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1801. Disparate perspectives: exploring healthcare professionals' misaligned mental models of older adults' transitions of care between the emergency department and skilled nursing facility. | PSNet
      psnet.ahrq.gov/issue/disparate-perspectives-exploring-healthcare-professionals-misaligned-mental-models-older
      May 11, 2022 - Study Disparate perspectives: exploring healthcare professionals' misaligned mental models of older adults' transitions of care between the emergency department and skilled nursing facility. Citation Text: Werner NE, Rutkowski RA, Krause S, et al. Disparate perspectives: exploring health…

1802. Expanding frontiers of risk management: care safety in nursing home during COVID-19 pandemic. | PSNet
      psnet.ahrq.gov/issue/expanding-frontiers-risk-management-care-safety-nursing-home-during-covid-19-pandemic
      February 15, 2023 - Commentary Expanding frontiers of risk management: care safety in nursing home during COVID-19 pandemic. Citation Text: Scopetti M, Santurro A, Tartaglia R, et al. Expanding frontiers of risk management: care safety in nursing home during COVID-19 pandemic. Int J Qual Health Care. 2021;3…

1803. Accurate measurement in California's safety-net health systems has gaps and barriers. | PSNet
      psnet.ahrq.gov/issue/accurate-measurement-californias-safety-net-health-systems-has-gaps-and-barriers
      April 04, 2018 - Study Accurate measurement in California's safety-net health systems has gaps and barriers. Citation Text: Khoong EC, Cherian R, Rivadeneira NA, et al. Accurate Measurement In California's Safety-Net Health Systems Has Gaps And Barriers. Health Aff (Millwood). 2018;37(11):1760-1769. doi:…

1804. Patient involvement for improved patient safety: a qualitative study of nurses' perceptions and experiences. | PSNet
      psnet.ahrq.gov/issue/patient-involvement-improved-patient-safety-qualitative-study-nurses-perceptions-and
      July 19, 2019 - Study Patient involvement for improved patient safety: a qualitative study of nurses' perceptions and experiences. Citation Text: Skagerström J, Ericsson C, Nilsen P, et al. Patient involvement for improved patient safety: A qualitative study of nurses' perceptions and experiences. Nurs …

1805. Contraindicated medication use in dialysis patients undergoing percutaneous coronary intervention. | PSNet
      psnet.ahrq.gov/issue/contraindicated-medication-use-dialysis-patients-undergoing-percutaneous-coronary
      February 03, 2011 - Study Contraindicated medication use in dialysis patients undergoing percutaneous coronary intervention. Citation Text: Tsai TT, Maddox TM, Roe MT, et al. Contraindicated medication use in dialysis patients undergoing percutaneous coronary intervention. JAMA. 2009;302(22):2458-64. doi:…

1806. Implementation of a custom alert to prevent medication-timing errors associated with computerized prescriber order entry. | PSNet
      psnet.ahrq.gov/issue/implementation-custom-alert-prevent-medication-timing-errors-associated-computerized
      April 25, 2016 - Study Implementation of a custom alert to prevent medication-timing errors associated with computerized prescriber order entry. Citation Text: Idemoto LM, Williams BL, Ching JM, et al. Implementation of a custom alert to prevent medication-timing errors associated with computerized presc…

1807. Direct Oral Anticoagulants are High-Risk Medications with Potentially Complex Dosing | PSNet
      psnet.ahrq.gov/web-mm/direct-oral-anticoagulants-are-high-risk-medications-potentially-complex-dosing
      August 21, 2005 - Direct Oral Anticoagulants are High-Risk Medications with Potentially Complex Dosing Citation Text: Giannini J, Wong M, Dager W, et al. Direct Oral Anticoagulants are High-Risk Medications with Potentially Complex Dosing. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Depar…

1808. Measuring Patient Safety | PSNet
      psnet.ahrq.gov/perspective/measuring-patient-safety
      December 14, 2022 - Severe hypoglycemia events are avoidable adverse drug events.

1809. Lost in the Black Hole | PSNet
      psnet.ahrq.gov/web-mm/lost-black-hole
      December 01, 2005 - Lost in the Black Hole Citation Text: Wachter R. Lost in the Black Hole. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMe…

1810. Handoffs and transitions of care: a systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma. | PSNet
      psnet.ahrq.gov/issue/handoffs-and-transitions-care-systematic-review-meta-analysis-and-practice-management
      September 23, 2020 - Review Handoffs and transitions of care: a systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma. Citation Text: Appelbaum RD, Puzio TJ, Bauman Z, et al. Handoffs and transitions of care: a systematic review, meta-analy…

1811. Quality and Safety Education for Nurses. | PSNet
      psnet.ahrq.gov/issue/quality-and-safety-education-nurses
      November 26, 2014 - Special or Theme Issue Quality and Safety Education for Nurses. Citation Text: Quality and Safety Education for Nurses. Cronenwett L, ed. Nurs Outlook. 2007;55(3):117-162. Copy Citation Save Save to your library Print Download PDF Share …

1812. In Conversation With... Dr. Michelle Schreiber on Measuring Patient Safety | PSNet
      psnet.ahrq.gov/perspective/conversation-dr-michelle-schreiber-measuring-patient-safety
      December 14, 2022 - Severe hypoglycemia events are avoidable adverse drug events.

1813. Medication errors during treatment with new oral anticancer agents: consequences for clinical practice based on the AMBORA Study. | PSNet
      psnet.ahrq.gov/issue/medication-errors-during-treatment-new-oral-anticancer-agents-consequences-clinical-practice
      April 21, 2021 - Study Medication errors during treatment with new oral anticancer agents: consequences for clinical practice based on the AMBORA Study. Citation Text: Schlichtig K, Dürr P, Dörje F, et al. Medication errors during treatment with new oral anticancer agents: consequences for clinical pract…

1814. Using human factors methods to mitigate bias in artificial intelligence-based clinical decision support. | PSNet
      psnet.ahrq.gov/issue/using-human-factors-methods-mitigate-bias-artificial-intelligence-based-clinical-decision
      July 10, 2019 - Commentary Using human factors methods to mitigate bias in artificial intelligence-based clinical decision support. Citation Text: Militello LG, Diiulio J, Wilson DL, et al. Using human factors methods to mitigate bias in artificial intelligence-based clinical decision support. J Am Med …

1815. The devil is in the detail: how a closed-loop documentation system for IV infusion administration contributes to and compromises patient safety. | PSNet
      psnet.ahrq.gov/issue/devil-detail-how-closed-loop-documentation-system-iv-infusion-administration-contributes-and
      February 12, 2020 - Study The devil is in the detail: how a closed-loop documentation system for IV infusion administration contributes to and compromises patient safety. Citation Text: Furniss D, Dean Franklin B, Blandford A. The devil is in the detail: how a closed-loop documentation system for IV infusi…

1816. Accreditation and Regulation: Can They Help Improve Patient Safety? | PSNet
      psnet.ahrq.gov/perspective/accreditation-and-regulation-can-they-help-improve-patient-safety
      April 01, 2009 - Accreditation and Regulation: Can They Help Improve Patient Safety? Rebecca N. Warburton, PhD | April 1, 2009  Also Read a Conversation View more articles from the same authors. Citation Text: Warburton RN. Accreditation and Regulation: Can They Help Improve Pat…

1817. In Conversation With... Remle P. Crowe, PhD | PSNet
      psnet.ahrq.gov/perspective/conversation-remle-p-crowe-phd
      May 16, 2022 - In Conversation With... Remle P. Crowe, PhD May 16, 2022  Also Read the Essay Citation Text: In Conversation With.. Remle P. Crowe, PhD . PSNet [internet]. 2022.In Conversation With... Remle P. Crowe, PhD . PSNet [internet]. Rockville (MD): Agency for Healthcare …

1818. Check Twice, Transport Once | PSNet
      psnet.ahrq.gov/web-mm/check-twice-transport-once
      March 15, 2023 - Check Twice, Transport Once Citation Text: DePew A, Rice J, Chou J. Check Twice, Transport Once. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 …

1819. Understanding the facilitators and barriers to barcode medication administration by nursing staff using behavioural science frameworks. A mixed methods study. | PSNet
      psnet.ahrq.gov/issue/understanding-facilitators-and-barriers-barcode-medication-administration-nursing-staff-using
      August 28, 2024 - Study Understanding the facilitators and barriers to barcode medication administration by nursing staff using behavioural science frameworks. A mixed methods study. Citation Text: Grailey K, Hussain R, Wylleman E, et al. Understanding the facilitators and barriers to barcode medication a…

1820. Improving quality and safety of care using "technovigilance": an ethnographic case study of secondary use of data from an electronic prescribing and decision support system. | PSNet
      psnet.ahrq.gov/issue/improving-quality-and-safety-care-using-technovigilance-ethnographic-case-study-secondary-use
      March 05, 2014 - Study Improving quality and safety of care using "technovigilance": an ethnographic case study of secondary use of data from an electronic prescribing and decision support system. Citation Text: Dixon-Woods M, Redwood S, Leslie M, et al. Improving quality and safety of care using "techno…