Undetected Foreign Object. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2012.
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Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged P…
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psnet.ahrq.gov/node/49455/psn-pdf
July 01, 2004 - The Worst Headache
July 1, 2004
Edlow JA. The Worst Headache. PSNet [internet]. 2004.
https://psnet.ahrq.gov/web-mm/worst-headache
The Case
A 48-year-old woman with a history of migraine headaches and hypertension presented to her outpatient
clinic with a 4-day history of headache. While shopping 4 days earlier, …
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psnet.ahrq.gov/node/867676/psn-pdf
February 26, 2025 - Responding to Patient Safety Events
February 26, 2025
Shaikh U. Responding to Patient Safety Events. PSNet [internet]. 2025.
https://psnet.ahrq.gov/primer/responding-patient-safety-events
Background
Patient safety events that occur in health care facilities require prompt action to ensure that further harm is
mit…