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psnet.ahrq.gov/node/33916/psn-pdf
December 22, 2014 - Training of Hospital Staff To Respond to a Mass Casualty
Incident. Summary, Evidence Report/Technology
Assessment.
December 22, 2014
Hsu EB, Jenckes MW, Catlett CL, et al. In: AHRQ Evidence Report Summaries. Rockville, MD: Agency for
Healthcare Research and Quality; 1998-2005. 95. AHRQ Publication No. 04-E015-1
h…
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psnet.ahrq.gov/node/864386/psn-pdf
March 13, 2024 - Time for prefilled syringes - everywhere.
March 13, 2024
Whitaker DK, Lomas JP. Time for prefilled syringes – everywhere. Anaesthesia. 2024;79(2):119-122.
doi:10.1111/anae.16181.
https://psnet.ahrq.gov/issue/time-prefilled-syringes-everywhere
Simplifying complex processes is a strategy to engineer safety into heal…
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psnet.ahrq.gov/node/38405/psn-pdf
February 11, 2009 - Development of a self-report instrument to measure
patient safety attitudes, skills, and knowledge.
February 11, 2009
Schnall R, Stone PW, Currie L, et al. Development of a self-report instrument to measure patient safety
attitudes, skills, and knowledge. J Nurs Scholarsh. 2008;40(4):391-4. doi:10.1111/j.1547-
506…
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psnet.ahrq.gov/node/45842/psn-pdf
April 12, 2017 - Time-out and checklists: a survey of rural and urban
operating room personnel.
April 12, 2017
Lyons VE, Popejoy LL. Time-Out and Checklists: A Survey of Rural and Urban Operating Room Personnel.
J Nurs Care Qual. 2017;32(1):E3-E10.
https://psnet.ahrq.gov/issue/time-out-and-checklists-survey-rural-and-urban-operati…
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psnet.ahrq.gov/node/60671/psn-pdf
July 08, 2020 - Hidden in plain sight — reconsidering the use of race
correction in clinical algorithms.
July 8, 2020
Vyas DA, Eisenstein LG, Jones DS. Hidden in plain sight — reconsidering the use of race correction in
clinical algorithms. N Engl J Med. 2020;383(9):874-882. doi:10.1056/nejmms2004740.
https://psnet.ahrq.gov/issue…
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psnet.ahrq.gov/node/42057/psn-pdf
February 20, 2013 - Improving patient safety in the operating theatre and
perioperative care: obstacles, interventions, and priorities
for accelerating progress.
February 20, 2013
Sevdalis N, Hull L, Birnbach DJ. Improving patient safety in the operating theatre and perioperative care:
obstacles, interventions, and priorities for acc…
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psnet.ahrq.gov/node/40487/psn-pdf
June 01, 2011 - Developing and testing a tool to measure nurse/physician
communication in the intensive care unit.
June 1, 2011
Carbo AR, Tess AV, Roy CL, et al. Developing a High-Performance Team Training Framework for Internal
Medicine Residents. J Patient Saf. 2011;7(2). doi:10.1097/pts.0b013e31820dbe02.
https://psnet.ahrq.gov…
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psnet.ahrq.gov/node/38813/psn-pdf
June 16, 2010 - Medication reconciliation performed by pharmacy
technicians at the time of preoperative screening.
June 16, 2010
van den Bemt PM, van den Broek S, van Nunen AK, et al. Medication reconciliation performed by
pharmacy technicians at the time of preoperative screening. Ann Pharmacother. 2009;43(5):868-74.
doi:10.1345…
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psnet.ahrq.gov/node/836870/psn-pdf
April 26, 2022 - A Conversation Among Stakeholders on Medical
Malpractice.
April 6, 2022
Collaborative for Accountability and Improvement. April 26, 2022.
https://psnet.ahrq.gov/issue/conversation-among-stakeholders-medical-malpractice
Communication and resolution programs (CRP) can improve response to patients and families a…
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psnet.ahrq.gov/node/50646/psn-pdf
November 06, 2019 - My patient almost died from a mistake I made. I
apologized and it changed my life.
November 6, 2019
McLean K. Huffington Post. October 16, 2019.
https://psnet.ahrq.gov/issue/my-patient-almost-died-mistake-i-made-i-apologized-and-it-changed-my-life
Medical mistakes cause stress for both patients and their clinician…
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psnet.ahrq.gov/node/37881/psn-pdf
July 02, 2008 - Simulated laparoscopic operating room crisis: an
approach to enhance the surgical team performance.
July 2, 2008
Powers KA, Rehrig ST, Irias N, et al. Simulated laparoscopic operating room crisis: An approach to
enhance the surgical team performance. Surg Endosc. 2008;22(4):885-900.
https://psnet.ahrq.gov/issue/si…
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psnet.ahrq.gov/node/38592/psn-pdf
April 29, 2009 - The teaching of a structured tool improves the clarity and
content of interprofessional clinical communication.
April 29, 2009
Marshall S, Harrison J, Flanagan B. The teaching of a structured tool improves the clarity and content of
interprofessional clinical communication. Qual Saf Health Care. 2009;18(2):137-40.
…
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psnet.ahrq.gov/node/851658/psn-pdf
July 26, 2023 - The spectrum of hospitalization-associated harm in the
elderly.
July 26, 2023
Schattner A. The spectrum of hospitalization-associated harm in the elderly. Eur J Intern Med.
2023;115(Sept):29-33. doi:10.1016/j.ejim.2023.05.025.
https://psnet.ahrq.gov/issue/spectrum-hospitalization-associated-harm-elderly
Older pat…
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psnet.ahrq.gov/node/40861/psn-pdf
October 19, 2011 - Registered nurses' judgments of the classification and
risk level of patient care errors.
October 19, 2011
Chipps E, Wills CE, Tanda R, et al. Registered nurses' judgments of the classification and risk level of
patient care errors. J Nurs Care Qual. 2011;26(4):302-310. doi:10.1097/NCQ.0b013e31820f4c57.
https://ps…
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psnet.ahrq.gov/node/866869/psn-pdf
October 02, 2024 - Core Elements of Hospital Diagnostic Excellence (DxEx).
October 2, 2024
Core Elements of Hospital Diagnostic Excellence (DxEx). Centers for Disease Control and Prevention.
https://psnet.ahrq.gov/issue/core-elements-hospital-diagnostic-excellence-dxex
Diagnostic excellence is an expansion of the diagnostic error red…
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psnet.ahrq.gov/node/36935/psn-pdf
September 01, 2011 - When should a multicampus hospital be considered a
single entity for public reporting on patient safety issues?
September 1, 2011
Naessens JM, Culbertson R, Lefante JJ, et al. When should a multicampus hospital be considered a single
entity for public reporting on patient safety issues? Qual Manag Health Care. 2007…
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psnet.ahrq.gov/node/43985/psn-pdf
December 06, 2017 - Development of a medication safety and quality survey
for small rural hospitals.
December 6, 2017
Winterstein AG, Johns TE, Campbell KN, et al. Development of a Medication Safety and Quality Survey for
Small Rural Hospitals. J Patient Saf. 2017;13(4):249-254. doi:10.1097/PTS.0000000000000154.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/37746/psn-pdf
May 14, 2008 - Reducing preventable medication safety events by
recognizing renal risk.
May 14, 2008
Fields W, Tedeschi C, Foltz J, et al. Reducing preventable medication safety events by recognizing renal
risk. Clin Nurse Spec. 2008;22(2):73-8; quiz 79-80. doi:10.1097/01.NUR.0000311795.69476.2f.
https://psnet.ahrq.gov/issue/red…
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psnet.ahrq.gov/node/46332/psn-pdf
September 24, 2017 - Sharing the process of diagnostic decision making.
September 24, 2017
Brush JE, Brophy JM. Sharing the Process of Diagnostic Decision Making. JAMA Intern Med.
2017;177(9):1245-1246. doi:10.1001/jamainternmed.2017.1929.
https://psnet.ahrq.gov/issue/sharing-process-diagnostic-decision-making
Improving diagnosis has …
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psnet.ahrq.gov/node/60885/psn-pdf
September 02, 2020 - Becoming a High Reliability Organization.
September 2, 2020
VHA Forum. Summer 2020;1-12.
https://psnet.ahrq.gov/issue/becoming-high-reliability-organization
High reliability attainment is a stated goal for health care organizations. This special issue covers
established initiatives at the United States Veterans He…