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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45028/psn-pdf
    May 25, 2016 - 'Just culture': improving safety by achieving substantive, procedural and restorative justice. May 25, 2016 Dekker SWA, Breakey H. ‘Just culture:’ Improving safety by achieving substantive, procedural and restorative justice. Saf Sci. 2016;85. doi:10.1016/j.ssci.2016.01.018. https://psnet.ahrq.gov/issue/just-cultu…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60718/psn-pdf
    July 22, 2020 - First Do No Harm. The Report of the Independent Medicines and Medical Devices Safety Review. July 22, 2020 Cumberlege J. London, England, Crown Copyright. July 8, 2020. https://psnet.ahrq.gov/issue/first-do-no-harm-report-independent-medicines-and-medical-devices-safety- review Implicit biases are known to affect…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/854382/psn-pdf
    October 11, 2023 - Battling alarm fatigue in the pediatric intensive care unit. October 11, 2023 Herrera H, Wood D. Battling alarm fatigue in the pediatric intensive care unit. Crit Care Nurs Clin North Am. 2023;35(3):347-355. doi:10.1016/j.cnc.2023.05.003. https://psnet.ahrq.gov/issue/battling-alarm-fatigue-pediatric-intensive-care-…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837212/psn-pdf
    June 08, 2022 - Engaging Physicians in Teamwork Training for Quality and Safety - Or Why Don’t Your Physicians Get Engaged? May 25, 2022 AHA Team Training. June 8, 2022. https://psnet.ahrq.gov/issue/engaging-physicians-teamwork-training-quality-and-safety-or-why-dont-your- physicians-get Physicians are instrumental to the succes…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34978/psn-pdf
    June 30, 2011 - Personal digital assistant-based drug information sources: potential to improve medication safety. June 30, 2011 Galt K, Rule AM, Houghton B, et al. Personal digital assistant-based drug information sources: potential to improve medication safety. J Med Libr Assoc. 2005;93(2):229-36. https://psnet.ahrq.gov/issue/p…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35899/psn-pdf
    January 02, 2017 - Labeling solutions and medications in sterile procedural settings. January 2, 2017 Sheridan DJ. Labeling solutions and medications in sterile procedural settings. Jt Comm J Qual Patient Saf. 2006;32(5):276-82. https://psnet.ahrq.gov/issue/labeling-solutions-and-medications-sterile-procedural-settings In response …
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46973/psn-pdf
    June 25, 2018 - Balancing innovation and safety when integrating digital tools into health care. June 25, 2018 Auerbach AD, Neinstein A, Khanna R. Balancing Innovation and Safety When Integrating Digital Tools Into Health Care. Ann Intern Med. 2018;168(10):733-734. doi:10.7326/M17-3108. https://psnet.ahrq.gov/issue/balancing-inno…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38456/psn-pdf
    May 02, 2014 - Burden of difficult encounters in primary care: data from the Minimizing Error, Maximizing Outcomes Study. May 2, 2014 An PG, Rabatin JS, Manwell LB, et al. Burden of difficult encounters in primary care: data from the minimizing error, maximizing outcomes study. Arch Intern Med. 2009;169(4):410-4. doi:10.1001/arc…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46751/psn-pdf
    July 23, 2018 - A call for a systems-thinking approach to medication adherence: stop blaming the patient. July 23, 2018 Lauffenburger JC, Choudhry NK. A Call for a Systems-Thinking Approach to Medication Adherence: Stop Blaming the Patient. JAMA Intern Med. 2018;178(7):950-951. doi:10.1001/jamainternmed.2018.0790. https://psnet.a…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41249/psn-pdf
    December 21, 2014 - Physicians' needs in coping with emotional stressors: the case for peer support. December 21, 2014 Hu Y-Y, Fix ML, Hevelone ND, et al. Physicians' needs in coping with emotional stressors: the case for peer support. Arch Surg. 2012;147(3):212-217. doi:10.1001/archsurg.2011.312. https://psnet.ahrq.gov/issue/physici…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/839829/psn-pdf
    November 09, 2022 - Pulse oximeters and their inaccuracies will get FDA scrutiny today. What took so long? November 9, 2022 McFarling UL. STAT. November 1, 2022. https://psnet.ahrq.gov/issue/pulse-oximeters-and-their-inaccuracies-will-get-fda-scrutiny-today-what-took- so-long Evidence is building to delineate the effect of systemic …
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47408/psn-pdf
    September 19, 2018 - Ways to Improve Electronic Health Record Safety. September 19, 2018 Philadelphia, PA: Pew Charitable Trusts, American Medical Association, and Medstar Health; 2018. https://psnet.ahrq.gov/issue/ways-improve-electronic-health-record-safety Electronic health records both contribute to and detract from safe care. This…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42382/psn-pdf
    July 16, 2014 - Huddling for high reliability and situation awareness. July 16, 2014 Goldenhar LM, Brady PW, Sutcliffe K, et al. Huddling for high reliability and situation awareness. BMJ Qual Saf. 2013;22(11):899-906. doi:10.1136/bmjqs-2012-001467. https://psnet.ahrq.gov/issue/huddling-high-reliability-and-situation-awareness Se…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46392/psn-pdf
    October 13, 2018 - The clinical and medicolegal implications of radiology results communication. October 13, 2018 Aryal B, Khorsand DA, Dubinsky TJ. The Clinical and Medicolegal Implications of Radiology Results Communication. Curr Probl Diagn Radiol. 2018;47(5):287-289. doi:10.1067/j.cpradiol.2017.09.009. https://psnet.ahrq.gov/iss…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38996/psn-pdf
    March 04, 2011 - Overcoming barriers to the implementation of a pharmacy bar code scanning system for medication dispensing: a case study. March 4, 2011 Nanji KC, Cina J, Patel N, et al. Overcoming barriers to the implementation of a pharmacy bar code scanning system for medication dispensing: a case study. J Am Med Inform Assoc. …
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/48006/psn-pdf
    May 15, 2019 - Limits on opioid prescribing leave patients with chronic pain vulnerable. May 15, 2019 Rubin R. Limits on Opioid Prescribing Leave Patients With Chronic Pain Vulnerable. JAMA. 2019;321(21):2059-2062. doi:10.1001/jama.2019.5188. https://psnet.ahrq.gov/issue/limits-opioid-prescribing-leave-patients-chronic-pain-vuln…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44066/psn-pdf
    September 21, 2016 - Raising an alarm, doctors fight to yank hospital ICUs into the modern era. September 21, 2016 McFarling UL. STAT. September 7, 2016. https://psnet.ahrq.gov/issue/raising-alarm-doctors-fight-yank-hospital-icus-modern-era Intensive care units (ICUs) are complex environments that harbor various challenges to safe car…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50782/psn-pdf
    January 08, 2020 - What can patient safety teach us about clinician burnout? January 8, 2020 Wu AW, Dzau VJ. What Can Patient Safety Teach Us About Clinician Burnout? Ann Intern Med. 2019;171(12):933-934. doi:10.7326/m19-2397. https://psnet.ahrq.gov/issue/what-can-patient-safety-teach-us-about-clinician-burnout This commentary discu…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43119/psn-pdf
    April 16, 2014 - Still outside the bull's eye: 2014–2015 Targeted Medication Safety Best Practices. April 16, 2014 ISMP Medication Safety Alert! Acute care edition. March 27, 2014;19:1-5. https://psnet.ahrq.gov/issue/still-outside-bulls-eye-2014-2015-targeted-medication-safety-best-practices This newsletter article reports results…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36769/psn-pdf
    June 15, 2011 - Using incident reporting to improve patient safety: a conceptual model. June 15, 2011 Pronovost PJ, Holzmueller CG, Young J, et al. Using Incident Reporting to Improve Patient Safety. J Patient Saf. 2008;3(1). doi:10.1097/pts.0b013e318030ca05. https://psnet.ahrq.gov/issue/using-incident-reporting-improve-patient-s…

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