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psnet.ahrq.gov/node/49728/psn-pdf
March 01, 2015 - Medication Mix-Up: From Bad to Worse
March 1, 2015
Wollitz A, O'Connor MF. Medication Mix-Up: From Bad to Worse. PSNet [internet]. 2015.
https://psnet.ahrq.gov/web-mm/medication-mix-bad-worse
The Case
A 69-year-old man with chronic kidney disease and essential hypertension was admitted to the hospital
with chest …
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psnet.ahrq.gov/perspective/conversation-withsir-liam-donaldson-md-msc
May 01, 2007 - Most doctors, at least in my country, are not assessed once they've gone into autonomous practicefor
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psnet.ahrq.gov/node/45483/psn-pdf
March 20, 2018 - Impact of initial hospital diagnosis on mortality for acute
myocardial infarction: a national cohort study.
March 20, 2018
Wu J, Gale CP, Hall M, et al. Editor's Choice - Impact of initial hospital diagnosis on mortality for acute
myocardial infarction: A national cohort study. Eur Heart J Acute Cardiovasc Care. 20…
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psnet.ahrq.gov/node/46108/psn-pdf
December 21, 2017 - Speaking up about traditional and professionalism-related
patient safety threats: a national survey of interns and
residents.
December 21, 2017
Martinez W, Lehmann LS, Thomas EJ, et al. Speaking up about traditional and professionalism-related
patient safety threats: a national survey of interns and residents. BMJ…
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psnet.ahrq.gov/node/46851/psn-pdf
January 23, 2019 - To care is human—collectively confronting the clinician-
burnout crisis.
January 23, 2019
Dzau VJ, Kirch DG, Nasca TJ. To Care Is Human — Collectively Confronting the Clinician-Burnout Crisis.
New Engl J Med. 2018;378(4):312-314. doi:10.1056/nejmp1715127.
https://psnet.ahrq.gov/issue/care-human-collectively-confro…
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psnet.ahrq.gov/node/40048/psn-pdf
December 01, 2010 - Temporal trends in rates of patient harm resulting from
medical care.
December 1, 2010
Landrigan CP, Parry G, Bones CB, et al. Temporal trends in rates of patient harm resulting from medical
care. N Engl J Med. 2010;363(22):2124-34. doi:10.1056/NEJMsa1004404.
https://psnet.ahrq.gov/issue/temporal-trends-rates-pati…
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psnet.ahrq.gov/node/43915/psn-pdf
September 27, 2017 - The quality of hospital work environments and missed
nursing care is linked to heart failure readmissions: a
cross-sectional study of US hospitals.
September 27, 2017
Carthon MB, Lasater KB, Sloane DM, et al. The quality of hospital work environments and missed nursing
care is linked to heart failure readmissions:…
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psnet.ahrq.gov/node/47602/psn-pdf
January 27, 2019 - Association of nurse workload with missed nursing care
in the neonatal intensive care unit.
January 27, 2019
Tubbs-Cooley HL, Mara CA, Carle AC, et al. Association of Nurse Workload With Missed Nursing Care in
the Neonatal Intensive Care Unit. JAMA Pediatr. 2019;173(1):44-51.
doi:10.1001/jamapediatrics.2018.3619.
…
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psnet.ahrq.gov/node/40726/psn-pdf
July 03, 2014 - Automated identification of postoperative complications
within an electronic medical record using natural
language processing.
July 3, 2014
Murff HJ, FitzHenry F, Matheny ME, et al. Automated identification of postoperative complications within an
electronic medical record using natural language processing. JAMA. …
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psnet.ahrq.gov/node/38120/psn-pdf
June 16, 2011 - Organizational culture, team climate and diabetes care in
small office-based practices.
June 16, 2011
Bosch M, Dijkstra R, Wensing M, et al. Organizational culture, team climate and diabetes care in small
office-based practices. BMC Health Serv Res. 2008;8:180. doi:10.1186/1472-6963-8-180.
https://psnet.ahrq.gov/i…
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psnet.ahrq.gov/node/46110/psn-pdf
January 01, 2019 - Examination of the relationship between management and
clinician perception of patient safety climate and patient
satisfaction.
December 21, 2018
Mazurenko O, Richter J, Kazley AS, et al. Examination of the relationship between management and
clinician perception of patient safety climate and patient satisfaction.…
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psnet.ahrq.gov/node/47609/psn-pdf
December 19, 2018 - Nurse Staffing Levels, Missed Vital Signs and Mortality in
Hospitals: Retrospective Longitudinal Observational
Study.
December 19, 2018
Griffiths P, Ball JE, Bloor K, et al. Nurse Staffing Levels, Missed Vital Signs And Mortality In Hospitals:
Retrospective Longitudinal Observational Study. Southampton, UK: NIHR J…
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psnet.ahrq.gov/node/37543/psn-pdf
March 03, 2011 - Rates of medication errors among depressed and burnt
out residents: prospective cohort study.
March 3, 2011
Fahrenkopf AM, Sectish TC, Barger LK, et al. Rates of medication errors among depressed and burnt out
residents: prospective cohort study. BMJ. 2008;336(7642):488-91. doi:10.1136/bmj.39469.763218.BE.
https:/…
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psnet.ahrq.gov/node/47150/psn-pdf
November 21, 2018 - Investigating the association of alerts from a national
mortality surveillance system with subsequent hospital
mortality in England: an interrupted time series analysis.
November 21, 2018
Cecil E, Bottle A, Esmail A, et al. Investigating the association of alerts from a national mortality
surveillance system with …
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psnet.ahrq.gov/node/40166/psn-pdf
April 03, 2017 - A strategic approach for managing conflict in hospitals:
responding to The Joint Commission leadership
standard—part 1 and part 2.
April 3, 2017
Scott C, Gerardi D. A strategic approach for managing conflict in hospitals: responding to the Joint
Commission leadership standard, Part 1. Jt Comm J Qual Patient Saf. 2…
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psnet.ahrq.gov/node/44374/psn-pdf
August 12, 2015 - ASHP national survey of pharmacy practice in hospital
settings: dispensing and administration—2014.
August 12, 2015
Pedersen CA, Schneider PJ, Scheckelhoff DJ. ASHP national survey of pharmacy practice in hospital
settings: Dispensing and administration--2014. Am J Health Syst Pharm. 2015;72(13):1119-37.
doi:10.21…
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psnet.ahrq.gov/node/39071/psn-pdf
November 04, 2009 - Identification of patient information corruption in the
intensive care unit: using a scoring tool to direct quality
improvements in handover.
November 4, 2009
Pickering BW, Hurley K, Marsh B. Identification of patient information corruption in the intensive care unit:
using a scoring tool to direct quality improve…
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psnet.ahrq.gov/node/43157/psn-pdf
May 07, 2014 - Governing board, C-suite, and clinical management
perceptions of quality and safety structures, processes,
and priorities in US hospitals.
May 7, 2014
Vaughn T, Koepke M, Levey S, et al. Governing board, C-suite, and clinical management perceptions of
quality and safety structures, processes, and priorities in U.S…
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psnet.ahrq.gov/node/46112/psn-pdf
December 21, 2017 - Analysis of variations in the display of drug names in
computerized prescriber-order-entry systems.
December 21, 2017
Quist AJL, Hickman T-TT, Amato MG, et al. Analysis of variations in the display of drug names in
computerized prescriber-order-entry systems. American Journal of Health-System Pharmacy. 2017;74(7).
…
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psnet.ahrq.gov/node/44719/psn-pdf
February 14, 2017 - Prevalence and characteristics of physicians prone to
malpractice claims.
February 14, 2017
Studdert DM, Bismark M, Mello MM, et al. Prevalence and Characteristics of Physicians Prone to
Malpractice Claims. New Engl J Med. 2016;374(4):354-362. doi:10.1056/NEJMsa1506137.
https://psnet.ahrq.gov/issue/prevalence-and-…