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psnet.ahrq.gov/issue/medication-dispensing-errors-and-potential-adverse-drug-events-and-after-implementing-bar
June 28, 2010 - Study
Classic
Medication dispensing errors and potential adverse drug events before and after implementing bar code technology in the pharmacy.
Citation Text:
Poon EG, Cina J, Churchill WW, et al. Medication dispensing errors and potential adverse drug events …
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psnet.ahrq.gov/issue/exploring-impact-safety-culture-incident-reporting-lessons-learned-machine-learning-analysis
February 21, 2024 - Study
Exploring the impact of safety culture on incident reporting: lessons learned from machine learning analysis of NHS England staff survey and incident data.
Citation Text:
Kaya GK, Ustebay S, Nixon J, et al. Exploring the impact of safety culture on incident reporting: lessons learn…
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psnet.ahrq.gov/issue/proposed-approach-allegations-sexual-boundary-violation-health-care
October 19, 2022 - Study
A proposed approach to allegations of sexual boundary violation in health care.
Citation Text:
Cooper WO, Foster JJ, Hickson GB, et al. A proposed approach to allegations of sexual boundary violation in health care. Jt Comm J Qual Patient Saf. 2023;49(12):671-679. doi:10.1016/j.jcj…
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psnet.ahrq.gov/issue/abusive-supervision-systematic-review-and-fundamental-rethink
May 18, 2022 - Review
Abusive supervision: a systematic review and fundamental rethink.
Citation Text:
Fischer T, Tian AW, Lee A, et al. Abusive supervision: a systematic review and fundamental rethink. The Leadership Q. 2021;32(6):101540. doi:10.1016/j.leaqua.2021.101540.
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psnet.ahrq.gov/issue/medication-dose-calculation-errors-and-other-numeracy-mishaps-hospitals-analysis-nature-and
May 11, 2022 - Study
Medication dose calculation errors and other numeracy mishaps in hospitals: analysis of the nature and enablers of incident reports.
Citation Text:
Mulac A, Hagesaether E, Granas AG. Medication dose calculation errors and other numeracy mishaps in hospitals: analysis of the nature …
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psnet.ahrq.gov/issue/implementation-second-victim-program-neonatal-intensive-care-unit-interim-analysis-employee
January 12, 2022 - Study
Implementation of a second victim program in the neonatal intensive care unit: an interim analysis of employee satisfaction.
Citation Text:
Merandi J, Winning AM, Liao NN, et al. Implementation of a second victim program in the neonatal intensive care unit: An interim analysis of e…
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psnet.ahrq.gov/issue/implementing-rise-second-victim-support-programme-johns-hopkins-hospital-case-study
March 03, 2019 - Study
Implementing the RISE second victim support programme at the Johns Hopkins Hospital: a case study.
Citation Text:
Edrees HH, Connors C, Paine LA, et al. Implementing the RISE second victim support programme at the Johns Hopkins Hospital: a case study. BMJ Open. 2016;6(9):e011708. d…
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psnet.ahrq.gov/issue/implementing-pre-operative-checklist-increase-patient-safety-1-year-follow-personnel
October 19, 2012 - Study
Implementing a pre-operative checklist to increase patient safety: a 1-year follow-up of personnel attitudes.
Citation Text:
Nilsson L, Lindberget O, Gupta A, et al. Implementing a pre-operative checklist to increase patient safety: a 1-year follow-up of personnel attitudes. Acta…
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psnet.ahrq.gov/issue/data-driven-quality-improvement-culture-change-and-high-reliability-journey-special-hospital
March 24, 2021 - Commentary
Data-driven quality improvement, culture change, and the high reliability journey at a special hospital for people with medically complex developmental disabilities.
Citation Text:
Barba V, Foreman K, Robey K. Data-driven quality improvement, culture change, and the high relia…
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psnet.ahrq.gov/issue/are-temporary-staff-associated-more-severe-emergency-department-medication-errors
June 29, 2011 - Study
Are temporary staff associated with more severe emergency department medication errors?
Citation Text:
Pham JC, Andrawis M, Shore AD, et al. Are temporary staff associated with more severe emergency department medication errors? J Healthc Qual. 2011;33(4):9-18. doi:10.1111/j.1945…
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/prevhosp/treat-release.html
September 01, 2017 - AHRQ’s Safety Program for Nursing Homes: On-Time Preventable Hospital and Emergency Department Visits
Electronic Reports
Table 4. Sample ED Treat and Release Report
Facility Name:
Month:
Average Daily Census
30
Total Transfers (Obs, ED)
11
Resident Days (including bed holds)
300
Tot…
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psnet.ahrq.gov/issue/application-theoretical-framework-behavior-change-hospital-workers-real-time-explanations
October 12, 2022 - Study
Application of a theoretical framework for behavior change to hospital workers' real-time explanations for noncompliance with hand hygiene guidelines.
Citation Text:
Fuller C, Besser S, Savage J, et al. Application of a theoretical framework for behavior change to hospital worker…
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psnet.ahrq.gov/issue/morbidity-and-mortality-caused-noncompliance-california-hospital-licensure-immediate
May 19, 2021 - Study
Morbidity and mortality caused by noncompliance with California hospital licensure: immediate jeopardies in California hospitals, 2007-2017.
Citation Text:
Zheng MY, Lui H, Patino G, et al. Morbidity and mortality caused by noncompliance with California hospital licensure: immediat…
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psnet.ahrq.gov/issue/effect-clinical-pharmacist-led-training-programme-intravenous-medication-errors-controlled
March 04, 2011 - Study
The effect of a clinical pharmacist-led training programme on intravenous medication errors: a controlled before and after study.
Citation Text:
Nguyen H-T, Pham H-T, Vo D-K, et al. The effect of a clinical pharmacist-led training programme on intravenous medication errors: a cont…
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psnet.ahrq.gov/issue/icu-nurses-acceptance-electronic-health-records
December 31, 2014 - Study
ICU nurses' acceptance of electronic health records.
Citation Text:
Carayon P, Cartmill R, Blosky MA, et al. ICU nurses' acceptance of electronic health records. J Am Med Inform Assoc. 2011;18(6):812-9. doi:10.1136/amiajnl-2010-000018.
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psnet.ahrq.gov/issue/enhancing-surgical-safety-using-digital-multimedia-technology
October 09, 2013 - Study
Enhancing surgical safety using digital multimedia technology.
Citation Text:
Dixon JL, Mukhopadhyay D, Hunt J, et al. Enhancing surgical safety using digital multimedia technology. Am J Surg. 2016;211(6):1095-8. doi:10.1016/j.amjsurg.2015.08.023.
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Format:
…
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psnet.ahrq.gov/issue/association-hospital-public-quality-reporting-electronic-health-record-medication-safety
October 21, 2020 - Study
Association of hospital public quality reporting with electronic health record medication safety performance.
Citation Text:
Holmgren AJ, Bates DW. Association of hospital public quality reporting with electronic health record medication safety performance. JAMA Netw Open. 2021;4(9…
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psnet.ahrq.gov/issue/safety-criterion-quality-critical-nursing-situation-index-paediatric-critical-care
March 01, 2011 - Study
Safety as a criterion for quality: The Critical Nursing Situation Index in paediatric critical care, an observational study.
Citation Text:
de Neef M, Bos AP, Tol D. Safety as a criterion for quality: the critical nursing situation index in paediatric critical care, an observatio…
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psnet.ahrq.gov/issue/doctor-was-rude-toilets-are-dirty-utilizing-soft-signals-regulation-patient-safety
October 06, 2021 - Study
The doctor was rude, the toilets are dirty. Utilizing 'soft signals' in the regulation of patient safety.
Citation Text:
Kok J, Wallenburg I, Leistikow I, et al. The doctor was rude, the toilets are dirty. Utilizing ‘soft signals’ in the regulation of patient safety. Safety Sci. 20…
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psnet.ahrq.gov/issue/impact-alarm-fatigue-work-nurses-intensive-care-environment-systematic-review
August 31, 2022 - Review
Classic
Impact of alarm fatigue on the work of nurses in an intensive care environment--a systematic review.
Citation Text:
Lewandowska K, Weisbrot M, Cieloszyk A, et al. Impact of alarm fatigue on the work of nurses in an intensive care environment--a s…