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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/node/49717/psn-pdf
September 01, 2014 - A Lot of Pain (Medications)
September 1, 2014
Herzig SJ. A Lot of Pain (Medications). PSNet [internet]. 2014.
https://psnet.ahrq.gov/web-mm/lot-pain-medications
Case Objectives
Appreciate the challenges of managing acute pain in hospitalized patients on chronic opioids.
Describe the importance of understanding th…
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psnet.ahrq.gov/node/34993/psn-pdf
June 22, 2009 - Five system barriers to achieving ultrasafe health care.
June 22, 2009
Amalberti R, Auroy Y, Berwick D, et al. Five system barriers to achieving ultrasafe health care. Ann Intern
Med. 2005;142(9):756-64.
https://psnet.ahrq.gov/issue/five-system-barriers-achieving-ultrasafe-health-care
This commentary builds on the…
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psnet.ahrq.gov/node/33761/psn-pdf
February 01, 2014 - or
nurse might go to a quiet space to review orders or complete other high-risk functions such as calculating
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psnet.ahrq.gov/web-mm/lot-pain-medications
September 23, 2020 - SPOTLIGHT CASE
A Lot of Pain (Medications)
Citation Text:
Herzig SJ. A Lot of Pain (Medications). PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2014.
Copy Citation
Format:
Google Scholar BibTeX EndNote X3 XM…
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psnet.ahrq.gov/node/50890/psn-pdf
February 12, 2020 - Impact of pharmacist-led multidisciplinary medication
review on the safety and medication cost of the elderly
people living in a nursing home: a before-after study.
February 12, 2020
Leguelinel-Blache G, Castelli C, Rolain J, et al. Impact of pharmacist-led multidisciplinary medication
review on the safety and med…
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psnet.ahrq.gov/node/35577/psn-pdf
April 06, 2011 - Safety culture assessment in community pharmacy:
development, face validity, and feasibility of the
Manchester Patient Safety Assessment Framework.
April 6, 2011
Ashcroft DM, Morecroft C, Parker D, et al. Safety culture assessment in community pharmacy:
development, face validity, and feasibility of the Manchester…
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psnet.ahrq.gov/web-mm/fatal-error-neonate-does-just-culture-provide-answer
June 24, 2020 - In the process of calculating the dose with the concentration of lipid emulsion available on the unit
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psnet.ahrq.gov/node/47547/psn-pdf
February 13, 2019 - Prevention of prescription opioid misuse and projected
overdose deaths in the United States.
February 13, 2019
Chen Q, Larochelle MR, Weaver DT, et al. Prevention of Prescription Opioid Misuse and Projected
Overdose Deaths in the United States. JAMA Netw Open. 2019;2(2):e187621.
doi:10.1001/jamanetworkopen.2018.76…
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psnet.ahrq.gov/node/37706/psn-pdf
December 23, 2016 - Preventing pediatric medication errors.
December 23, 2016
Preventing pediatric medication errors. Sentinel event alert. 2008;39:1-4.
https://psnet.ahrq.gov/issue/preventing-pediatric-medication-errors
The Joint Commission issues sentinel event alerts one to two times yearly to highlight areas of high risk
and to p…
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psnet.ahrq.gov/node/42705/psn-pdf
November 26, 2013 - Improving America's Hospitals: The Joint Commission's
Annual Report on Quality and Safety 2013.
November 26, 2013
Oakbrook Terrace, IL: The Joint Commission; October 2013.
https://psnet.ahrq.gov/issue/improving-americas-hospitals-joint-commissions-annual-report-quality-and-
safety-2013
This Joint Commission…
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psnet.ahrq.gov/node/35906/psn-pdf
May 27, 2011 - Error reduction in pediatric chemotherapy: computerized
order entry and failure modes and effects analysis.
May 27, 2011
Kim G, Chen AR, Arceci RJ, et al. Error reduction in pediatric chemotherapy: computerized order entry and
failure modes and effects analysis. Arch Pediatr Adolesc Med. 2006;160(5):495-8.
https:/…
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psnet.ahrq.gov/node/47735/psn-pdf
June 24, 2019 - The Financial and Human Cost of Medical Error... and
How Massachusetts Can Lead the Way on Patient Safety.
June 24, 2019
Boston, MA: Betsy Lehman Center for Patient Safety; June 2019.
https://psnet.ahrq.gov/issue/financial-and-human-cost-medical-error-and-how-massachusetts-can-lead-
way-patient-safety
The Betsy L…
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psnet.ahrq.gov/node/41726/psn-pdf
September 26, 2012 - Improving America's Hospitals: The Joint Commission's
Annual Report on Quality and Safety 2012.
September 26, 2012
Oakbrook Terrace, IL: The Joint Commission; September 2012.
https://psnet.ahrq.gov/issue/improving-americas-hospitals-joint-commissions-annual-report-quality-and-
safety-2012
The seventh annual Joint…
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psnet.ahrq.gov/node/42831/psn-pdf
October 31, 2014 - Overdiagnosis in low-dose computed tomography
screening for lung cancer.
October 31, 2014
Patz EF, Pinsky P, Gatsonis C, et al. Overdiagnosis in low-dose computed tomography screening for lung
cancer. JAMA Intern Med. 2014;174(2):269-74. doi:10.1001/jamainternmed.2013.12738.
https://psnet.ahrq.gov/issue/overdiagno…
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psnet.ahrq.gov/node/34688/psn-pdf
March 28, 2005 - Adverse drug events in hospitalized patients: excess
length of stay, extra costs, and attributable mortality.
March 28, 2005
Classen DC, Pestotnik SL, Evans RS, et al. Adverse drug events in hospitalized patients. Excess length of
stay, extra costs, and attributable mortality. JAMA. 1997;277(4):301-6.
https://psne…
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psnet.ahrq.gov/node/47752/psn-pdf
May 29, 2019 - How do nurses use early warning scoring systems to
detect and act on patient deterioration to ensure patient
safety? A scoping review.
May 29, 2019
Wood C, Chaboyer W, Carr P. How do nurses use early warning scoring systems to detect and act on
patient deterioration to ensure patient safety? A scoping review. Int …
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psnet.ahrq.gov/web-mm/volume-too-low-and-out
July 01, 2017 - information technology will be far exceeded by the removal of mathematical errors and oversights in calculating
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psnet.ahrq.gov/node/44131/psn-pdf
May 13, 2015 - Patient–doctor continuity and diagnosis of cancer:
electronic medical records study in general practice.
May 13, 2015
Ridd MJ, Ferreira DLS, Montgomery AA, et al. Patient-doctor continuity and diagnosis of cancer: electronic
medical records study in general practice. Br J Gen Pract. 2015;65(634):e305-11.
doi:10.33…
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psnet.ahrq.gov/node/45610/psn-pdf
November 01, 2017 - Economic value of pharmacist-led medication
reconciliation for reducing medication errors after
hospital discharge.
November 1, 2017
Najafzadeh M, Schnipper JL, Shrank WH, et al. Economic value of pharmacist-led medication reconciliation
for reducing medication errors after hospital discharge. Am J Manag Care. 201…