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  1. psnet.ahrq.gov/issue/patient-safety-dentistry-development-candidate-never-event-list-primary-care
    April 12, 2017 - Study Patient safety in dentistry: development of a candidate 'never event' list for primary care. Citation Text: Black I, Bowie P. Patient safety in dentistry: development of a candidate 'never event' list for primary care. Br Dent J. 2017;222(10):782-788. doi:10.1038/sj.bdj.2017.456. …
  2. psnet.ahrq.gov/issue/spoons-systematically-bias-dosing-liquid-medicine
    November 03, 2015 - Study Spoons systematically bias dosing of liquid medicine. Citation Text: Wansink B, van Ittersum K. Spoons systematically bias dosing of liquid medicine. Ann Intern Med. 2010;152(1):66-7. doi:10.7326/0003-4819-152-1-201001050-00024. Copy Citation Format: DOI Google Scho…
  3. psnet.ahrq.gov/issue/point-care-testing-error-sources-and-amplifiers-taxonomy-prevention-strategies-and-detection
    January 08, 2016 - Study Point-of-care testing error: sources and amplifiers, taxonomy, prevention strategies, and detection monitors. Citation Text: Meier FA, Jones BA. Point-of-care testing error: sources and amplifiers, taxonomy, prevention strategies, and detection monitors. Arch Pathol Lab Med. 2005…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35761/psn-pdf
    February 15, 2017 - SBAR: a shared mental model for improving communication between clinicians. February 15, 2017 Haig KM, Sutton S, Whittington J. SBAR: a shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf. 2006;32(3):167-75. https://psnet.ahrq.gov/issue/sbar-shared-mental-model-improving-…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41711/psn-pdf
    September 26, 2012 - Beyond FMEA: the structured what-if technique (SWIFT). September 26, 2012 Card AJ, Ward JR, Clarkson PJ. Beyond FMEA: The structured what-if technique (SWIFT). J Healthc Risk Manag. 2012;31(4):23-29. doi:10.1002/jhrm.20101. https://psnet.ahrq.gov/issue/swift-new-tool-identifying-prospective-hazards This commentary…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41442/psn-pdf
    May 30, 2012 - Radiation Therapy Safety: The Critical Role of the Radiation Therapist. May 30, 2012 Odle TG, Rosier N. Albuquerque, NM: American Society of Radiologic Technologists Education and Research Foundation; 2012. https://psnet.ahrq.gov/issue/radiation-therapy-safety-critical-role-radiation-therapist Summarizing the rol…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37339/psn-pdf
    January 02, 2017 - A check-up for safety culture in "my patient care area." January 2, 2017 Sexton JB, Paine LA, Manfuso J, et al. A Check-up for Safety Culture in “My Patient Care Area”. doi:10.1016/s1553-7250(07)33081-x. https://psnet.ahrq.gov/issue/check-safety-culture-my-patient-care-area This tool is designed to allow frontline…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47556/psn-pdf
    November 28, 2018 - Improving Diagnosis. November 28, 2018 Deutsch E, ed. PA-PSRS Pa Patient Saf Advis. 2018 Oct 31;15(suppl 1):1-70. https://psnet.ahrq.gov/issue/improving-diagnosis This special issue raises awareness of challenges to reducing diagnostic error. Articles discuss insights from experts about how to improve diagnosis, t…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43800/psn-pdf
    August 02, 2016 - Patient Safety Culture: Theory, Methods and Application. August 2, 2016 Waterson P, ed. London, UK: Ashgate; 2014. ISBN: 9781409448143. https://psnet.ahrq.gov/issue/patient-safety-culture-theory-methods-and-application This publication covers patient safety culture including its background in high-risk industries, …
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50633/psn-pdf
    November 06, 2019 - Findings of Two Inaugural Leapfrog Surveys 2019. November 6, 2019 Washington DC: Leapfrog Group; 2019. https://psnet.ahrq.gov/issue/findings-two-inaugural-leapfrog-surveys-2019 Ambulatory surgery centers (ASC) are established venues for surgical care despite engagement in assessment to ensure their safety. This re…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60332/psn-pdf
    May 13, 2020 - Circle Up Training. May 13, 2020 Center for Medical Simulation. https://psnet.ahrq.gov/issue/circle-training Communication strategies are important for engaging staff in behaviors that support effective teamwork. This website highlights a process that involves briefings, supportive conversations, and debriefings a…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39937/psn-pdf
    December 06, 2010 - Hospital safety climate surveys: measurement issues. December 6, 2010 Jackson J, Sarac C, Flin R. Hospital safety climate surveys: measurement issues. Curr Opin Crit Care. 2010;16(6):632-8. doi:10.1097/MCC.0b013e32833f0ee6. https://psnet.ahrq.gov/issue/hospital-safety-climate-surveys-measurement-issues This review…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37951/psn-pdf
    May 26, 2011 - The Leapfrog Group's CPOE standard and evaluation tool. May 26, 2011 Metzger JB, Welebob E, Turisco F, et al. Patient Saf Qual Healthc. July/August 2008;5:22-25. https://psnet.ahrq.gov/issue/leapfrog-groups-cpoe-standard-and-evaluation-tool This article describes an evaluation tool designed for…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34926/psn-pdf
    February 03, 2010 - Strategies to improve the patient safety outcome indicator: preventing or reducing falls. February 3, 2010 Bright L. Strategies to improve the patient safety outcome indicator: preventing or reducing falls. Home Healthc Nurse. 2005;23(1):29-36. https://psnet.ahrq.gov/issue/strategies-improve-patient-safety-outcome…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/844798/psn-pdf
    September 25, 2019 - Poetry and Medicine. Mistakes. September 25, 2019 Kittleson M. JAMA. 2019;322(10):984. https://psnet.ahrq.gov/issue/poetry-and-medicine-mistakes-0 Medical mistakes are a source of anxiety for both patients and clinicians. This poem articulates a physician's perspective regarding the psychological impact of uncerta…
  16. psnet.ahrq.gov/web-mm/missed-appendicitis
    March 13, 2013 - SPOTLIGHT CASE Missed Appendicitis Citation Text: Adams JG. Missed Appendicitis. 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 E…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49480/psn-pdf
    May 01, 2005 - Diagnosing Diagnostic Mistakes May 1, 2005 McNutt RA, Abrams RI, Hasler S. Diagnosing Diagnostic Mistakes. PSNet [internet]. 2005. https://psnet.ahrq.gov/web-mm/diagnosing-diagnostic-mistakes Learning Objectives Understand the biases that may contribute to overcalling medical errors Describe the impact of conside…
  18. psnet.ahrq.gov/issue/post-operative-mortality-missed-care-and-nurse-staffing-nine-countries-cross-sectional-study
    December 12, 2014 - June 22, 2022 Factors associated with missed nursing care and nurse-assessed quality
  19. psnet.ahrq.gov/issue/safety-attitudes-questionnaire-psychometric-properties-benchmarking-data-and-emerging
    June 16, 2011 - nursing homes: variance of six patient safety climate factor scores across nursing homes and wards—assessed
  20. psnet.ahrq.gov/issue/why-patient-summaries-electronic-health-records-do-not-provide-cognitive-support-necessary
    January 18, 2013 - January 18, 2013 The effect of hospital electronic health record adoption on nurse-assessed

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