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psnet.ahrq.gov/node/49831/psn-pdf
June 01, 2018 - Emergency Department Visits by County Type.(2)
County Group Total EDs Total Visits Visit Range Median … Incidence and predictors of silent myocardial infarction in type 2
diabetes and the effect of fenofibrate
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psnet.ahrq.gov/web-mm/dont-wait-collect-accurate-weight-case-subtherapeutic-insulin-therapy
July 01, 2008 - The Case A 16-year-old girl with type 1 diabetes presented to the emergency department (ED) complaining … WebM&M Cases
Inpatient Stroke Management in an Adolescent with Type
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psnet.ahrq.gov/web-mm/amended-lab-results-communication-slip
September 26, 2012 - Continued development of these software systems may play a key role in reducing the type of errors noted
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psnet.ahrq.gov/issue/patient-safety-psychiatric-inpatient-care-literature-review
September 27, 2017 - Review
Patient safety in psychiatric inpatient care: a literature review.
Citation Text:
Kanerva A, Lammintakanen J, Kivinen T. Patient safety in psychiatric inpatient care: a literature review. J Psychiatr Ment Health Nurs. 2013;20(6):541-8. doi:10.1111/j.1365-2850.2012.01949.x.
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psnet.ahrq.gov/issue/safe-use-health-information-technology
December 23, 2016 - Sentinel Event Alerts
Safe use of health information technology.
Citation Text:
Safe use of health information technology. Sentinel Event Alert. March 31, 2015;(54):1-6.
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psnet.ahrq.gov/issue/factors-influencing-perioperative-nurses-error-reporting-preferences
June 23, 2010 - Study
Factors influencing perioperative nurses' error reporting preferences.
Citation Text:
Espin S, Regehr G, Levinson W, et al. Factors influencing perioperative nurses' error reporting preferences. AORN J. 2007;85(3):527-43.
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psnet.ahrq.gov/issue/rapid-response-teams-walk-dont-run
March 21, 2012 - Commentary
Classic
Rapid response teams—walk, don't run.
Citation Text:
Winters BD, Pham JC, Pronovost PJ. Rapid Response Teams—Walk, Don't Run. JAMA. 2006;296(13). doi:10.1001/jama.296.13.1645.
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psnet.ahrq.gov/issue/laneys-story-problem-delayed-diagnosis-pediatric-stroke
April 24, 2018 - Commentary
Laney's story: the problem of delayed diagnosis of pediatric stroke.
Citation Text:
Fitzsimons BT, Fitzsimons LL, Sun LR. Laney's Story: The Problem of Delayed Diagnosis of Pediatric Stroke. Pediatrics. 2019;143(4):e20183458. doi:10.1542/peds.2018-3458.
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psnet.ahrq.gov/issue/teamwork-behaviours-and-errors-during-neonatal-resuscitation
September 13, 2011 - Study
Teamwork behaviours and errors during neonatal resuscitation.
Citation Text:
Williams AL, Lasky RE, Dannemiller JL, et al. Teamwork behaviours and errors during neonatal resuscitation. Qual Saf Health Care. 2010;19(1):60-4. doi:10.1136/qshc.2007.025320.
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psnet.ahrq.gov/issue/liquid-medication-dosing-errors-hispanic-parents-role-health-literacy-and-english-proficiency
December 14, 2016 - Study
Liquid medication dosing errors by Hispanic parents: role of health literacy and English proficiency.
Citation Text:
Harris LM, Dreyer BP, Mendelsohn A, et al. Liquid Medication Dosing Errors by Hispanic Parents: Role of Health Literacy and English Proficiency. Acad Pediatr. 2017;1…
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psnet.ahrq.gov/issue/ihi-skilled-nursing-facility-trigger-tool-measuring-adverse-events
February 15, 2017 - Book/Report
IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events.
Citation Text:
IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events. Adler L, Moore J, Federico F. Cambridge, MA: Institute for Healthcare Improvement; November 2015.
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psnet.ahrq.gov/issue/improving-patient-care-cognitive-psychology-missed-diagnoses
October 03, 2012 - Commentary
Improving patient care. The cognitive psychology of missed diagnoses.
Citation Text:
Redelmeier DA. Improving patient care. The cognitive psychology of missed diagnoses. Ann Intern Med. 2005;142(2):115-120.
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psnet.ahrq.gov/issue/piece-my-mind-despite-my-best-intentions
September 13, 2016 - Commentary
A piece of my mind. Despite my best intentions.
Citation Text:
Kahn JS. Despite My Best Intentions. JAMA. 2017;318(17). doi:10.1001/jama.2017.6123.
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psnet.ahrq.gov/issue/intrathecal-chemotherapy-potential-medication-error
February 23, 2015 - Review
Intrathecal chemotherapy: potential for medication error.
Citation Text:
Gilbar PJ. Intrathecal chemotherapy: potential for medication error. Cancer Nurs. 2014;37(4):299-309. doi:10.1097/NCC.0000000000000108.
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psnet.ahrq.gov/issue/cognitive-errors-and-logistical-breakdowns-contributing-missed-and-delayed-diagnoses-breast
March 02, 2011 - Study
Cognitive errors and logistical breakdowns contributing to missed and delayed diagnoses of breast and colorectal cancers: a process analysis of closed malpractice claims.
Citation Text:
Poon EG, Kachalia A, Puopolo AL, et al. Cognitive errors and logistical breakdowns contributin…
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psnet.ahrq.gov/perspective/safety-radiology
October 01, 2013 - We had about a thousand of each type of exam across four San Francisco Bay Area institutions. … The brain perfusion scan had just become a common study type, even for patients who should not have had … this type of study.
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psnet.ahrq.gov/issue/collective-intelligence-increases-diagnostic-accuracy-general-practice-setting
August 03, 2017 - Study
Collective intelligence increases diagnostic accuracy in a general practice setting.
Citation Text:
Blanchard MD, Herzog SM, Kämmer JE, et al. Collective intelligence increases diagnostic accuracy in a general practice setting. Med Decis Making. 2024;44(4):451-462. doi:10.1177/0272…
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psnet.ahrq.gov/issue/cultural-and-associated-enablers-and-barriers-adverse-incident-reporting
March 23, 2011 - Study
Cultural and associated enablers of, and barriers to, adverse incident reporting.
Citation Text:
Braithwaite J, Westbrook MT, Travaglia J, et al. Cultural and associated enablers of, and barriers to, adverse incident reporting. Qual Saf Health Care. 2010;19(3):229-233. doi:10.113…
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psnet.ahrq.gov/issue/emergency-department-visits-antibiotic-associated-adverse-events
October 31, 2014 - Study
Emergency department visits for antibiotic-associated adverse events.
Citation Text:
Shehab N, Patel PR, Srinivasan A, et al. Emergency department visits for antibiotic-associated adverse events. Clin Infect Dis. 2008;47(6):735-43. doi:10.1086/591126.
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psnet.ahrq.gov/issue/primary-care-pediatricians-interest-diagnostic-error-reduction
March 19, 2018 - Study
Primary care pediatricians' interest in diagnostic error reduction.
Citation Text:
Rinke ML, Singh H, Ruberman S, et al. Primary care pediatricians' interest in diagnostic error reduction. Diagnosis (Berl). 2016;3(2):65-69. doi:10.1515/dx-2015-0033.
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