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81. Why studying human behavior is a critical component of patient safety. | PSNet
    psnet.ahrq.gov/issue/why-studying-human-behavior-critical-component-patient-safety
    January 15, 2020 - video analysis of teams in critical situations informed adjustments to training to reduce risks in cardiac … April 22, 2015 Application of the aviation black box principle in pediatric cardiac surgery … : tracking all failures in the pediatric cardiac operating room. … May 25, 2011 A reduction in cardiac arrests and duration of clinical instability after … December 16, 2009 Nurses' perceptions of subspecialization in pediatric cardiac intensive

82. Hospitals as cultures of entrapment: a re-analysis of the Bristol Royal Infirmary. | PSNet
    psnet.ahrq.gov/issue/hospitals-cultures-entrapment-re-analysis-bristol-royal-infirmary
    May 21, 2019 - of postoperative mortality, surgeons at the Bristol Royal Infirmary continued to perform pediatric cardiac … National Aeronautics and Space Administration "threat and error" model applied to pediatric cardiac … April 22, 2015 Application of the aviation black box principle in pediatric cardiac surgery … : tracking all failures in the pediatric cardiac operating room. … July 31, 2012 A prospective study of paediatric cardiac surgical microsystems: assessing

83. Implementation of a rapid response team decreases cardiac arrest outside of the intensive care unit. | PSNet
    psnet.ahrq.gov/issue/implementation-rapid-response-team-decreases-cardiac-arrest-outside-intensive-care-unit
    September 26, 2012 - Study Implementation of a rapid response team decreases cardiac arrest outside of … Implementation of a rapid response team decreases cardiac arrest outside of the intensive care unit. … on the use of a rapid response team (RRT) in their hospital and found a 50% reduction in non-ICU cardiac … Implementation of a rapid response team decreases cardiac arrest outside of the intensive care unit. … 2014 Transparency, public reporting, and a culture of change to quality and safety in cardiac

84. Cardiac surgery errors: results from the UK National Reporting and Learning System. | PSNet
    psnet.ahrq.gov/issue/cardiac-surgery-errors-results-uk-national-reporting-and-learning-system
    May 24, 2012 - Study Cardiac surgery errors: results from the UK National Reporting and Learning … Cardiac surgery errors: results from the UK National Reporting and Learning System. … Cardiac surgery errors: results from the UK National Reporting and Learning System. … June 29, 2022 Fast tracking in cardiac surgery: is it safe? … surgery: tracking all failures in the pediatric cardiac operating room.

85. Introduction of a rapid response system at a United States Veterans Affairs hospital reduced cardiac arrests. | PSNet
    psnet.ahrq.gov/issue/introduction-rapid-response-system-united-states-veterans-affairs-hospital-reduced-cardiac
    January 02, 2017 - Introduction of a rapid response system at a United States Veterans Affairs hospital reduced cardiac … Introduction of a rapid response system at a United States veterans affairs hospital reduced cardiac … This study demonstrated a 57% reduction in cardiac arrests following implementation of a physician-led … Introduction of a rapid response system at a United States veterans affairs hospital reduced cardiac … May 25, 2010 A reduction in cardiac arrests and duration of clinical instability after

86. Better nurse staffing is associated with survival for Black patients and diminishes racial disparities in survival after in-hospital cardiac arrests. | PSNet
    psnet.ahrq.gov/issue/better-nurse-staffing-associated-survival-black-patients-and-diminishes-racial-disparities
    June 02, 2021 - associated with survival for Black patients and diminishes racial disparities in survival after in-hospital cardiac … associated with survival for black patients and diminishes racial disparities in survival after in-hospital cardiac … states assessed the relationship between nurse staffing and survival disparities after in-hospital cardiac … associated with survival for black patients and diminishes racial disparities in survival after in-hospital cardiac

87. Hospital-wide cardiac arrest in situ simulation to identify and mitigate latent safety threats. | PSNet
    psnet.ahrq.gov/issue/hospital-wide-cardiac-arrest-situ-simulation-identify-and-mitigate-latent-safety-threats
    April 14, 2021 - Study Hospital-wide cardiac arrest in situ simulation to identify and mitigate latent … Hospital-wide cardiac arrest in situ simulation to identify and mitigate latent safety threats. … Seventy-four in situ cardiac arrest simulations were conducted in one hospital, identifying 106 unique … Hospital-wide cardiac arrest in situ simulation to identify and mitigate latent safety threats.

88. Health system redesign of cardiac monitoring oversight to optimize alarm management, safety, and staff engagement. | PSNet
    psnet.ahrq.gov/issue/health-system-redesign-cardiac-monitoring-oversight-optimize-alarm-management-safety-and
    February 15, 2023 - Study Health system redesign of cardiac monitoring oversight to optimize alarm management … Health system redesign of cardiac monitoring oversight to optimize alarm management, safety, and staff … This study reports on one health system’s redesign of cardiac monitoring structure to reduce alert … Health system redesign of cardiac monitoring oversight to optimize alarm management, safety, and staff

89. Introduction to the STS National Database Series: outcomes analysis, quality improvement, and patient safety. | PSNet
    psnet.ahrq.gov/issue/introduction-sts-national-database-series-outcomes-analysis-quality-improvement-and-patient
    August 04, 2021 - surgery teams: a national survey among cardiac anesthesiologists, cardiac surgeons, clinical perfusionists … , and cardiac operating room nurses. … November 9, 2022 Starting elective cardiac surgery after 3 pm does not impact patient … surgery: tracking all failures in the pediatric cardiac operating room. … October 22, 2014 Quality, patient safety, and the cardiac surgical team.

90. Psn-Pdf (pdf file)
    psnet.ahrq.gov/node/837333/psn-pdf
    June 08, 2022 - Hospital-wide cardiac arrest in situ simulation to identify and mitigate latent safety threats. … Hospital-wide cardiac arrest in situ simulation to identify and mitigate latent safety threats. … https://psnet.ahrq.gov/issue/hospital-wide-cardiac-arrest-situ-simulation-identify-and-mitigate-latent-safety … Seventy-four in situ cardiac arrest simulations were conducted in one hospital, identifying 106 unique … https://psnet.ahrq.gov/issue/situ-simulated-cardiac-arrest-exercises-detect-system-vulnerabilities https

91. Psn-Pdf (pdf file)
    psnet.ahrq.gov/node/853439/psn-pdf
    September 13, 2023 - In-situ simulations to detect patient safety threats during in-hospital cardiac arrest. … In-situ simulations to detect patient safety threats during in- hospital cardiac arrest. … https://psnet.ahrq.gov/issue/situ-simulations-detect-patient-safety-threats-during-hospital-cardiac-arrest … In this study, 36 unannounced in situ in- hospital cardiac arrest (IHCA) simulations were conducted … https://psnet.ahrq.gov/issue/situ-simulated-cardiac-arrest-exercises-detect-system-vulnerabilities https

92. Dealing with unforeseen complexity in the OR: the role of heedful interrelating in medical teams. | PSNet
    psnet.ahrq.gov/issue/dealing-unforeseen-complexity-or-role-heedful-interrelating-medical-teams
    July 06, 2011 - Through direct observation, this study analyzed how pediatric cardiac surgery teams dealt with unanticipated … Related Resources From the Same Author(s) A prospective study of paediatric cardiac … January 26, 2022 Application of the aviation black box principle in pediatric cardiac … surgery: tracking all failures in the pediatric cardiac operating room. … June 8, 2011 Standardized multidisciplinary protocol improves handover of cardiac surgery

93. Do hospitals provide lower quality care on weekends? | PSNet
    psnet.ahrq.gov/issue/do-hospitals-provide-lower-quality-care-weekends
    January 12, 2022 - patients admitted on weekends were significantly less likely to undergo invasive treatments (such as cardiac … Association of measured quality and future financial performance among hospitals performing cardiac … December 7, 2022 Hospital-acquired functional decline and clinical outcomes in older cardiac … September 24, 2016 Impact of anesthetic handover on mortality and morbidity in cardiac … February 10, 2015 The relationship between inpatient cardiac surgery mortality and nurse

94. Psn-Pdf (pdf file)
    psnet.ahrq.gov/node/861761/psn-pdf
    January 31, 2024 - Adverse safety events in emergency medical services care of children with out-of-hospital cardiac arrest … Adverse safety events in emergency medical services care of children with out-of-hospital cardiac arrest … /psnet.ahrq.gov/issue/adverse-safety-events-emergency-medical-services-care-children-out-hospital- cardiac-arrest … Adverse safety events (ASE) are common in pediatric out-of-hospital cardiac arrests (OHCA). … https://psnet.ahrq.gov/issue/safety-events-pediatric-out-hospital-cardiac-arrest https://psnet.ahrq.gov

95. Psn-Pdf (pdf file)
    psnet.ahrq.gov/node/853236/psn-pdf
    September 06, 2023 - Video review of simulated pediatric cardiac arrest to identify errors/latent safety threats: a mixed … Video review of simulated pediatric cardiac arrest to identify errors/latent safety threats: a mixed … https://psnet.ahrq.gov/issue/video-review-simulated-pediatric-cardiac-arrest-identify-errorslatent-safety … By analyzing video recordings of pediatric cardiac arrest simulations, researchers were able to identify … https://psnet.ahrq.gov/issue/video-review-simulated-pediatric-cardiac-arrest-identify-errorslatent-safety-threats-mixed

96. How does audit and feedback influence intentions of health professionals to improve practice? A laboratory experiment and field study in cardiac rehabilitation. | PSNet
    psnet.ahrq.gov/issue/how-does-audit-and-feedback-influence-intentions-health-professionals-improve-practice
    February 14, 2024 - A laboratory experiment and field study in cardiac rehabilitation. … A laboratory experiment and field study in cardiac rehabilitation. … A laboratory experiment and field study in cardiac rehabilitation. … January 3, 2017 In situ simulated cardiac arrest exercises to detect system vulnerabilities … 2011 Importance of prevention and early intervention of adverse events in pediatric cardiac

97. Psn-Pdf (pdf file)
    psnet.ahrq.gov/node/851158/psn-pdf
    June 28, 2023 - Ventricular Wall Injury during a Diagnostic Cardiac Catheterization June 28, 2023 Pham TH, Atreja … Ventricular Wall Injury during a Diagnostic Cardiac Catheterization. PSNet [internet]. 2023. … Risks of diagnostic cardiac catheterization Although it is a relatively safe procedure, cardiac catheterization … The history of cardiac catheterization. Can J Cardiol. 2005;21(12):1011-1014.  2. … Complications of cardiac catheterization.

98. Coming Undone: Failure of Closure Device | PSNet
    psnet.ahrq.gov/web-mm/coming-undone-failure-closure-device
    April 01, 2006 - The Commentary Cardiac catheterization is a diagnostic procedure that can be used to evaluate cardiac … In the following discussion, the most common complications of cardiac catheterization and measures to … Cardiac catheterization is one of the most commonly performed procedures in medical practice and has … Coronary arteriography 1984-1987: a report of the Registry of the Society for Cardiac Angiography and … Stroke as a complication of cardiac catheterization: risk factors and clinical features.

99. A reduction in cardiac arrests and duration of clinical instability after implementation of a paediatric rapid response system. | PSNet
    psnet.ahrq.gov/issue/reduction-cardiac-arrests-and-duration-clinical-instability-after-implementation-paediatric
    January 03, 2017 - Study A reduction in cardiac arrests and duration of clinical instability after implementation … A reduction in cardiac arrests and duration of clinical instability after implementation of a paediatric … This pediatric study found fewer cardiac arrests after implementing a rapid response team (RRT) consisting … A reduction in cardiac arrests and duration of clinical instability after implementation of a paediatric … 2022 View More Related Resources Diagnostic errors in paediatric cardiac

100. More than half a million heart surgery patients at risk of a dangerous infection. | PSNet
     psnet.ahrq.gov/issue/more-half-million-heart-surgery-patients-risk-dangerous-infection
     April 22, 2015 - have been exposed to a deadly bacterial infection related to an essential piece of equipment used in cardiac … Association between handover of anesthesiology care and 1-year mortality among adults undergoing cardiac … More Related Resources Mortality due to hospital-acquired infection after cardiac … September 30, 2015 Cardiac surgical ICU care: eliminating "preventable" complications … September 11, 2013 A handoff protocol from the cardiovascular operating room to cardiac