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Psn-Pdf (pdf file)
psnet.ahrq.gov/node/837797/psn-pdfAugust 10, 2022 - Toward constructive change after making a medical error: recovery from situations of error theory as a psychosocial model for clinician recovery. August 10, 2022 Harrison R, Johnson J, Mcmullan RD, et al. Toward constructive change after making a medical error: recovery from situations of error theory as a psychos… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/42001/psn-pdfAugust 02, 2015 - Diagnostic inaccuracy of smartphone applications for melanoma detection. August 2, 2015 Wolf JA, Moreau JF, Akilov O, et al. Diagnostic inaccuracy of smartphone applications for melanoma detection. JAMA Dermatol. 2013;149(4):422-426. doi:10.1001/jamadermatol.2013.2382. https://psnet.ahrq.gov/issue/diagnostic-inacc… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/40477/psn-pdfMarch 23, 2012 - Adverse drug events in U.S. adult ambulatory medical care. March 23, 2012 Sarkar U, Lopez A, Maselli JH, et al. Adverse drug events in U.S. adult ambulatory medical care. Health Serv Res. 2011;46(5):1517-1533. doi:10.1111/j.1475-6773.2011.01269.x. https://psnet.ahrq.gov/issue/adverse-drug-events-us-adult-ambulator… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/34698/psn-pdfJanuary 04, 2017 - Using Health Care Failure Mode and Effect Analysis: the VA National Center for Patient Safety's prospective risk analysis system. January 4, 2017 DeRosier JM, Stalhandske E, Bagian JP, et al. Using health care Failure Mode and Effect Analysis: the VA National Center for Patient Safety's prospective risk analysis s… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/37706/psn-pdfDecember 23, 2016 - Preventing pediatric medication errors. December 23, 2016 Preventing pediatric medication errors. Sentinel event alert. 2008;39:1-4. https://psnet.ahrq.gov/issue/preventing-pediatric-medication-errors The Joint Commission issues sentinel event alerts one to two times yearly to highlight areas of high risk and to p… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/74866/psn-pdfFebruary 23, 2022 - Eliminating explicit and implicit biases in health care: evidence and research needs. February 23, 2022 Vela MB, Erondu AI, Smith NA, et al. Eliminating explicit and implicit biases in health care: evidence and research needs. Annu Rev Public Health. 2022;43(1):477-501. doi:10.1146/annurev-publhealth-052620- 10352… -
psnet.ahrq.gov/issue/patient-safety-healthcare-acquired-conditions-and-serious-reportable-eventsMarch 25, 2025 - Press Release/Announcement Patient safety: healthcare acquired conditions and serious reportable events. Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL September 23, 2009 This …
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Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46309/psn-pdfDecember 22, 2018 - Effects of the I-PASS nursing handoff bundle on communication quality and workflow. December 22, 2018 Starmer AJ, Schnock KO, Lyons A, et al. Effects of the I-PASS Nursing Handoff Bundle on communication quality and workflow. BMJ Qual Saf. 2017;26(12):949-957. doi:10.1136/bmjqs-2016-006224. https://psnet.ahrq.gov/… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/37207/psn-pdfSeptember 09, 2008 - Publicly available hospital comparison web sites: determination of useful, valid, and appropriate information for comparing surgical quality. September 9, 2008 Leonardi MJ, McGory ML, Ko CY. Publicly available hospital comparison web sites: determination of useful, valid, and appropriate information for comparing … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/74206/psn-pdfDecember 22, 2021 - Direct oral anticoagulant-related medication incidents and pharmacists' interventions in hospital in-patients: evaluation using Reason's accident causation theory. December 22, 2021 Haque H, Alrowily A, Jalal Z, et al. Direct oral anticoagulant-related medication incidents and pharmacists’ interventions in hospita… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/838126/psn-pdfSeptember 21, 2022 - Sustained improvement in quality of patient handoffs after orthopaedic surgery I-PASS intervention. September 21, 2022 Stenquist DS, Yeung CM, Szapary HJ, et al. Sustained improvement in quality of patient handoffs after orthopaedic surgery I-PASS intervention. J Am Acad Orthop Surg Glob Res Rev. 2022;6(9):e22.0007… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/866161/psn-pdfJune 19, 2024 - Patient Safety Indicators at an academic veterans affairs hospital: addressing dual goals of clinical care and validity. June 19, 2024 Allaudeen N, Schalch E, Neff M, et al. Patient Safety Indicators at an Academic Veterans Affairs Hospital: Addressing Dual Goals of Clinical Care and Validity. Jt Comm J Qual Patie… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/38935/psn-pdfMarch 01, 2017 - Leadership committed to safety. December 23, 2016 Sentinel Event Alert. August 27, 2009;(43):1-3. https://psnet.ahrq.gov/issue/leadership-committed-safety Despite the past decade's focus on improving patient safety, most health care organizations are still striving to achieve high reliability status—consistently p… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/837063/psn-pdfMay 11, 2022 - Patients' experiences and perspectives of patient- reported outcome measures in clinical care: a systematic review and qualitative meta-synthesis. May 11, 2022 Carfora L, Foley CM, Hagi-Diakou P, et al. Patients’ experiences and perspectives of patient-reported outcome measures in clinical care: a systematic revie… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/61121/psn-pdfNovember 11, 2020 - Out of sight, out of mind: a prospective observational study to estimate the duration of the Hawthorne effect on hand hygiene events. November 11, 2020 Vaisman A, Bannerman G, Matelski J, et al. Out of sight, out of mind: a prospective observational study to estimate the duration of the Hawthorne effect on hand hy… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/854384/psn-pdfJanuary 01, 2024 - Look-alike medications in the perioperative setting: scoping review of medication incidents and risk reduction interventions. October 11, 2023 Ryan AN, Robertson KL, Glass BD. Look-alike medications in the perioperative setting: scoping review of medication incidents and risk reduction interventions. Int J Clin Ph… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/856586/psn-pdfNovember 29, 2023 - The complexities of communication at hospital discharge of older patients: a qualitative study of healthcare professionals' views. November 29, 2023 Cam H, Wennlöf B, Gillespie U, et al. The complexities of communication at hospital discharge of older patients: a qualitative study of healthcare professionals’ view… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/73608/psn-pdfJanuary 01, 2022 - Pharmacist-led intervention on the reduction of inappropriate medication use in patients with heart failure: a systematic review of randomized trials and non- randomized intervention studies. August 18, 2021 Hernández-Prats C, López-Pintor E, Lumbreras B. Pharmacist-led intervention on the reduction of inappropri… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/60277/psn-pdfJanuary 01, 2021 - Evidence that nurses need to participate in diagnosis: lessons from malpractice claims. April 29, 2020 Gleason KT, Jones RM, Rhodes C, et al. Evidence that nurses need to participate in diagnosis: lessons from malpractice claims. J Patient Saf. 2021;17(8):e959-e963. doi:10.1097/pts.0000000000000621. https://psnet.… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/836924/psn-pdfApril 13, 2022 - The analysis of hospital readmission rates after the implementation of Hospital Readmissions Reduction Program. April 13, 2022 Muchiri S, Azadeh-Fard N, Pakdil F. The analysis of hospital readmission rates after the implementation of hospital readmissions reduction program. J Patient Saf. 2022;18(3):237-244. doi:…
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