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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33674/psn-pdf
    February 01, 2009 - In Conversation with…Robert M. Wachter, MD October 1, 2008 In Conversation with…Robert M. Wachter, MD. PSNet [internet]. 2008. https://psnet.ahrq.gov/perspective/conversation-withrobert-m-wachter-md Editor's note: At the University of California, San Francisco, Robert M. Wachter, MD, is Professor and Chief of the…
  2. effectivehealthcare.ahrq.gov/sites/default/files/related_files/mhs4-infection-prevention-mdro-protocol.pdf
    July 01, 2023 - EHC Protocol: Addressing Social Isolation To Improve Health of Older Adults: A Rapid Evidence Review 1 Evidence-based Practice Center Rapid Review Protocol Project Title: Making Healthcare Safer IV: Prevention of Transmission of Infection with Multi-Drug Resistant Organisms (MDROs) Review Questions…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49483/psn-pdf
    June 01, 2005 - Getting to the Root of the Matter June 1, 2005 Saint S, Flanders S. Getting to the Root of the Matter. PSNet [internet]. 2005. https://psnet.ahrq.gov/web-mm/getting-root-matter Case Objectives Appreciate the goals and limitations of root cause analysis Outline the steps to conduct root cause analysis The Case A…
  4. psnet.ahrq.gov/issue/critical-care-simulation-education-program-during-covid-19-pandemic
    June 22, 2022 - Commentary Critical care simulation education program during the COVID-19 pandemic. Citation Text: Leibner ES, Baron EL, Shah RS, et al. Critical care simulation education program during the COVID-19 pandemic. J Patient Saf. 2022;18(4):e810-e815. doi:10.1097/pts.0000000000000928. Copy …
  5. psnet.ahrq.gov/issue/communicating-patient-safety-information-through-video-and-oral-formats-comparison
    November 16, 2022 - Study Communicating patient safety information through video and oral formats-a comparison. Citation Text: Bånnsgård M, Nouri A, Finizia C, et al. Communicating patient safety information through video and oral formats-a comparison. J Patient Saf. 2023;19(2):137-142. doi:10.1097/pts.0000…
  6. psnet.ahrq.gov/issue/optimizing-patient-safety-clinical-trials-improving-transitions-care
    October 16, 2024 - Study Optimizing patient safety in clinical trials by improving transitions of care. Citation Text: Nair SC, Satish KP, Al Maini M, et al. Optimizing patient safety in clinical trials by improving transitions of care. Jt Comm J Qual Patient Saf. 2020;46(4). doi:10.1016/j.jcjq.2020.01.001…
  7. psnet.ahrq.gov/issue/how-reliable-are-patient-completed-medication-reconciliation-forms-compared-pharmacy-lists
    April 24, 2018 - Study How reliable are patient-completed medication reconciliation forms compared with pharmacy lists? Citation Text: Meyer C, Stern M, Woolley W, et al. How reliable are patient-completed medication reconciliation forms compared with pharmacy lists? Am J Emerg Med. 2012;30(7):1048-54.…
  8. Layout 1 (pdf file)

    effectivehealthcare.ahrq.gov/sites/default/files/related_files/atrial-fibrillation-ablation_executive.pdf
    July 01, 2009 - Layout 1 Background The Agency for Healthcare Research and Quality commissioned this report to review the evidence for the clinical effect and safety of radiofrequency (RF) catheter ablation for the management of atrial fibrillation (AF). AF is the most common sustained arrhythmia seen in clinical practice. Its prev…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45769/psn-pdf
    December 21, 2016 - National Scorecard on Rates of Hospital-Acquired Conditions 2010 to 2015: Interim Data From National Efforts to Make Health Care Safer. December 21, 2016 Rockville, MD: Agency for Healthcare Research and Quality; December 2016. https://psnet.ahrq.gov/issue/national-scorecard-rates-hospital-acquired-conditions-2010…
  10. psnet.ahrq.gov/issue/critical-care-checklists-keystone-project-and-office-human-research-protections-case
    May 04, 2014 - Commentary Critical care checklists, the Keystone Project, and the Office for Human Research Protections: a case for streamlining the approval process in quality-improvement research. Citation Text: Savel RH, Goldstein EB, Gropper MA. Critical care checklists, the Keystone Project, an…
  11. psnet.ahrq.gov/issue/intensive-care-units-communication-between-nurses-and-physicians-and-patients-outcomes
    May 28, 2008 - Study Intensive care units, communication between nurses and physicians, and patients' outcomes. Citation Text: Manojlovich M, Antonakos CL, Ronis DL. Intensive care units, communication between nurses and physicians, and patients' outcomes. Am J Crit Care. 2009;18(1):21-30. doi:10.403…
  12. psnet.ahrq.gov/issue/compendium-strategies-prevent-hais-acute-care-hospitals-2014
    July 02, 2009 - Special or Theme Issue Compendium of Strategies to Prevent HAIs in Acute Care Hospitals 2014. Citation Text: Compendium of Strategies to Prevent HAIs in Acute Care Hospitals 2014. Infect Control Hosp Epidemiol. 2014;35(Suppl 2):s1-s178;35:460-463;797-801. Copy Citation …
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47559/psn-pdf
    November 14, 2018 - Changes in prevalence of health care-associated infections in U.S. hospitals. November 14, 2018 Magill SS, O'Leary E, Janelle SJ, et al. Changes in Prevalence of Health Care-Associated Infections in U.S. Hospitals. N Engl J Med. 2018;379(18):1732-1744. doi:10.1056/NEJMoa1801550. https://psnet.ahrq.gov/issue/change…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49635/psn-pdf
    September 01, 2011 - Central, not Epidural September 1, 2011 Simmons D. Central, not Epidural. PSNet [internet]. 2011. https://psnet.ahrq.gov/web-mm/central-not-epidural The Case A 55-year-old man with lung cancer recently had the lower lobe of his left lung removed. Post-operatively, he was awake, alert, and oriented to time, place,…
  15. psnet.ahrq.gov/web-mm/not-so-therapeutic-tap
    December 01, 2014 - SPOTLIGHT CASE Not-So-Therapeutic Tap Citation Text: Barsuk JH. Not-So-Therapeutic Tap. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2012. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote …
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45533/psn-pdf
    November 02, 2016 - Multimethod study of a large-scale programme to improve patient safety using a harm-free care approach. November 2, 2016 Power M, Brewster L, Parry G, et al. Multimethod study of a large-scale programme to improve patient safety using a harm-free care approach. BMJ Open. 2016;6(9):e011886. doi:10.1136/bmjopen-2016-…
  17. psnet.ahrq.gov/issue/embracing-errors-simulation-based-training-effect-error-training-retention-and-transfer
    May 23, 2013 - Study Embracing errors in simulation-based training: the effect of error training on retention and transfer of central venous catheter skills. Citation Text: Gardner AK, Abdelfattah K, Wiersch J, et al. Embracing Errors in Simulation-Based Training: The Effect of Error Training on Retent…
  18. psnet.ahrq.gov/issue/hybrid-methodology-modeling-risk-adverse-events-complex-health-care-settings
    November 11, 2015 - Study A hybrid methodology for modeling risk of adverse events in complex health-care settings. Citation Text: Kazemi R, Mosleh A, Dierks M. A Hybrid Methodology for Modeling Risk of Adverse Events in Complex Health-Care Settings. Risk Anal. 2017;37(3):421-440. doi:10.1111/risa.12702. …
  19. psnet.ahrq.gov/issue/improving-patient-safety-intensive-care-units-michigan
    February 17, 2011 - Study Classic Improving patient safety in intensive care units in Michigan. Citation Text: Pronovost P, Berenholtz SM, Goeschel CA, et al. Improving patient safety in intensive care units in Michigan. J Crit Care. 2008;23(2):207-212. doi:10.1016/j.jcrc.2007.09…
  20. psnet.ahrq.gov/issue/wisdom-and-justice-not-paying-preventable-complications
    January 22, 2014 - Commentary Classic The wisdom and justice of not paying for "preventable complications." Citation Text: Pronovost P, Goeschel CA, Wachter R. The wisdom and justice of not paying for "preventable complications". JAMA. 2008;299(18):2197-9. doi:10.1001/jama.299.1…