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psnet.ahrq.gov/node/49654/psn-pdf
June 01, 2012 - errors associated with inter-hospital transport.(7-10)
This case highlights what can potentially go wrong
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psnet.ahrq.gov/node/49828/psn-pdf
May 01, 2018 - She logged into the medical record of one of these patients—the wrong one—and saw
a normal CRP value
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psnet.ahrq.gov/node/49543/psn-pdf
September 01, 2007 - First, the preoperative consultant sowed the seeds of this
adverse event by obtaining the wrong preadmission
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psnet.ahrq.gov/node/33744/psn-pdf
February 01, 2013 - To me, that was the wrong approach.
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psnet.ahrq.gov/node/50392/psn-pdf
September 01, 2019 - Bringing that thinking to
health care and saying wrong-site surgery or foreign bodies being left in
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psnet.ahrq.gov/web-mm/weight-and-height-juxtaposition-electronic-medical-record-causing-accidental-medication
March 15, 2023 - The first “hole” occurred when the intake technician recorded the wrong weight and height into the EHR
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psnet.ahrq.gov/node/49437/psn-pdf
March 01, 2004 - Chest X-Ray with Catheter in Wrong Position*
*Not the actual radiograph from this case.
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psnet.ahrq.gov/node/33643/psn-pdf
December 01, 2006 - I'm a great fan of structured
communications, don't get me wrong.
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psnet.ahrq.gov/node/60745/psn-pdf
October 01, 2020 - up to one-third of these errors leading to observed patient harm.2,3 The most common errors include
wrong
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psnet.ahrq.gov/web-mm/complaints-safety-surveillance
May 05, 2021 - October 7, 2020
WebM&M Cases
Right Place, Right Drug, Wrong
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psnet.ahrq.gov/web-mm/spinal-epidural-abscess
November 13, 2019 - were identified including failure/delay to follow-up critical piece of history data, ordering of the wrong
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psnet.ahrq.gov/web-mm/coming-err-missed-diagnosis-patient-recurrent-pneumothorax
December 14, 2022 - 30, 2019
WebM&M Cases
Slow Down: Right Drug, Wrong
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psnet.ahrq.gov/primer/deprescribing-patient-safety-strategy
December 15, 2024 - Pharmacist Intervention
March 1, 2017
WebM&M Cases
Wrong-Time
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psnet.ahrq.gov/web-mm/when-taking-sglt2-inhibitor-remember-sstop-stop-sglt2-inhibitor-three-days-bef-o-re
February 01, 2023 - Development and implementation of a subcutaneous insulin pen label bar code scanning protocol to prevent wrong-patient
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psnet.ahrq.gov/perspective/second-victim-phenomenon-harsh-reality-health-care-professions
November 13, 2024 - Let's say a nurse on the evening shift harms a patient by administering the wrong medication.
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psnet.ahrq.gov/web-mm/techno-trip
May 01, 2005 - Was there a history of receiving transfer patients with wrong diagnoses?
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psnet.ahrq.gov/web-mm/perils-diagnosing-stroke
August 15, 2017 - WebM&M Cases
From Possible to Probable to Sure to Wrong—Premature
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psnet.ahrq.gov/node/863650/psn-pdf
February 28, 2024 - preventable.2 A
medical error is the failure to complete a planned action as intended, or the use of the wrong
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psnet.ahrq.gov/web-mm/coming-undone-failure-closure-device
April 01, 2006 - Fecal Contamination of the Peritoneum from Laparoscopic Trocar Injury: A Routine Operation Goes Wrong
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psnet.ahrq.gov/web-mm/result-stopped-here
December 01, 2006 - Resources From the Same Author(s)
WebM&M Cases
Right Patient, Wrong