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psnet.ahrq.gov/node/867230/psn-pdf
December 04, 2024 - Adaption of a trigger tool to identify harmful incidents, no
harm incidents, and near misses in prehospital
emergency care of children.
December 4, 2024
Packendorff N, Magnusson C, Axelsson C, et al. Adaption of a trigger tool to identify harmful incidents, no
harm incidents, and near misses in prehospital emergen…
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psnet.ahrq.gov/node/60726/psn-pdf
January 01, 2021 - User-testing guidelines to improve the safety of
intravenous medicines administration: a randomised in
situ simulation study.
July 29, 2020
Jones MD, McGrogan A, Raynor DK, et al. User-testing guidelines to improve the safety of intravenous
medicines administration: a randomised in situ simulation study. BMJ Qual …
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psnet.ahrq.gov/node/837890/psn-pdf
August 24, 2022 - Accuracy of pressure ulcer events in US nursing home
ratings.
August 24, 2022
Chen Z, Gleason LJ, Sanghavi P. Accuracy of pressure ulcer events in US nursing home ratings. Med
Care. 2022;60(10):775-783. doi:10.1097/mlr.0000000000001763.
https://psnet.ahrq.gov/issue/accuracy-pressure-ulcer-events-us-nursing-home-ra…
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psnet.ahrq.gov/node/74151/psn-pdf
January 01, 2022 - Nursing interventions to reduce medication errors in
paediatrics and neonates: systematic review and meta-
analysis.
December 8, 2021
Marufu TC, Bower R, Hendron E, et al. Nursing interventions to reduce medication errors in paediatrics and
neonates: systematic review and meta-analysis. J Pediatr Nurs. 2022;62:e13…
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psnet.ahrq.gov/node/848366/psn-pdf
May 03, 2023 - The effect of documenting patient weight in kilograms on
pediatric medication dosing errors in emergency medical
services.
May 3, 2023
Ward CE, Taylor M, Keeney C, et al. The effect of documenting patient weight in kilograms on pediatric
medication dosing errors in emergency medical services. Prehosp Emerg Care. 2…
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psnet.ahrq.gov/node/43047/psn-pdf
August 02, 2015 - Hospital readmission after noncardiac surgery: the role of
major complications.
August 2, 2015
Glance LG, Kellermann AL, Osler T, et al. Hospital readmission after noncardiac surgery: the role of major
complications. JAMA Surg. 2014;149(5):439-45.
https://psnet.ahrq.gov/issue/hospital-readmission-after-noncardiac-…
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psnet.ahrq.gov/node/34786/psn-pdf
March 28, 2005 - Errors in drug computations during newborn intensive
care.
March 28, 2005
Perlstein PH, Callison C, White M, et al. Errors in Drug Computations During Newborn Intensive Care. Arch
Pediatr Adolesc Med. 1979;133(4):376-379. doi:10.1001/archpedi.1979.02130040030006.
https://psnet.ahrq.gov/issue/errors-drug-computatio…
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psnet.ahrq.gov/node/49621/psn-pdf
March 01, 2011 - medications, fluids, and even tracking outputs in all infants and children should be
quantitatively calculated
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psnet.ahrq.gov/web-mm/hazards-loading-doses
December 01, 2003 - Hazards of Loading Doses
Citation Text:
Mucksavage JJ, Tesoro EP. Hazards of Loading Doses. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
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psnet.ahrq.gov/issue/transitions-care-toc-portal
March 07, 2018 - Multi-use Website
Transitions of Care (TOC) Portal.
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February 27, 2013
This Web site provides resources for clinicians and patien…
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psnet.ahrq.gov/node/47130/psn-pdf
October 10, 2018 - Are clinical instructors preventing or provoking adverse
events involving students: a contemporary issue.
October 10, 2018
Christensen L. Are clinical instructors preventing or provoking adverse events involving students: A
contemporary issue. Nurse Educ Today. 2018;70:121-123. doi:10.1016/j.nedt.2018.08.024.
http…
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psnet.ahrq.gov/node/46304/psn-pdf
November 01, 2017 - Comparative performance of pediatric weight estimation
techniques: a human factor errors analysis.
November 1, 2017
Abdel-Rahman SM, Jacobsen R, Watts JL, et al. Comparative performance of pediatric weight estimation
techniques: a human factor errors analysis. Pediatr Emerg Care. 2015;33(8):548-552.
doi:10.1097/pe…
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psnet.ahrq.gov/node/43645/psn-pdf
November 12, 2014 - Health IT and Clinical Decision Support Systems.
November 12, 2014
Ohno-Machado L, ed. J Am Med Inform Assoc. 2014;21:e180-e375.
https://psnet.ahrq.gov/issue/health-it-and-clinical-decision-support-systems
A universal agreement on how to calculate the return on investment for health information technology (IT)
and…
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psnet.ahrq.gov/node/865344/psn-pdf
March 27, 2024 - Use of computerized physician order entry with clinical
decision support to prevent dose errors in pediatric
medication orders: a systematic review.
March 27, 2024
Ruutiainen H, Holmström A-R, Kunnola E, et al. Use of computerized physician order entry with clinical
decision support to prevent dose errors in pedia…
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psnet.ahrq.gov/node/842421/psn-pdf
January 11, 2023 - Weight and size descriptors for drug dosing: too many
options and too many errors.
January 11, 2023
Erstad BL, Romero AV, Barletta JF. Weight and size descriptors for drug dosing: Too many options and too
many errors. Am J Health Syst Pharm. 2023;80(2):87-91. doi:10.1093/ajhp/zxac283.
https://psnet.ahrq.gov/issue/…
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psnet.ahrq.gov/node/50736/psn-pdf
December 11, 2019 - Prevalence and nature of medication errors and
preventable adverse drug events in paediatric and
neonatal intensive care settings: a systematic review.
December 11, 2019
Alghamdi AA, Keers RN, Sutherland A, et al. Prevalence and Nature of Medication Errors and Preventable
Adverse Drug Events in Paediatric and Neon…
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psnet.ahrq.gov/web-mm/eptifibatide-epilogue
March 04, 2011 - Eptifibatide Epilogue
Citation Text:
Churchill WW, Fiumara K. Eptifibatide Epilogue. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2009.
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psnet.ahrq.gov/issue/ashrm-patient-safety-portal
September 27, 2016 - Multi-use Website
ASHRM Patient Safety Portal.
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March 21, 2012
This Web site provides access to educational resources for risk ma…
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psnet.ahrq.gov/node/43958/psn-pdf
April 22, 2015 - Non-intercepted dose errors in prescribing antineoplastic
treatment: a prospective, comparative cohort study.
April 22, 2015
Mattsson TO, Holm B, Michelsen H, et al. Non-intercepted dose errors in prescribing anti-neoplastic
treatment: a prospective, comparative cohort study. Ann Oncol. 2015;26(5):981-6.
doi:10.10…
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psnet.ahrq.gov/web-mm/dont-wait-collect-accurate-weight-case-subtherapeutic-insulin-therapy
July 01, 2008 - Don’t Wait to Collect an Accurate Weight: A Case of Subtherapeutic Insulin Therapy
Citation Text:
Newton B, Seitz R. Don’t Wait to Collect an Accurate Weight: A Case of Subtherapeutic Insulin Therapy. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and H…