-
psnet.ahrq.gov/node/864847/psn-pdf
March 20, 2024 - Inter-hospital transfer is an independent risk factor for
hospital-associated infection.
March 20, 2024
Gardner C, Rubinfeld IS, Gupta AH, et al. Inter-hospital transfer is an independent risk factor for hospital-
associated infection. Surg Infect (Larchmt). 2024;25(2):125-132. doi:10.1089/sur.2023.077.
https://ps…
-
psnet.ahrq.gov/node/73417/psn-pdf
June 23, 2021 - Classification of failures in the perception of
conversational agents (CAs) and their implications on
patient safety.
June 23, 2021
Aftab H, Shah SHH, Habli I. Classification of failures in the perception of conversational agents (CAs) and
their implications on patient safety. Stud Health Technol Inform. 2021;281:…
-
psnet.ahrq.gov/node/48013/psn-pdf
May 29, 2019 - Economic outcomes associated with safety interventions
by a pharmacist–adjudicated prior authorization consult
service.
May 29, 2019
Jacob S, Britt RB, Bryan WE, et al. Economic Outcomes Associated with Safety Interventions by a
Pharmacist-Adjudicated Prior Authorization Consult Service. J Manag Care Spec Pharm. 2…
-
psnet.ahrq.gov/node/47975/psn-pdf
May 29, 2019 - Surgical Innovation, New Techniques and Technologies:
A Guide to Good Practice.
May 29, 2019
London, UK: Royal College of Surgeons of England; 2019.
https://psnet.ahrq.gov/issue/surgical-innovation-new-techniques-and-technologies-guide-good-practice
Introducing innovations in practice involves taking calculated ri…
-
psnet.ahrq.gov/issue/use-bar-code-technology-medication-administration
January 23, 2019 - December 1, 2021
Medication dose calculation errors and other numeracy mishaps in hospitals
-
psnet.ahrq.gov/node/39119/psn-pdf
November 25, 2009 - Effect of a weight-based prescribing method within an
electronic health record on prescribing errors.
November 25, 2009
Ginzburg R, Barr WB, Harris M, et al. Effect of a weight-based prescribing method within an electronic
health record on prescribing errors. Am J Health Syst Pharm. 2009;66(22):2037-41.
doi:10.214…
-
psnet.ahrq.gov/node/36367/psn-pdf
April 11, 2011 - Emergency medical services system changes reduce
pediatric epinephrine dosing errors in the prehospital
setting.
April 11, 2011
Kaji AH, Gausche-Hill M, Conrad H, et al. Emergency medical services system changes reduce pediatric
epinephrine dosing errors in the prehospital setting. Pediatrics. 2006;118(4):1493-150…
-
psnet.ahrq.gov/node/45986/psn-pdf
March 29, 2017 - Pediatric prehospital medication dosing errors: a national
survey of paramedics.
March 29, 2017
Hoyle JD, Crowe RP, Bentley MA, et al. Pediatric prehospital medication dosing errors: a national survey of
paramedics. Prehosp Emerg Care. 2017;21(2):185-191. doi:10.1080/10903127.2016.1227001.
https://psnet.ahrq.gov/i…
-
psnet.ahrq.gov/node/45547/psn-pdf
October 05, 2016 - Sick children face potentially deadly danger: medication
errors.
October 5, 2016
Furfaro H. Wall Street Journal. September 25, 2016.
https://psnet.ahrq.gov/issue/sick-children-face-potentially-deadly-danger-medication-errors
Medication errors in pediatric care are common in the hospital and at home. This newspaper…
-
psnet.ahrq.gov/node/35749/psn-pdf
May 09, 2014 - Chemotherapy dose limits set by users of a computer
order entry system.
May 9, 2014
DuBeshter B; Griggs J; Angel C; Loughner J.
https://psnet.ahrq.gov/issue/chemotherapy-dose-limits-set-users-computer-order-entry-system
To avoid excessive dosing of chemotherapeutic agents, standardized dose limits must be agreed u…
-
psnet.ahrq.gov/node/36895/psn-pdf
March 10, 2011 - A systematic review of the performance characteristics of
clinical event monitor signals used to detect adverse drug
events in the hospital setting.
March 10, 2011
Handler S, Altman RL, Perera S, et al. A systematic review of the performance characteristics of clinical
event monitor signals used to detect adverse …
-
psnet.ahrq.gov/node/44082/psn-pdf
April 22, 2015 - Impact of including readmissions for qualifying events in
the Patient Safety Indicators.
April 22, 2015
Davies SM, Saynina O, Baker LC, et al. Impact of including readmissions for qualifying events in the patient
safety indicators. Am J Med Qual. 2015;30(2):114-8. doi:10.1177/1062860613518341.
https://psnet.ahrq.g…
-
psnet.ahrq.gov/node/860724/psn-pdf
January 17, 2024 - Retrospective cohort study of wrong-patient imaging
order errors: how many reach the patient?
January 17, 2024
Kneifati-Hayek JZ, Geist E, Applebaum JR, et al. Retrospective cohort study of wrong-patient imaging
order errors: how many reach the patient? BMJ Qual Saf. 2024;33(2):132-135. doi:10.1136/bmjqs-2023-
016…
-
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…
-
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 …
-
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…
-
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-…
-
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…
-
psnet.ahrq.gov/node/49394/psn-pdf
April 01, 2003 - Premature or Overdue?
April 1, 2003
Thomas J, Hannah M. Premature or Overdue? PSNet [internet]. 2003.
https://psnet.ahrq.gov/web-mm/premature-or-overdue
The Case
A 32-year-old woman, gravida 3, para 1, presented for prenatal care at 24 weeks. Her past medical history
was unremarkable, and results of her prenatal …
-
psnet.ahrq.gov/issue/transitions-care-toc-portal
March 07, 2018 - Multi-use Website
Transitions of Care (TOC) Portal.
Save
Save to your library
Print
Download PDF
Share
Facebook
Twitter
Linkedin
Copy URL
February 27, 2013
This Web site provides resources for clinicians and patien…