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  1. Nurse–pharmacist collaboration on medication reconciliation prevents potential harm. | PSNet

    psnet.ahrq.gov/issue/nurse-pharmacist-collaboration-medication-reconciliation-prevents-potential-harm
    August 08, 2018 - Study Nurse–pharmacist collaboration on medication reconciliation prevents potential harm. Citation Text: Feldman LS, Costa LL, Feroli R, et al. Nurse-pharmacist collaboration on medication reconciliation prevents potential harm. J Hosp Med. 2012;7(5):396-401. doi:10.1002/jhm.1921. …

  2. Structural empowerment and patient safety culture among registered nurses working in adult critical care units. | PSNet

    psnet.ahrq.gov/issue/structural-empowerment-and-patient-safety-culture-among-registered-nurses-working-adult
    January 23, 2008 - Study Structural empowerment and patient safety culture among registered nurses working in adult critical care units. Citation Text: Armellino D, Griffin MTQ, Fitzpatrick JJ. Structural empowerment and patient safety culture among registered nurses working in adult critical care units.…

  3. Potentially inappropriate medication use in hospitalized elders. | PSNet

    psnet.ahrq.gov/issue/potentially-inappropriate-medication-use-hospitalized-elders
    February 17, 2011 - Study Potentially inappropriate medication use in hospitalized elders. Citation Text: Rothberg MB, Pekow PS, Liu F, et al. Potentially inappropriate medication use in hospitalized elders. J Hosp Med. 2008;3(2):91-102. doi:10.1002/jhm.290. Copy Citation Format: DOI Google …

  4. Acceptance of recommendations by inpatient pharmacy case managers: unintended consequences of hospitalist and specialist care. | PSNet

    psnet.ahrq.gov/issue/acceptance-recommendations-inpatient-pharmacy-case-managers-unintended-consequences
    November 16, 2022 - Study Acceptance of recommendations by inpatient pharmacy case managers: unintended consequences of hospitalist and specialist care. Citation Text: Anderegg S, Demik DE, Carter BL, et al. Acceptance of recommendations by inpatient pharmacy case managers: unintended consequences of hosp…

  5. Critical incident reports concerning anaesthetic equipment: analysis of the UK National Reporting and Learning System (NRLS) data from 2006-2008. | PSNet

    psnet.ahrq.gov/issue/critical-incident-reports-concerning-anaesthetic-equipment-analysis-uk-national-reporting-and
    August 03, 2022 - Study Critical incident reports concerning anaesthetic equipment: analysis of the UK National Reporting and Learning System (NRLS) data from 2006-2008. Citation Text: Cassidy CJ, Smith AF, Arnot-Smith J. Critical incident reports concerning anaesthetic equipment: analysis of the UK Nat…

  6. Perspective: ten thousand hours to patient safety, sooner or later. | PSNet

    psnet.ahrq.gov/issue/perspective-ten-thousand-hours-patient-safety-sooner-or-later
    June 23, 2009 - Commentary Perspective: ten thousand hours to patient safety, sooner or later. Citation Text: Pellegrini VD. Perspective: ten thousand hours to patient safety, sooner or later. Acad Med. 2012;87(2):164-7. doi:10.1097/ACM.0b013e31823f7202. Copy Citation Format: DOI Google…

  7. A perfect storm averted: flawed systems, a dropped ball, and cognitive biases delay a critical diagnosis. | PSNet

    psnet.ahrq.gov/issue/perfect-storm-averted-flawed-systems-dropped-ball-and-cognitive-biases-delay-critical
    November 30, 2022 - Commentary A perfect storm averted: flawed systems, a dropped ball, and cognitive biases delay a critical diagnosis. Citation Text: Roberts TJ, Sellars MC, Sands JM, et al. A perfect storm averted: flawed systems, a dropped ball, and cognitive biases delay a critical diagnosis. JCO Oncol…

  8. Impact of the Care Quality Commission on Provider Performance: Room for Improvement? | PSNet

    psnet.ahrq.gov/issue/impact-care-quality-commission-provider-performance-room-improvement
    November 18, 2015 - Book/Report Impact of the Care Quality Commission on Provider Performance: Room for Improvement? Citation Text: Impact of the Care Quality Commission on Provider Performance: Room for Improvement? Smithson R, Richardson E, Roberts J, et al. The King's Fund, Alliance Manchester Business S…

  9. Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients. | PSNet

    psnet.ahrq.gov/issue/increases-mortality-length-stay-and-cost-associated-hospital-acquired-infections-trauma
    December 21, 2014 - Study Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients. Citation Text: Glance LG, Stone PW, Mukamel DB, et al. Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients.…

  10. A culture of safety in EMS systems. | PSNet

    psnet.ahrq.gov/issue/culture-safety-ems-systems-0
    February 18, 2011 - Organizational Policy/Guidelines A culture of safety in EMS systems. Citation Text: A culture of safety in EMS systems. American College of Emergency Physicians, National Association of Emergency Medical Services.  Ann Emerg Med. 2021;78(3):e37-e57.  Copy Citation …

  11. Maintaining safety in the dialysis facility. | PSNet

    psnet.ahrq.gov/issue/maintaining-safety-dialysis-facility
    May 25, 2011 - Commentary Maintaining safety in the dialysis facility. Citation Text: Kliger AS. Maintaining safety in the dialysis facility. Clin J Am Soc Nephrol. 2015;10(4):688-95. doi:10.2215/CJN.08960914. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7…

  12. Delayed Admissions to the Pediatric Intensive Care Unit: Progression of Disease or Errors in Emergency Department Management | PSNet

    psnet.ahrq.gov/issue/delayed-admissions-pediatric-intensive-care-unit-progression-disease-or-errors-emergency
    June 14, 2019 - Journal Article Delayed Admissions to the Pediatric Intensive Care Unit: Progression of Disease or Errors in Emergency Department Management Citation Text: Czolgosz T, Cashen K, Farooqi A, et al. Delayed Admissions to the Pediatric Intensive Care Unit: Progression of Disease or Errors in…

  13. Use of failure mode and effects analysis to improve emergency department handoff processes. | PSNet

    psnet.ahrq.gov/issue/use-failure-mode-and-effects-analysis-improve-emergency-department-handoff-processes
    October 19, 2022 - Commentary Use of failure mode and effects analysis to improve emergency department handoff processes. Citation Text: Sorrentino P. Use of Failure Mode and Effects Analysis to Improve Emergency Department Handoff Processes. Clin Nurse Spec. 2016;30(1):28-37. doi:10.1097/NUR.0000000000000…

  14. New solutions to reduce wrong route medication errors. | PSNet

    psnet.ahrq.gov/issue/new-solutions-reduce-wrong-route-medication-errors
    March 20, 2019 - Review New solutions to reduce wrong route medication errors. Citation Text: Litman RS, Smith VI, Mainland P. New solutions to reduce wrong route medication errors. Paediatr Anaesth. 2018;28(1):8-12. doi:10.1111/pan.13279. Copy Citation Format: DOI Google Scholar PubMed Bib…

  15. Implementing AORN recommended practices for transfer of patient care information. | PSNet

    psnet.ahrq.gov/issue/implementing-aorn-recommended-practices-transfer-patient-care-information
    October 07, 2013 - Commentary Implementing AORN recommended practices for transfer of patient care information. Citation Text: Seifert PC. Implementing AORN recommended practices for transfer of patient care information. AORN J. 2012;96(5):475-93. doi:10.1016/j.aorn.2012.08.011. Copy Citation Forma…

  16. The implementation of a perioperative checklist increases patients' perioperative safety and staff satisfaction. | PSNet

    psnet.ahrq.gov/issue/implementation-perioperative-checklist-increases-patients-perioperative-safety-and-staff
    April 03, 2013 - Study The implementation of a perioperative checklist increases patients' perioperative safety and staff satisfaction. Citation Text: Böhmer AB, Wappler F, Tinschmann T, et al. The implementation of a perioperative checklist increases patients' perioperative safety and staff satisfacti…

  17. The role of checklists and human factors for improved patient safety in plastic surgery. | PSNet

    psnet.ahrq.gov/issue/role-checklists-and-human-factors-improved-patient-safety-plastic-surgery
    November 02, 2016 - Commentary The role of checklists and human factors for improved patient safety in plastic surgery. Citation Text: Oppikofer C, Schwappach DLB. The Role of Checklists and Human Factors for Improved Patient Safety in Plastic Surgery. Plast Reconstr Surg. 2017;140(6):812e-817e. doi:10.1097…

  18. Understanding the cognitive work of nursing in the acute care environment. | PSNet

    psnet.ahrq.gov/issue/understanding-cognitive-work-nursing-acute-care-environment
    July 20, 2022 - Study Understanding the cognitive work of nursing in the acute care environment. Citation Text: Potter P, Wolf L, Boxerman S, et al. Understanding the cognitive work of nursing in the acute care environment. J Nurs Adm. 2005;35(7-8):327-335. https://journals.lww.com/jonajournal/Abstract/…

  19. Use of medical emergency team (MET) responses to detect medical errors. | PSNet

    psnet.ahrq.gov/issue/use-medical-emergency-team-met-responses-detect-medical-errors
    April 06, 2011 - Study Use of medical emergency team (MET) responses to detect medical errors. Citation Text: Braithwaite RS, Devita MA, Mahidhara R, et al. Use of medical emergency team (MET) responses to detect medical errors. Qual Saf Health Care. 2004;13(4):255-259. Copy Citation Format: …

  20. Mapping research on culture and safety in high-risk organizations: arguments for a sociotechnical understanding of safety culture. | PSNet

    psnet.ahrq.gov/issue/mapping-research-culture-and-safety-high-risk-organizations-arguments-sociotechnical
    August 09, 2017 - Commentary Mapping research on culture and safety in high-risk organizations: arguments for a sociotechnical understanding of safety culture. Citation Text: Naevestad T-O. Mapping Research on Culture and Safety in High-Risk Organizations: Arguments for a Sociotechnical Understanding of…
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