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  1. Pharmacy e-prescription dispensing before and after CancelRx implementation. | PSNet

    psnet.ahrq.gov/issue/pharmacy-e-prescription-dispensing-and-after-cancelrx-implementation
    October 05, 2022 - Study Pharmacy e-prescription dispensing before and after CancelRx implementation. Citation Text: Pitts SI, Olson S, Yanek LR, et al. Pharmacy e-prescription dispensing before and after CancelRx implementation. JAMA Intern Med. 2023;183(10):1120-1126. doi:10.1001/jamainternmed.2023.4192.…

  2. Exploring the human factors of prescribing errors in paediatric intensive care units. | PSNet

    psnet.ahrq.gov/issue/exploring-human-factors-prescribing-errors-paediatric-intensive-care-units
    March 06, 2024 - Study Emerging Classic Exploring the human factors of prescribing errors in paediatric intensive care units. Citation Text: Sutherland A, Ashcroft DM, Phipps D. Exploring the human factors of prescribing errors in paediatric intensive care units. Arch Dis Child.…

  3. A randomised controlled trial of the effect of continuous electronic physiological monitoring on the adverse event rate in high risk medical and surgical patients. | PSNet

    psnet.ahrq.gov/issue/randomised-controlled-trial-effect-continuous-electronic-physiological-monitoring-adverse
    August 04, 2021 - Study A randomised controlled trial of the effect of continuous electronic physiological monitoring on the adverse event rate in high risk medical and surgical patients. Citation Text: Watkinson PJ, Barber VS, Price JD, et al. A randomised controlled trial of the effect of continuous e…

  4. Analysis of adverse events in pediatric surgery using criteria validated from the adult population: justifying the need for pediatric-focused outcome measures. | PSNet

    psnet.ahrq.gov/issue/analysis-adverse-events-pediatric-surgery-using-criteria-validated-adult-population
    May 06, 2009 - Study Analysis of adverse events in pediatric surgery using criteria validated from the adult population: justifying the need for pediatric-focused outcome measures. Citation Text: Rice-Townsend S, Hall M, Jenkins KJ, et al. Analysis of adverse events in pediatric surgery using criteri…

  5. Medication errors with antituberculosis therapy in an inpatient, academic setting: forgotten but not gone. | PSNet

    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…

  6. What happens to the medication regimens of older adults during and after an acute hospitalization? | PSNet

    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…

  7. Developing, implementing, evaluating electronic apparent cause analysis across a health care system. | PSNet

    psnet.ahrq.gov/issue/developing-implementing-evaluating-electronic-apparent-cause-analysis-across-health-care
    February 07, 2018 - Study Developing, implementing, evaluating electronic apparent cause analysis across a health care system. Citation Text: Oster CA, Woods E, Mumma J, et al. Developing, implementing, evaluating electronic apparent cause analysis across a health care system. Jt Comm J Qual Patient Saf. 2…

  8. Comparing rates of adverse events and medical errors on inpatient psychiatric units at Veterans Health Administration and community-based general hospitals. | PSNet

    psnet.ahrq.gov/issue/comparing-rates-adverse-events-and-medical-errors-inpatient-psychiatric-units-veterans-health
    January 30, 2019 - Study Comparing rates of adverse events and medical errors on inpatient psychiatric units at Veterans Health Administration and community-based general hospitals. Citation Text: Cullen SW, Xie M, Vermeulen JM, et al. Comparing Rates of Adverse Events and Medical Errors on Inpatient Psych…

  9. The state of the evidence for computerized provider order entry: a systematic review and analysis of the quality of the literature. | PSNet

    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 …

  10. Healthcare Inspection: Evaluation of the Veterans Health Administration's National Consult Delay Review and Associated Fact Sheet. | PSNet

    psnet.ahrq.gov/issue/healthcare-inspection-evaluation-veterans-health-administrations-national-consult-delay
    September 10, 2014 - Book/Report Healthcare Inspection: Evaluation of the Veterans Health Administration's National Consult Delay Review and Associated Fact Sheet. Citation Text: Healthcare Inspection: Evaluation of the Veterans Health Administration's National Consult Delay Review and Associated Fact Sheet.…

  11. Pharmacologically inappropriate prescriptions for elderly patients in general practice: how common? | PSNet

    psnet.ahrq.gov/issue/pharmacologically-inappropriate-prescriptions-elderly-patients-general-practice-how-common
    March 08, 2023 - Study Pharmacologically inappropriate prescriptions for elderly patients in general practice: how common? Citation Text: Brekke M, Rognstad S, Straand J, et al. Pharmacologically inappropriate prescriptions for elderly patients in general practice: How common? Baseline data from The Pr…

  12. Specimen labeling errors: a Q-probes analysis of 147 clinical laboratories. | PSNet

    psnet.ahrq.gov/issue/specimen-labeling-errors-q-probes-analysis-147-clinical-laboratories
    February 15, 2010 - Study Specimen labeling errors: a Q-probes analysis of 147 clinical laboratories. Citation Text: Wagar EA, Stankovic AK, Raab SS, et al. Specimen labeling errors: a Q-probes analysis of 147 clinical laboratories. Arch Pathol Lab Med. 2008;132(10):1617-22. doi:10.1043/1543-2165(2008)…

  13. Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. | PSNet

    psnet.ahrq.gov/issue/wrong-site-nerve-blocks-10-yr-experience-large-multihospital-health-care-system
    January 14, 2011 - Study Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. Citation Text: Hudson ME, Chelly JE, Lichter JR. Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. Br J Anaesth. 2015;114(5):818-24. doi:10.1093/bja/aeu490. …

  14. Identification errors involving clinical laboratories: a College of American Pathologists Q-Probes study of patient and specimen identification errors at 120 institutions. | PSNet

    psnet.ahrq.gov/issue/identification-errors-involving-clinical-laboratories-college-american-pathologists-q-probes
    February 15, 2010 - Study Identification errors involving clinical laboratories: a College of American Pathologists Q-Probes study of patient and specimen identification errors at 120 institutions. Citation Text: Pathologists C of A, Valenstein PN, Raab SS, et al. Identification errors involving clinical …

  15. Getting it right for patient safety: specimen collection process improvement from operating room to pathology. | PSNet

    psnet.ahrq.gov/issue/getting-it-right-patient-safety-specimen-collection-process-improvement-operating-room
    July 16, 2013 - Commentary Getting it right for patient safety: specimen collection process improvement from operating room to pathology. Citation Text: D'Angelo R, Mejabi O. Getting It Right for Patient Safety:  Specimen Collection Process Improvement From Operating Room to Pathology. Am J Clin Pathol.…

  16. A call to bridge across silos during care transitions. | PSNet

    psnet.ahrq.gov/issue/call-bridge-across-silos-during-care-transitions
    November 20, 2024 - Commentary A call to bridge across silos during care transitions. Citation Text: Sheikh F, Gathecha E, Bellantoni M, et al. A Call to Bridge Across Silos during Care Transitions. Jt Comm J Qual Patient Saf. 2018;44(5):270-278. doi:10.1016/j.jcjq.2017.10.006. Copy Citation Format: …

  17. An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training. | PSNet

    psnet.ahrq.gov/issue/observational-analysis-surgical-team-compliance-perioperative-safety-practices-after-crew
    May 04, 2012 - Study An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training. Citation Text: France DJ, Leming-Lee S, Jackson T, et al. An observational analysis of surgical team compliance with perioperative safety practices a…

  18. Cross-Check QA: a quality assurance workflow to prevent missed diagnoses by alerting inadvertent discordance between the radiologist and AI in the interpretation of high acuity CT scans. | PSNet

    psnet.ahrq.gov/issue/cross-check-qa-quality-assurance-workflow-prevent-missed-diagnoses-alerting-inadvertent
    March 04, 2015 - Study Cross-Check QA: a quality assurance workflow to prevent missed diagnoses by alerting inadvertent discordance between the radiologist and AI in the interpretation of high acuity CT scans. Citation Text: Chekmeyan M, Baccei SJ, Garwood ER. Cross-Check QA: a quality assurance workflow…

  19. Automated communication tools and computer-based medication reconciliation to decrease hospital discharge medication errors. | PSNet

    psnet.ahrq.gov/issue/automated-communication-tools-and-computer-based-medication-reconciliation-decrease-hospital
    September 23, 2020 - Study Automated communication tools and computer-based medication reconciliation to decrease hospital discharge medication errors. Citation Text: Smith KJ, Handler S, Kapoor WN, et al. Automated Communication Tools and Computer-Based Medication Reconciliation to Decrease Hospital Dischar…

  20. Patient safety. Factors for and perceived consequences of nursing errors by nursing staff in home care services. | PSNet

    psnet.ahrq.gov/issue/patient-safety-factors-and-perceived-consequences-nursing-errors-nursing-staff-home-care
    May 18, 2022 - Study Patient safety. Factors for and perceived consequences of nursing errors by nursing staff in home care services. Citation Text: Jachan DE, Müller‐Werdan U, Lahmann NA. Patient safety. Factors for and perceived consequences of nursing errors by nursing staff in home care services. N…
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