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  1. Errors during resuscitation: the impact of perceived authority on delivery of care. | PSNet

    psnet.ahrq.gov/issue/errors-during-resuscitation-impact-perceived-authority-delivery-care
    April 03, 2019 - Study Errors during resuscitation: the impact of perceived authority on delivery of care. Citation Text: Delaloye NJ, Tobler K, OʼNeill T, et al. Errors during resuscitation: the impact of perceived authority on delivery of care. J Patient Saf. 2020;16(1). doi:10.1097/pts.000000000000035…

  2. Register-based research of adverse events revealing incomplete records threatening patient safety. | PSNet

    psnet.ahrq.gov/issue/register-based-research-adverse-events-revealing-incomplete-records-threatening-patient
    October 06, 2021 - Review Register-based research of adverse events revealing incomplete records threatening patient safety. Citation Text: Kinnunen U-M, Kivekäs E, Palojoki S, et al. Register-based research of adverse events revealing incomplete records threatening patient safety. Stud Health Technol Info…

  3. How health care systems let our patients down: a systematic review into suicide deaths. | PSNet

    psnet.ahrq.gov/issue/how-health-care-systems-let-our-patients-down-systematic-review-suicide-deaths
    October 19, 2022 - Review How health care systems let our patients down: a systematic review into suicide deaths. Citation Text: Wyder M, Ray MK, Roennfeldt H, et al. How health care systems let our patients down: a systematic review into suicide deaths. Int J Qual Health Care. 2020;32(5):285-291. doi:10.1…

  4. Potentially inappropriate prescribing in long-term care and its relationship with probable delirium. | PSNet

    psnet.ahrq.gov/issue/potentially-inappropriate-prescribing-long-term-care-and-its-relationship-probable-delirium
    September 23, 2020 - Study Potentially inappropriate prescribing in long-term care and its relationship with probable delirium. Citation Text: Webber C, Milani C, Bjerre LM, et al. Potentially inappropriate prescribing in long-term care and its relationship with probable delirium. J Am Med Dir Assoc. 2024;25…

  5. A cognitive task analysis of information management strategies in a computerized provider order entry environment. | PSNet

    psnet.ahrq.gov/issue/cognitive-task-analysis-information-management-strategies-computerized-provider-order-entry
    May 27, 2011 - Study A cognitive task analysis of information management strategies in a computerized provider order entry environment. Citation Text: Weir C, Nebeker JJR, Hicken BL, et al. A cognitive task analysis of information management strategies in a computerized provider order entry environme…

  6. Triggers contributing to health care clinicians' disruptive behaviors. | PSNet

    psnet.ahrq.gov/issue/triggers-contributing-health-care-clinicians-disruptive-behaviors
    June 24, 2020 - Study Triggers contributing to health care clinicians' disruptive behaviors. Citation Text: Bae S-H, Dang D, Karlowicz KA, et al. Triggers contributing to health care clinicians' disruptive behaviors. J Patient Saf. 2020;16(3):e148-e155. doi:10.1097/pts.0000000000000288. Copy Citation …

  7. Can we rely on patients' reports of adverse events? | PSNet

    psnet.ahrq.gov/issue/can-we-rely-patients-reports-adverse-events
    December 29, 2014 - Study Classic Can we rely on patients' reports of adverse events? Citation Text: Zhu J, Stuver SO, Epstein AM, et al. Can we rely on patients' reports of adverse events? Med Care. 2011;49(10):948-55. doi:10.1097/MLR.0b013e31822047a8. Copy Citation Format…

  8. Decreasing handoff-related care failures in children's hospitals. | PSNet

    psnet.ahrq.gov/issue/decreasing-handoff-related-care-failures-childrens-hospitals
    April 24, 2018 - Study Decreasing handoff-related care failures in children's hospitals. Citation Text: Bigham MT, Logsdon TR, Manicone PE, et al. Decreasing handoff-related care failures in children's hospitals. Pediatrics. 2014;134(2):e572-e579. doi:10.1542/peds.2013-1844. Copy Citation Format: …

  9. Evidence that nurses need to participate in diagnosis: lessons from malpractice claims. | PSNet

    psnet.ahrq.gov/issue/evidence-nurses-need-participate-diagnosis-lessons-malpractice-claims
    September 12, 2018 - Study Evidence that nurses need to participate in diagnosis: lessons from malpractice claims. Citation Text: 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…

  10. Healthcare team resilience during COVID-19: a qualitative study. | PSNet

    psnet.ahrq.gov/issue/healthcare-team-resilience-during-covid-19-qualitative-study
    February 20, 2019 - Study Healthcare team resilience during COVID-19: a qualitative study. Citation Text: Ambrose JW, Catchpole K, Evans HL, et al. Healthcare team resilience during COVID-19: a qualitative study. BMC Health Serv Res. 2024;24(1):459. doi:10.1186/s12913-024-10895-3. Copy Citation Format…

  11. Care Deficiencies and Leaders' Inadequate Reviews of a Patient Who Died at the Lt. Col. Luke Weathers, Jr. VA Medical Center in Memphis, Tennessee. | PSNet

    psnet.ahrq.gov/issue/care-deficiencies-and-leaders-inadequate-reviews-patient-who-died-lt-col-luke-weathers-jr-va
    April 10, 2024 - Book/Report Care Deficiencies and Leaders' Inadequate Reviews of a Patient Who Died at the Lt. Col. Luke Weathers, Jr. VA Medical Center in Memphis, Tennessee. Citation Text: Care Deficiencies and Leaders' Inadequate Reviews of a Patient Who Died at the Lt. Col. Luke Weathers, Jr. VA Me…

  12. Comparing measures of patient safety for inpatient care provided to veterans within and outside the VA system in New York. | PSNet

    psnet.ahrq.gov/issue/comparing-measures-patient-safety-inpatient-care-provided-veterans-within-and-outside-va
    March 04, 2011 - Study Comparing measures of patient safety for inpatient care provided to veterans within and outside the VA system in New York. Citation Text: Weeks WB, West AN, Rosen AK, et al. Comparing measures of patient safety for inpatient care provided to veterans within and outside the VA sys…

  13. The effect of a clinical decision support for pending laboratory results at emergency department discharge. | PSNet

    psnet.ahrq.gov/issue/effect-clinical-decision-support-pending-laboratory-results-emergency-department-discharge
    April 24, 2018 - Study The effect of a clinical decision support for pending laboratory results at emergency department discharge. Citation Text: Driver BE, Scharber SK, Fagerstrom ET, et al. The Effect of a Clinical Decision Support for Pending Laboratory Results at Emergency Department Discharge. J Eme…

  14. Systems engineering analysis of diagnostic referral closed-loop processes. | PSNet

    psnet.ahrq.gov/issue/systems-engineering-analysis-diagnostic-referral-closed-loop-processes
    December 07, 2022 - Study Systems engineering analysis of diagnostic referral closed-loop processes. Citation Text: Nehls N, Yap TS, Salant T, et al. Systems engineering analysis of diagnostic referral closed-loop processes. BMJ Open Qual. 2021;10(4):e001603. doi:10.1136/bmjoq-2021-001603. Copy Citation …

  15. From reporting to improving: how root cause analysis in teams shape patient safety culture. | PSNet

    psnet.ahrq.gov/issue/reporting-improving-how-root-cause-analysis-teams-shape-patient-safety-culture
    July 31, 2024 - Study From reporting to improving: how root cause analysis in teams shape patient safety culture. Citation Text: Tsamasiotis C, Fiard G, Bouzat P, et al. From reporting to improving: how root cause analysis in teams shape patient safety culture. Risk Manag Healthc Policy. 2024;17:1847-18…

  16. Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality. | PSNet

    psnet.ahrq.gov/issue/patient-handover-surgery-intensive-care-using-formula-1-pit-stop-and-aviation-models-improve
    October 03, 2011 - Study Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality. Citation Text: Catchpole K, de Leval MR, McEwan A, et al. Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to …

  17. Fall prevention with the Smart Socks System reduces hospital fall rates. | PSNet

    psnet.ahrq.gov/issue/fall-prevention-smart-socks-system-reduces-hospital-fall-rates
    September 09, 2020 - Study Fall prevention with the Smart Socks System reduces hospital fall rates. Citation Text: Moore T, Kline D, Palettas M, et al. Fall prevention with the Smart Socks System reduces hospital fall rates. J Nurs Care Qual. 2023;38(1):55-60. doi:10.1097/ncq.0000000000000653. Copy Citatio…

  18. Remote patient monitoring improves patient falls and reduces harm. | PSNet

    psnet.ahrq.gov/issue/remote-patient-monitoring-improves-patient-falls-and-reduces-harm
    April 16, 2018 - Study Remote patient monitoring improves patient falls and reduces harm. Citation Text: Zimbro KS, Bridges C, Bunn S, et al. Remote patient monitoring improves patient falls and reduces harm. J Nurs Care Qual. 2024;39(3):212-219. doi:10.1097/ncq.0000000000000749. Copy Citation Form…

  19. Patterns of opioid administration among opioid-naive inpatients and associations with postdischarge opioid use: a cohort study. | PSNet

    psnet.ahrq.gov/issue/patterns-opioid-administration-among-opioid-naive-inpatients-and-associations-postdischarge
    November 05, 2008 - Study Patterns of opioid administration among opioid-naive inpatients and associations with postdischarge opioid use: a cohort study. Citation Text: Donohue JM, Kennedy JN, Seymour CW, et al. Patterns of Opioid Administration Among Opioid-Naive Inpatients and Associations With Postdischa…

  20. Can medical record reviewers reliably identify errors and adverse events in the ED? | PSNet

    psnet.ahrq.gov/issue/can-medical-record-reviewers-reliably-identify-errors-and-adverse-events-ed
    October 11, 2023 - Study Can medical record reviewers reliably identify errors and adverse events in the ED? Citation Text: Klasco RS, Wolfe RE, Lee T, et al. Can medical record reviewers reliably identify errors and adverse events in the ED? Am J Emerg Med. 2016;34(6):1043-8. doi:10.1016/j.ajem.2016.03.00…
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