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psnet.ahrq.gov/issue/patient-safety-and-quality
January 19, 2022 - July 6, 2011
Bringing change-of-shift report to the bedside: a patient- and family-centered
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psnet.ahrq.gov/node/865540/psn-pdf
April 11, 2024 - During nursing shift change, the incoming nurse was told that the NG tube was ready for use. … of closed loop communication between the physician and the
nurse, and between nurses at change of shift … communication
between the provider and initial nurse, inaccurate information was conveyed to the oncoming shift … Readers should not interpret any statement in this report as an official position of AHRQ or
of the … authors has any affiliation or financial
involvement that conflicts with the material presented in this report
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psnet.ahrq.gov/issue/evaluation-problem-specific-sbar-tool-improve-after-hours-nurse-physician-phone-communication
December 30, 2014 - Annual Perspective: Topics in Medication Safety
March 31, 2022
Using incident reports … December 30, 2014
Bedside shift reports: what does the evidence say? … December 19, 2014
Task uncertainty and communication during nursing shift handovers.
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psnet.ahrq.gov/web-mm/lapse-antibiotics-leads-sepsis
November 21, 2021 - A recent systematic study suggested that bedside handoffs during nursing shift transition is a potential … solution to the communication errors associated with shift-to-shift handoffs.( 10 ) Problems arising … Nursing staff, physicians in the receiving units, and pharmacy staff all report reminding physicians … Bedside shift-to-shift handoffs: a systematic review of the literature. … Readers should not interpret any statement in this report as an official position of AHRQ or of the U.S
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psnet.ahrq.gov/issue/measuring-nursing-error-psychometrics-misscare-and-practice-and-professional-issues-items
October 17, 2012 - March 30, 2016
Bedside shift-to-shift handoffs: a systematic review of the literature
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psnet.ahrq.gov/issue/admission-conference-call-novel-approach-optimizing-pediatric-emergency-department-admitting
December 21, 2022 - This project report describes a novel procedure for handoffs from the emergency department to the inpatient … December 5, 2018
Bedside shift report improves patient safety and nurse accountability
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psnet.ahrq.gov/issue/risk-and-event-assessment
August 12, 2020 - January 3, 2017
Bringing change-of-shift report to the bedside: a patient- and family-centered
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psnet.ahrq.gov/issue/perinatal-patient-safety-and-quality
January 19, 2022 - July 6, 2011
Bringing change-of-shift report to the bedside: a patient- and family-centered
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psnet.ahrq.gov/issue/symposium-simulation-science-health-and-medicine
April 03, 2017 - April 3, 2017
Bringing change-of-shift report to the bedside: a patient- and family-centered
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psnet.ahrq.gov/issue/health-it-implementation-stories-hands-care-plan-tool-seeks-improve-nurse-communication
December 24, 2008 - August 21, 2019
Using Kotter's change model for implementing bedside handoff: a quality … February 4, 2011
The content and context of change of shift report on medical and surgical
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psnet.ahrq.gov/issue/association-registered-nurse-and-nursing-support-staffing-inpatient-hospital-mortality
September 09, 2011 - improvement: the American Organization of Nurse Executives implementation of Transforming Care at the Bedside … October 6, 2016
Nurses' shift length and overtime working in 12 European countries: the … March 26, 2015
Staffing matters—every shift.
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psnet.ahrq.gov/issue/medication-safety-operating-room-survey-preparation-methods-and-drug-concentration
December 22, 2018 - of medications administered by anesthesiologists in 2012 were still prepared by the provider at the bedside … Related Resources From the Same Author(s)
Medication errors in pediatric anesthesia: a report … May 27, 2011
Medication administration in anesthesia: time for a paradigm shift.
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psnet.ahrq.gov/issue/challenges-and-opportunities-agency-healthcare-research-and-quality-ahrq-research-summit
October 04, 2020 - recognition as a patient safety concern with the publication of the Improving Diagnosis in Health Care report … 2021
- October 6, 2021
Diagnostic Strategy for the COVID-19 Pandemic – Bench to Bedside
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psnet.ahrq.gov/web-mm/misplaced-nasogastric-tube-resulting-aspiration
August 01, 2009 - During nursing shift change, the incoming nurse was told that the NG tube was ready for use. … breakdown of closed loop communication between the physician and the nurse, and between nurses at change of shift … communication between the provider and initial nurse, inaccurate information was conveyed to the oncoming shift … June 16, 2019
ISMP medication error report analysis. … June 16, 2019
ISMP medication error report analysis.
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psnet.ahrq.gov/issue/diagnostic-errors-and-abnormal-diagnostic-tests-lost-follow-source-needless-waste-and-delay
December 22, 2008 - frames diagnostic errors and missed test results within the context of the Crossing the Quality Chasm report … December 22, 2008
Readiness to report medical treatment errors: the effects of safety … September 14, 2022
Bringing change-of-shift report to the bedside: a patient- and family-centered … September 18, 2013
Root cause analysis reports help identify common factors in delayed
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psnet.ahrq.gov/issue/ensuring-effective-care-transition-communication-implementation-electronic-medical-record
July 12, 2023 - December 21, 2017
Bedside shift reports: what does the evidence say? … January 18, 2013
Task uncertainty and communication during nursing shift handovers.
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psnet.ahrq.gov/issue/review-verbal-order-policies-acute-care-hospitals
January 03, 2017 - Related Resources From the Same Author(s)
Making the transition to nursing bedside … shift reports. … August 31, 2022
ISMP medication error report analysis. … December 3, 2008
Medication-related patient safety incidents in critical care: a review of reports
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psnet.ahrq.gov/web-mm/other-hand
December 12, 2012 - During the night shift, the midnight BP measurement using the right arm revealed a very low pressure … Methods of alerting the bedside practitioner are promising, yet they introduce new safety concerns. … The use of any bedside or applied patient alert (e.g., allergy bracelets, overhead signs, tattoos) relies … Allow time for a comprehensive report at nursing change of shift and during physician "hand-offs." … History
March 21, 2009
WebM&M Cases
Dangerous Shift
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psnet.ahrq.gov/issue/patient-handoffs-0
November 23, 2024 - January 18, 2017
Bedside shift reports: what does the evidence say?
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psnet.ahrq.gov/issue/nursing-peer-review-developing-framework-patient-safety
January 15, 2020 - December 12, 2018
Bringing change-of-shift report to the bedside: a patient- and family-centered