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psnet.ahrq.gov/issue/identifying-critically-ill-patients-risk-inappropriate-antibiotic-therapy-pilot-study-point
August 02, 2011 - Study
Identifying critically ill patients at risk for inappropriate antibiotic therapy: a pilot study of a point-of-care decision support alert.
Citation Text:
Micek ST, Heard KM, Gowan M, et al. Identifying critically ill patients at risk for inappropriate antibiotic therapy: a pilot st…
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psnet.ahrq.gov/issue/reducing-near-miss-medication-events-using-evidence-based-approach
July 07, 2021 - Study
Reducing near miss medication events using an evidence-based approach.
Citation Text:
Smith-Love J. Reducing near miss medication events using an evidence-based approach. J Nurs Care Qual. 2022;37(4):327-333. doi:10.1097/ncq.0000000000000630.
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psnet.ahrq.gov/issue/ed-handoffs-observed-practices-and-communication-errors
October 19, 2022 - Study
ED handoffs: observed practices and communication errors.
Citation Text:
Maughan BC, Lei L, Cydulka RK. ED handoffs: observed practices and communication errors. Am J Emerg Med. 2011;29(5):502-11. doi:10.1016/j.ajem.2009.12.004.
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psnet.ahrq.gov/issue/communication-vital-signs-emergency-department-handoff-opportunities-improvement
May 16, 2012 - Study
Communication of vital signs at emergency department handoff: opportunities for improvement.
Citation Text:
Venkatesh AK, Curley D, Chang Y, et al. Communication of Vital Signs at Emergency Department Handoff: Opportunities for Improvement. Ann Emerg Med. 2015;66(2):125-30. doi:10.…
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psnet.ahrq.gov/issue/medication-errors-antituberculosis-therapy-inpatient-academic-setting-forgotten-not-gone
April 27, 2016 - Study
Medication errors with antituberculosis therapy in an inpatient, academic setting: forgotten but not gone.
Citation Text:
Jen SP, Zucker J, Buczynski P, et al. Medication errors with antituberculosis therapy in an inpatient, academic setting: forgotten but not gone. J Clin Pharm Th…
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psnet.ahrq.gov/issue/measuring-perceptions-safety-climate-primary-care-cross-sectional-study
January 19, 2011 - Study
Measuring perceptions of safety climate in primary care: a cross-sectional study.
Citation Text:
de Wet C, Johnson P, Mash R, et al. Measuring perceptions of safety climate in primary care: a cross-sectional study. J Eval Clin Pract. 2010;18(1). doi:10.1111/j.1365-2753.2010.01537…
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psnet.ahrq.gov/issue/problems-detecting-medication-errors-hospitals
February 01, 2012 - Study
Classic
The problems of detecting medication errors in hospitals.
Citation Text:
Barker KN, McConnell WE. The Problems of Detecting Medication Errors in Hospitals. Am J Health Syst Pharm. 1962;19(8):360-369. doi:10.1093/ajhp/19.8.360.
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psnet.ahrq.gov/issue/what-happens-medication-regimens-older-adults-during-and-after-acute-hospitalization
May 19, 2021 - Study
What happens to the medication regimens of older adults during and after an acute hospitalization?
Citation Text:
Harris CM, Sridharan A, Landis R, et al. What happens to the medication regimens of older adults during and after an acute hospitalization? J Patient Saf. 2013;9(3):15…
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psnet.ahrq.gov/issue/impact-crisis-resource-management-simulation-based-training-interprofessional-and
November 13, 2019 - Review
Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: a systematic review.
Citation Text:
Fung L, Boet S, Bould D, et al. Impact of crisis resource management simulation-based training for interprofessional and interdisci…
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psnet.ahrq.gov/issue/implementation-crew-resource-management-qualitative-study-3-intensive-care-units
July 10, 2013 - Study
Implementation of crew resource management: a qualitative study in 3 intensive care units.
Citation Text:
Kemper PF, van Dyck C, Wagner C, et al. Implementation of Crew Resource Management: A Qualitative Study in 3 Intensive Care Units. J Patient Saf. 2017;13(4):223-231. doi:10.109…
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psnet.ahrq.gov/issue/development-trigger-tool-identify-adverse-events-and-harm-emergency-medical-services
August 07, 2024 - Study
Development of a trigger tool to identify adverse events and harm in emergency medical services.
Citation Text:
Howard IL, Bowen JM, Shaikh LAHA, et al. Development of a trigger tool to identify adverse events and harm in Emergency Medical Services. Emerg Med J. 2017;34(6):391-397.…
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psnet.ahrq.gov/issue/starting-elective-cardiac-surgery-after-3-pm-does-not-impact-patient-morbidity-mortality-or
February 12, 2020 - Study
Starting elective cardiac surgery after 3 pm does not impact patient morbidity, mortality, or hospital costs.
Citation Text:
Axtell AL, Moonsamy P, Melnitchouk S, et al. Starting elective cardiac surgery after 3 pm does not impact patient morbidity, mortality, or hospital costs. J …
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psnet.ahrq.gov/issue/impact-computerized-physician-order-entry-system-nurse-physician-collaboration-medication
February 23, 2009 - Study
Impact of a computerized physician order entry system on nurse-physician collaboration in the medication process.
Citation Text:
Pirnejad H, Niazkhani Z, van der Sijs H, et al. Impact of a computerized physician order entry system on nurse-physician collaboration in the medi…
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psnet.ahrq.gov/issue/educational-intervention-enhance-nurse-leaders-perceptions-patient-safety-culture
February 14, 2015 - Study
An educational intervention to enhance nurse leaders' perceptions of patient safety culture.
Citation Text:
Ginsburg LR, Norton PG, Casebeer A, et al. An educational intervention to enhance nurse leaders' perceptions of patient safety culture. Health Serv Res. 2005;40(4):997-1020…
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psnet.ahrq.gov/issue/triad-xii-are-patients-aware-and-agree-dnr-or-polst-orders-their-medical-records
September 15, 2021 - Study
TRIAD XII: are patients aware of and agree with DNR or POLST orders in their medical records.
Citation Text:
Mirarchi FL, Juhasz K, Cooney TE, et al. TRIAD XII: Are Patients Aware of and Agree With DNR or POLST Orders in Their Medical Records. J Patient Saf. 2019;15(3):230-237. doi…
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psnet.ahrq.gov/issue/state-evidence-computerized-provider-order-entry-systematic-review-and-analysis-quality
August 04, 2021 - Review
The state of the evidence for computerized provider order entry: a systematic review and analysis of the quality of the literature.
Citation Text:
Weir C, Staggers N, Phansalkar S. The state of the evidence for computerized provider order entry: a systematic review and analysis …
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psnet.ahrq.gov/issue/availability-hospital-it-applications-associated-hospitals-risk-adjusted-incidence-rate
September 01, 2021 - Study
Is the availability of hospital IT applications associated with a hospital's risk adjusted incidence rate for patient safety indicators: results from 66 Georgia hospitals.
Citation Text:
Culler SD, Hawley JN, Naylor V, et al. Is the availability of hospital IT applications associ…
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psnet.ahrq.gov/issue/fifteen-years-after-err-human-success-story-learn
August 04, 2021 - Commentary
Fifteen years after To Err Is Human: a success story to learn from.
Citation Text:
Pronovost P, Cleeman JI, Wright D, et al. Fifteen years after To Err is Human: a success story to learn from. BMJ Qual Saf. 2016;25(6):396-9. doi:10.1136/bmjqs-2015-004720.
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psnet.ahrq.gov/issue/utilization-role-based-head-covering-system-decrease-misidentification-operating-room
September 23, 2020 - Study
Utilization of a role-based head covering system to decrease misidentification in the operating room.
Citation Text:
Rosen DA, Criser AL, Petrone AB, et al. Utilization of a Role-Based Head Covering System to Decrease Misidentification in the Operating Room. J Patient Saf. 2019;15(…
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psnet.ahrq.gov/issue/estimating-breast-cancer-overdiagnosis-after-screening-mammography-among-older-women-united
October 19, 2022 - Study
Estimating breast cancer overdiagnosis after screening mammography among older women in the United States.
Citation Text:
Richman IB, Long JB, Soulos PR, et al. Estimating breast cancer overdiagnosis after screening mammography among older women in the United States. Ann Intern Med…