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psnet.ahrq.gov/node/73867/psn-pdf
September 22, 2021 - A dynamic risk management approach for reducing harm
from invasive bedside procedures performed during
residency.
September 22, 2021
Warm E, Ahmad Y, Kinnear B, et al. A dynamic risk management approach for reducing harm from
invasive bedside procedures performed during residency. Acad Med. 2021;96(9):1268-1275.
…
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psnet.ahrq.gov/node/840487/psn-pdf
November 30, 2022 - Interprofessional team collaboration and work
environment health in 68 US intensive care units.
November 30, 2022
Pun BT, Jun J, Tan A, et al. Interprofessional team collaboration and work environment health in 68 US
intensive care units. Am J Crit Care. 2022;31(6):443-451. doi:10.4037/ajcc2022546.
https://psnet.a…
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psnet.ahrq.gov/node/50908/psn-pdf
February 19, 2020 - Psychological safety and infection prevention practices:
results from a national survey.
February 19, 2020
Greene MT, Gilmartin HM, Saint S. Psychological safety and infection prevention practices: results from a
national survey. Am J Infect Control. 2020;48(1):2-6. doi:10.1016/j.ajic.2019.09.027.
https://psnet.ah…
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psnet.ahrq.gov/node/61101/psn-pdf
November 04, 2020 - Investigation into Management of Venous
Thromboembolism Risk in Patients Following
Thrombolysis for an Acute Stroke.
November 4, 2020
Farnborough, UK; Healthcare Safety Investigation Branch. October 2020
https://psnet.ahrq.gov/issue/investigation-management-venous-thromboembolism-risk-patients-following-
thrombol…
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psnet.ahrq.gov/node/848089/psn-pdf
April 26, 2023 - Patient Safety Advisory: fentanyl counterfeit prescription
medications that contain fentanyl and patient safety.
April 26, 2023
Jewell ML, Jewell HL, Singer R, et al. Patient Safety Advisory: fentanyl counterfeit prescription medications
that contain fentanyl and patient safety. Aesthetic Plast Surg. 2023;47(3):123…
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psnet.ahrq.gov/node/46126/psn-pdf
June 19, 2019 - A guide to evaluation of quality improvement and patient
safety educational programs: lessons from the VA Chief
Resident in Quality and Safety Program.
June 19, 2019
Butcher RL, Carluzzo KL, Watts B, et al. A Guide to Evaluation of Quality Improvement and Patient Safety
Educational Programs: Lessons From the VA Ch…
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psnet.ahrq.gov/node/50738/psn-pdf
January 01, 2020 - Effectiveness of interventions to improve adverse drug
reaction reporting by healthcare professionals over the
last decade: A systematic review
December 11, 2019
Li R, Zaidi STR, Chen T, et al. Effectiveness of interventions to improve adverse drug reaction reporting by
healthcare professionals over the last decad…
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psnet.ahrq.gov/node/46840/psn-pdf
June 20, 2018 - Interventions to improve employee health and well-being
within health care organizations: a systematic review.
June 20, 2018
Williams SP, Malik HT, Nicolay CR, et al. Interventions to improve employee health and well-being within
health care organizations: A systematic review. J Healthc Risk Manag. 2018;37(4):25-51…
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psnet.ahrq.gov/node/42547/psn-pdf
May 19, 2014 - Using AHRQ Patient Safety Indicators to detect
postdischarge adverse events in the Veterans Health
Administration.
May 19, 2014
Mull HJ, Borzecki A, Chen Q, et al. Using AHRQ patient safety indicators to detect postdischarge adverse
events in the Veterans Health Administration. Am J Med Qual. 2014;29(3):213-9.
do…
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psnet.ahrq.gov/node/50798/psn-pdf
January 15, 2020 - Testing alertness of emergency physicians: a novel
quantitative measure of alertness and implications for
worker and patient care.
January 15, 2020
Ferguson BA, Lauriski DR, Huecker M, et al. Testing Alertness of Emergency Physicians: A Novel
Quantitative Measure of Alertness and Implications for Worker and Patien…
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psnet.ahrq.gov/node/859341/psn-pdf
January 01, 2024 - Disparities in patient safety voluntary event reporting: a
scoping review.
December 20, 2023
Hoops K, Pittman E, Stockwell DC. Disparities in patient safety voluntary event reporting: a scoping review.
Jt Comm J Qual Patient Saf. 2024;50(1):41-48. doi:10.1016/j.jcjq.2023.10.009.
https://psnet.ahrq.gov/issue/dispar…
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psnet.ahrq.gov/node/43769/psn-pdf
December 17, 2014 - Prospective risk analysis and incident reporting for better
pharmaceutical care at paediatric hospital discharge.
December 17, 2014
Kaestli L-Z, Cingria L, Fonzo-Christe C, et al. Prospective risk analysis and incident reporting for better
pharmaceutical care at paediatric hospital discharge. Int J Clin Pharm. 2014…
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psnet.ahrq.gov/node/60303/psn-pdf
May 06, 2020 - Using safety culture results to guide the merger of four
general practices in the UK.
May 6, 2020
Lockwood AM, Proulx J, Hill M, et al. Using safety culture results to guide the merger of four general
practices in the UK. BMJ Open Qual. 2020;9(1):e000860. doi:10.1136/bmjoq-2019-000860.
https://psnet.ahrq.gov/issue…
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psnet.ahrq.gov/node/47300/psn-pdf
October 13, 2018 - Evaluation of accuracy of IHI Trigger Tool in identifying
adverse drug events: a prospective observational study.
October 13, 2018
Silva M das DG, Martins MAP, Viana L de G, et al. Evaluation of accuracy of IHI Trigger Tool in identifying
adverse drug events: a prospective observational study. Br J Clin Pharmacol. …
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psnet.ahrq.gov/node/37011/psn-pdf
September 24, 2010 - What do medical records tell us about potentially harmful
co-prescribing?
September 24, 2010
Lafata JE, Simpkins J, Kaatz S, et al. What do medical records tell us about potentially harmful co-
prescribing? Jt Comm J Qual Patient Saf. 2007;33(7):395-400.
https://psnet.ahrq.gov/issue/what-do-medical-records-tell-us…
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psnet.ahrq.gov/node/43521/psn-pdf
November 05, 2014 - From Science to Implementation: AHRQ's Program to
Prevent HAIs—Results and Lessons.
November 5, 2014
Battles JB, Cleeman JI, Kahn KL, Weinberg DA, eds. Am J Infect Control. 2014;42(suppl 10):S189-S296.
https://psnet.ahrq.gov/issue/science-implementation-ahrqs-program-prevent-hais-results-and-lessons
This companion…
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psnet.ahrq.gov/node/861276/psn-pdf
January 24, 2024 - Characteristics and patient impact of boarding in the
pediatric emergency department, 2018-2022.
January 24, 2024
Kappy B, Berkowitz D, Isbey S, et al. Characteristics and patient impact of boarding in the pediatric
emergency department, 2018–2022. Am J Emerg Med. 2023;77:139-146. doi:10.1016/j.ajem.2023.12.022.
h…
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psnet.ahrq.gov/node/60955/psn-pdf
September 30, 2020 - The emergency department trigger tool: a novel approach
to screening for quality and safety events.
September 30, 2020
Griffey RT, Schneider RM, Todorov AA. The emergency department trigger tool: a novel approach to
screening for quality and safety events. Ann Emerg Med. 2020;76(2):230-240.
doi:10.1016/j.annemergm…
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psnet.ahrq.gov/node/46939/psn-pdf
July 23, 2018 - Underdiagnosis of dementia: an observational study of
patterns in diagnosis and awareness in US older adults.
July 23, 2018
Amjad H, Roth DL, Sheehan OC, et al. Underdiagnosis of Dementia: an Observational Study of Patterns in
Diagnosis and Awareness in US Older Adults. J Gen Intern Med. 2018;33(7):1131-1138.
doi:…
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psnet.ahrq.gov/node/45827/psn-pdf
January 24, 2018 - Using failure mode and effects analysis to reduce patient
safety risks related to the dispensing process in the
community pharmacy setting.
January 24, 2018
Stojkovic T, Marinkovic V, Jaehde U, et al. Using Failure mode and Effects Analysis to reduce patient
safety risks related to the dispensing process in the co…