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psnet.ahrq.gov/node/46213/psn-pdf
June 28, 2017 - The second victim: a review.
June 28, 2017
Coughlan B, Powell D, Higgins MF. The Second Victim: a Review. Eur J Obstet Gynecol Reprod Biol.
2017;213:11-16. doi:10.1016/j.ejogrb.2017.04.002.
https://psnet.ahrq.gov/issue/second-victim-review
Maternity care is a high-risk environment. This review discusses second vic…
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psnet.ahrq.gov/node/60763/psn-pdf
August 05, 2020 - Supporting the emotional well-being of health care
workers during the COVID-19 pandemic.
August 5, 2020
Wu AW, Buckle P, Haut ER, et al. Supporting the emotional well-being of health care workers during the
COVID-19 pandemic. J Patient Saf Risk Manag. 2020;25(3):93-96. doi:10.1177/2516043520931971.
https://psnet.a…
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psnet.ahrq.gov/node/72476/psn-pdf
November 18, 2020 - Maintaining perioperative safety in uncertain times:
COVID-19 pandemic response strategies.
November 18, 2020
Mazzola SM, Grous C. Maintaining perioperative safety in uncertain times: COVID-19 pandemic response
strategies. AORN J. 2020;112(4):397-405. doi:10.1002/aorn.13195.
https://psnet.ahrq.gov/issue/maintainin…
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psnet.ahrq.gov/node/46623/psn-pdf
July 02, 2019 - Factors contributing to medication errors made when
using computerized order entry in pediatrics: a
systematic review.
July 2, 2019
Tolley CL, Forde NE, Coffey KL, et al. Factors contributing to medication errors made when using
computerized order entry in pediatrics: a systematic review. J Am Med Info Assoc. 2017…
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psnet.ahrq.gov/sites/default/files/2024-07/spotlight_case_mismanagement_of_acute_decompensated_heart_failure_slides_final.pptx
January 01, 2024 - 13
Background (5)
As a combined alpha/beta adrenergic blocker, labetalol is seen as an attractive choice … better why the clinicians on both ends of the admission decision felt comfortable with such a risky choice
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psnet.ahrq.gov/node/60294/psn-pdf
May 06, 2020 - Medically-necessary, time-sensitive procedures: a
scoring system to ethically and efficiently manage
resource scarcity and provider risk during the COVID-19
pandemic.
May 6, 2020
Prachand VN, Milner R, Angelos P, et al. Medically-necessary, time-sensitive procedures: a scoring system
to ethically and efficiently …
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psnet.ahrq.gov/print/pdf/node/845971
January 01, 2024 - on medical decision-making, for both patients and providers without actually
restricting individual choice … on medical decision-making, for both patients and providers without actually
restricting individual choice
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psnet.ahrq.gov/node/44280/psn-pdf
July 15, 2015 - Innovation in practice: a multidisciplinary medication
safety initiative.
July 15, 2015
Eid KA. Innovation in practice: A multidisciplinary medication safety initiative. Nursing. 2015;45(7):14-6.
doi:10.1097/01.NURSE.0000466458.62870.99.
https://psnet.ahrq.gov/issue/innovation-practice-multidisciplinary-medication…
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psnet.ahrq.gov/node/47507/psn-pdf
December 21, 2018 - The fate of medicine in the time of AI.
December 21, 2018
Coiera E. The fate of medicine in the time of AI. Lancet. 2018;392(10162):2331-2332. doi:10.1016/S0140-
6736(18)31925-1.
https://psnet.ahrq.gov/issue/fate-medicine-time-ai
Artificial intelligence can improve practice by making synthesized data available in …
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psnet.ahrq.gov/node/73068/psn-pdf
March 24, 2021 - The perception of patient safety in an alternate site of
care for elective surgery during the first wave of the novel
coronavirus pandemic in the United Kingdom: a survey of
158 patients.
March 24, 2021
Lee G, Clough OT, Walker JA, et al. The perception of patient safety in an alternate site of care for elective
…
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psnet.ahrq.gov/node/35448/psn-pdf
September 18, 2009 - Relationship between performance measurement and
accreditation: implications for quality of care and patient
safety.
September 18, 2009
Miller MR, Pronovost P, Donithan M, et al. Relationship between performance measurement and
accreditation: implications for quality of care and patient safety. Am J Med Qual. 2005…
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psnet.ahrq.gov/node/47465/psn-pdf
October 17, 2018 - Mix-ups between epidural analgesia and IV antibiotics in
labor and delivery units continue to cause harm.
October 17, 2018
ISMP Medication Safety Alert! Acute Care Edition. October 4, 2018;23:1-4.
https://psnet.ahrq.gov/issue/mix-ups-between-epidural-analgesia-and-iv-antibiotics-labor-and-delivery-
units-continue-…
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psnet.ahrq.gov/node/49693/psn-pdf
October 01, 2013 - be required for medical care and conveys that this is a medical condition and not the individual's choice … Take-Home Points
Transgender identity is a medical condition, not a person's choice, and care should
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psnet.ahrq.gov/node/49594/psn-pdf
December 01, 2009 - Decision-making capacity is defined by four criteria: (i) ability to communicate a choice, (ii) ability … care requires
that a competent patient's informed refusal should be honored even if the patient's choice
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psnet.ahrq.gov/perspective/conversation-eric-j-topol-md
February 26, 2025 - You've spent time in the last 5 or 10 years immersed in this world of patient choice and patient empowerment
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psnet.ahrq.gov/node/41703/psn-pdf
November 08, 2012 - Anatomy of an incident disclosure: the importance of
dialogue.
November 8, 2012
Iedema R, Allen S. Anatomy of an incident disclosure: the importance of dialogue. Jt Comm J Qual Patient
Saf. 2012;38(10):435-42.
https://psnet.ahrq.gov/issue/anatomy-incident-disclosure-importance-dialogue
Physician organizations who…
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psnet.ahrq.gov/node/33792/psn-pdf
September 01, 2015 - You've spent time in the last 5 or
10 years immersed in this world of patient choice and patient empowerment
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psnet.ahrq.gov/node/42208/psn-pdf
April 17, 2013 - Hospital staff nurses' shift length associated with safety
and quality of care.
April 17, 2013
Stimpfel AW, Aiken LH. Hospital staff nurses' shift length associated with safety and quality of care. J Nurs
Care Qual. 2013;28(2):122-129. doi:10.1097/NCQ.0b013e3182725f09.
https://psnet.ahrq.gov/issue/hospital-staff-n…
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psnet.ahrq.gov/node/35853/psn-pdf
May 20, 2015 - What practices will most improve safety? Evidence-based
medicine meets patient safety.
May 20, 2015
Leape L, Berwick DM, Bates DW. What practices will most improve safety? Evidence-based medicine
meets patient safety. JAMA. 2002;288(4):501-7.
https://psnet.ahrq.gov/issue/what-practices-will-most-improve-safety-evi…
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psnet.ahrq.gov/node/49445/psn-pdf
May 01, 2004 - No Blood, Please
May 1, 2004
Liang BA. No Blood, Please. PSNet [internet]. 2004.
https://psnet.ahrq.gov/web-mm/no-blood-please
The Case
A young woman, about 30 years of age, was injured in an automobile collision. She was brought to the
emergency department (ED) via ambulance, where she was found to be suffering …