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3901. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/836789/psn-pdf
      March 23, 2022 - COVID-19 Focused Inspection Initiative in Healthcare. March 23, 2022 Occupational Safety and Health Administration. March 2, 2022. https://psnet.ahrq.gov/issue/covid-19-focused-inspection-initiative-healthcare The impact of nursing home inspections to ensure the quality and safety of the service environment is…

3902. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46208/psn-pdf
      July 12, 2017 - Improving patient safety by practicing in a just culture. July 12, 2017 Duffy W. Improving Patient Safety by Practicing in a Just Culture. AORN J. 2017;106(1):66-68. doi:10.1016/j.aorn.2017.05.005. https://psnet.ahrq.gov/issue/improving-patient-safety-practicing-just-culture The importance of just culture is widel…

3903. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/862999/psn-pdf
      February 21, 2024 - Health tech hazards: at-home medical devices, AI governance on ECRI's new list. February 21, 2024 Miliard M. Healthcare IT News. February 1, 2024. https://psnet.ahrq.gov/issue/health-tech-hazards-home-medical-devices-ai-governance-ecris-new-list Technologies provide improvements and introduce unique problems to ca…

3904. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/34910/psn-pdf
      May 27, 2011 - Specificity of computerized physician order entry has a significant effect on the efficiency of workflow for critically ill patients. May 27, 2011 Ali NA, Mekhjian HS, Kuehn L, et al. Specificity of computerized physician order entry has a significant effect on the efficiency of workflow for critically ill patient…

3905. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44300/psn-pdf
      July 29, 2015 - Learning From Serious Failings in Care: Main Report. July 29, 2015 Short-Life Working Group on Hospital Reports. Edinburgh, Scotland: Academy of Medical Royal Colleges and Faculties in Scotland; May 2015. https://psnet.ahrq.gov/issue/learning-serious-failings-care-main-report Substantive reports of failures have t…

3906. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/866356/psn-pdf
      July 24, 2024 - To forgive, divine. July 24, 2024 Johnson V. To forgive, divine. N Engl J Med. 2024;391(1):6-7. doi:10.1056/nejmp2402006. https://psnet.ahrq.gov/issue/forgive-divine Resident physicians are vulnerable to psychological harm when they have made a mistake. This commentary shares one resident’s experiences with error.…

3907. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/40535/psn-pdf
      July 22, 2011 - A framework for classifying patient safety practices: results from an expert consensus process. July 22, 2011 Dy SM, Taylor SL, Carr LH, et al. A framework for classifying patient safety practices: results from an expert consensus process. BMJ Qual Saf. 2011;20(7):618-24. doi:10.1136/bmjqs.2010.049296. https://psn…

3908. Establishing a Safety Culture: Thinking Small | PSNet
      psnet.ahrq.gov/perspective/establishing-safety-culture-thinking-small
      December 01, 2006 - All sorts of safety culture measurements and assessments now exist.

3909. In Conversation with...J. Bryan Sexton, PhD, MA | PSNet
      psnet.ahrq.gov/perspective/conversation-withj-bryan-sexton-phd-ma
      December 01, 2006 - All sorts of safety culture measurements and assessments now exist.

3910. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47344/psn-pdf
      September 11, 2018 - Quality and Safety Between Ward and Board: a Biography of Artefacts Study. September 11, 2018 Keen J, Nicklin E, Long A, et al. Health Services and Delivery Research. Southampton, UK: NIHR Journals Library; 2018. https://psnet.ahrq.gov/issue/quality-and-safety-between-ward-and-board-biography-artefacts-study The …

3911. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/837744/psn-pdf
      July 27, 2022 - Medication orders with future start dates: how far away is too far? July 27, 2022 ISMP Medication Safety Alert! Acute care edition. July 14, 2022:27(14):1-4. https://psnet.ahrq.gov/issue/medication-orders-future-start-dates-how-far-away-too-far Human errors that occur while interacting with electronic health recor…

3912. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46510/psn-pdf
      January 01, 2019 - Pediatric weight errors and resultant medication dosing errors in the emergency department. November 22, 2017 Hirata KM, Kang AH, Ramirez G, et al. Pediatric Weight Errors and Resultant Medication Dosing Errors in the Emergency Department. Pediatr Emerg Care. 2019;35(9):637-642. doi:10.1097/PEC.0000000000001277. …

3913. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/36032/psn-pdf
      April 11, 2011 - Pediatric medication safety and the media: what does the public see? April 11, 2011 Stebbing C, Kaushal R, Bates DW. Pediatric medication safety and the media: what does the public see? Pediatrics. 2006;117(6):1907-1914. doi:10.1542/peds.2005-2017. https://psnet.ahrq.gov/issue/pediatric-medication-safety-and-media…

3914. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/867049/psn-pdf
      October 30, 2024 - National Review of Maternity Services in England 2022 to 2024. October 30, 2024 National Review Of Maternity Services In England 2022 To 2024. Newcastle Upon Tyne, UK: Care Quality Commission; September 2024. https://psnet.ahrq.gov/issue/national-review-maternity-services-england-2022-2024 Maternal safety is a gl…

3915. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/35127/psn-pdf
      February 24, 2011 - Beyond the medical record: other modes of error acknowledgment. February 24, 2011 Rosenthal M, Cornett PL, Sutcliffe K, et al. Beyond the medical record: other modes of error acknowledgment. J Gen Intern Med. 2005;20(5):404-9. https://psnet.ahrq.gov/issue/beyond-medical-record-other-modes-error-acknowledgment Thi…

3916. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/844793/psn-pdf
      September 11, 2019 - PC standards for maternal safety. September 11, 2019 The Joint Commission. R3 Report. August 21, 2019;24:1-6. https://psnet.ahrq.gov/issue/pc-standards-maternal-safety Maternal safety in the United States is gaining momentum as a system-level patient safety concern. This report reviews the new Joint Commission Pro…

3917. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/45275/psn-pdf
      November 01, 2017 - Electronic tools to support medication reconciliation—a systematic review. November 1, 2017 Marien S, Krug B, Spinewine A. Electronic tools to support medication reconciliation: a systematic review. J Am Med Inform Assoc. 2017;24(1):227-240. doi:10.1093/jamia/ocw068. https://psnet.ahrq.gov/issue/electronic-tools-s…

3918. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46298/psn-pdf
      October 18, 2017 - CVS taps a design legend to reinvent the prescription label. Next stop: the pharmacy. October 18, 2017 Kuang C. Fast Company. October 4, 2017. https://psnet.ahrq.gov/issue/cvs-taps-design-legend-reinvent-prescription-label-next-stop-pharmacy Complicated systems often require more than one change to improve their s…

3919. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46711/psn-pdf
      July 01, 2019 - The STOP Measure. Safe and Transparent Opioid Prescribing to Promote Patient Safety and Reduced Risk of Opioid Misuse. July 1, 2019 Washington, DC: America's Health Insurance Plans; 2019. https://psnet.ahrq.gov/issue/stop-measure-safe-and-transparent-opioid-prescribing-promote-patient-safety- and-reduced-risk Gu…

3920. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47758/psn-pdf
      April 17, 2019 - Contribution of adverse events to death of hospitalised patients. April 17, 2019 Haukland EC, Mevik K, von Plessen C, et al. Contribution of adverse events to death of hospitalised patients. BMJ Open Qual. 2019;8(1):e000377. doi:10.1136/bmjoq-2018-000377. https://psnet.ahrq.gov/issue/contribution-adverse-events-de…