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psnet.ahrq.gov/issue/identifying-medication-errors-neonatal-intensive-care-units-two-center-study
November 11, 2020 - Medication errors are thought to be common in neonatal intensive care units (NICUs).
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psnet.ahrq.gov/issue/surgical-errors-happen-are-learners-trained-recover-them-survey-north-american-surgical
July 28, 2021 - Nearly all respondents thought error recovery was a key competency, yet only one-third felt they were
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psnet.ahrq.gov/node/35313/psn-pdf
September 07, 2005 - The hard work of failure analysis.
September 7, 2005
Edmondson A, Cannon MD. Working Knowledge. August 22, 2005.
https://psnet.ahrq.gov/issue/hard-work-failure-analysis
This article reviews examples from health care and other sectors where learning is achieved through
thoughtful failure analysis.
https://psnet.ah…
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psnet.ahrq.gov/issue/preventing-medical-errors-how-proceed-caution
January 24, 2024 - April 19, 2023
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psnet.ahrq.gov/issue/report-faults-childrens-hospital-medication-errors
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Fires during surgeries a bigger risk than thought.
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psnet.ahrq.gov/sites/default/files/2022-08/final_spotlight_case_mesenteric_ischemia_08.05.2022.pdf
January 01, 2022 - The pain is thought to be due
to an inability to meet the increased blood flow demands of the postprandial … DIAGNOSTIC ERRORS
23
Nature of Diagnostic Errors (1)
24
• Diagnostic errors in healthcare are thought … • Based on a wide-ranging review of studies, the rate of diagnostic
error in clinical medicine is thought … Take-Home Points (2)
36
• Diagnostic errors are an underappreciated source of medical error and
are thought
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psnet.ahrq.gov/node/867986/psn-pdf
March 24, 2025 - For example,
people may admit to having had thoughts of killing themselves in the past two weeks, or … In the past, health systems thought that they only needed to keep people protected while
the person … If the person is positive on “thoughts of killing themselves” or “a recent
suicide attempt,” there are … For example, if they have intent to act on their suicidal
thoughts. … A person can have thoughts of killing themselves but say that they never intended to act on them.
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psnet.ahrq.gov/node/33793/psn-pdf
November 01, 2015 - My early thoughts were that the role of research would be to test some of these putative
interventions … RW: How has your thinking evolved in terms of this tension between the just-do-it camp and the we-need … It is possible to marry those two perspectives in
a way that I hadn't thought possible 15 years ago. … Our understanding of IT, thinking about rather than talking about errors so
much, talking about harms … RW: I have residents in our M&M say that "Here's what I thought was going on, but I was worried that
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psnet.ahrq.gov/node/837963/psn-pdf
August 31, 2022 - The
pain is thought to be due to an inability to meet the increased blood flow demands of the postprandial … Nature of Diagnostic Errors
Diagnostic errors in healthcare are thought to be a widespread, but difficult … .13 Based on a wide-ranging review of studies, the rate of diagnostic error in clinical medicine is
thought … Diagnostic errors are an underappreciated source of medical error and are thought to result from
both
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psnet.ahrq.gov/node/33740/psn-pdf
November 01, 2012 - I always thought the physical exam was quite fascinating. … I thought it
was the fun part of medicine and easy pickings. … Most important to me is the issue of safety and basically the disappointing
thought that we might actually … AV: Actually one of the big surprises is that I thought I would get a lot of pushback from people saying … Can you describe your thinking about that and how that dovetails with the physical exam?
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psnet.ahrq.gov/issue/medication-orders-future-start-dates-how-far-away-too-far
March 15, 2022 - June 7, 2016
We thought we would be perfect: medication errors before and after the initiation
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psnet.ahrq.gov/issue/5-pandemic-mistakes-we-keep-repeating-we-can-learn-our-failures
March 10, 2021 - March 10, 2021
‘He thought what he was doing was good for people.’
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psnet.ahrq.gov/issue/how-real-time-data-can-change-patient-safety-game
July 07, 2021 - October 21, 2020
I thought Daniel was safe with the NHS. He wasn't.
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psnet.ahrq.gov/issue/one-needle-one-syringe-only-one-time-survey-physician-and-nurse-knowledge-attitudes-and
June 28, 2013 - Nearly 8% of physicians thought this was an acceptable practice.