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  1. Instituting vincristine minibag administration: an innovative strategy using simulation to enhance chemotherapy safety. | PSNet

    psnet.ahrq.gov/issue/instituting-vincristine-minibag-administration-innovative-strategy-using-simulation-enhance
    April 24, 2018 - Commentary Instituting vincristine minibag administration: an innovative strategy using simulation to enhance chemotherapy safety. Citation Text: Corbitt N, Malick L, Nishioka J, et al. Instituting Vincristine Minibag Administration: An Innovative Strategy Using Simulation to Enhance Che…

  2. Developing a tool for assessing competency in root cause analysis. | PSNet

    psnet.ahrq.gov/issue/developing-tool-assessing-competency-root-cause-analysis
    May 01, 2014 - Study Developing a tool for assessing competency in root cause analysis. Citation Text: Gupta P, Varkey P. Developing a tool for assessing competency in root cause analysis. Jt Comm J Qual Patient Saf. 2009;35(1):36-42. Copy Citation Format: Google Scholar PubMed BibTeX E…

  3. Patient safety instruction in US health professions education. | PSNet

    psnet.ahrq.gov/issue/patient-safety-instruction-us-health-professions-education
    September 01, 2015 - Review Patient safety instruction in US health professions education. Citation Text: Kiersma ME, Plake KS, Darbishire PL. Patient safety instruction in US health professions education. Am J Pharm Educ. 2011;75(8):162. doi:10.5688/ajpe758162. Copy Citation Format: DOI Goog…

  4. Nurse/physician communication through a sensemaking lens: shifting the paradigm to improve patient safety. | PSNet

    psnet.ahrq.gov/issue/nursephysician-communication-through-sensemaking-lens-shifting-paradigm-improve-patient
    June 05, 2024 - Review Nurse/physician communication through a sensemaking lens: shifting the paradigm to improve patient safety. Citation Text: Manojlovich M. Nurse/physician communication through a sensemaking lens: shifting the paradigm to improve patient safety. Med Care. 2010;48(11):941-6. doi:10…

  5. Management of adverse surgical events: a structured education module for residents. | PSNet

    psnet.ahrq.gov/issue/management-adverse-surgical-events-structured-education-module-residents
    August 26, 2011 - Study Management of adverse surgical events: a structured education module for residents. Citation Text: Brewster LP, Risucci DA, Joehl RJ, et al. Management of adverse surgical events: a structured education module for residents. Am J Surg. 2005;190(5):687-90. Copy Citation Form…

  6. Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure." | PSNet

    psnet.ahrq.gov/issue/hospitalization-associated-disability-she-was-probably-able-ambulate-im-not-sure
    August 04, 2015 - Study Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure." Citation Text: Covinsky KE, Pierluissi E, Johnston B. Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure". JAMA. 2011;306(16):1782-93. doi:10.1001…

  7. The World Health Organization '5 moments of hand hygiene': the scientific foundation. | PSNet

    psnet.ahrq.gov/issue/world-health-organization-5-moments-hand-hygiene-scientific-foundation
    October 19, 2022 - Commentary The World Health Organization '5 moments of hand hygiene': the scientific foundation. Citation Text: Chou DTS, Achan P, Ramachandran M. The World Health Organization '5 moments of hand hygiene': the scientific foundation. J Bone Joint Surg Br. 2012;94(4):441-5. doi:10.1302/0…

  8. The importance of failing forward. All of us will fail and make mistakes, but how can they benefit us and our organizations? | PSNet

    psnet.ahrq.gov/issue/importance-failing-forward-all-us-will-fail-and-make-mistakes-how-can-they-benefit-us-and-our
    July 27, 2016 - Newspaper/Magazine Article The importance of failing forward. All of us will fail and make mistakes, but how can they benefit us and our organizations? Citation Text: Hofmann PB. The importance of failing forward. All of us will fail and make mistakes, but how can they benefit us and ou…

  9. Disclosure of harmful medical errors in out-of-hospital care. | PSNet

    psnet.ahrq.gov/issue/disclosure-harmful-medical-errors-out-hospital-care
    June 18, 2014 - Review Disclosure of harmful medical errors in out-of-hospital care. Citation Text: Lu DW, Guenther E, Wesley AK, et al. Disclosure of harmful medical errors in out-of-hospital care. Ann Emerg Med. 2013;61(2):215-21. doi:10.1016/j.annemergmed.2012.07.004. Copy Citation Format: …

  10. A systematic review of patient tracking systems for use in the pediatric emergency department. | PSNet

    psnet.ahrq.gov/issue/systematic-review-patient-tracking-systems-use-pediatric-emergency-department
    August 03, 2022 - Review A systematic review of patient tracking systems for use in the pediatric emergency department. Citation Text: Dobson I, Doan Q, Hung G. A systematic review of patient tracking systems for use in the pediatric emergency department. J Emerg Med. 2013;44(1):242-8. doi:10.1016/j.jem…

  11. Building capacity and capability for patient safety education: a train-the-trainers programme for senior doctors. | PSNet

    psnet.ahrq.gov/issue/building-capacity-and-capability-patient-safety-education-train-trainers-programme-senior
    January 15, 2014 - Study Building capacity and capability for patient safety education: a train-the-trainers programme for senior doctors. Citation Text: Ahmed M, Arora S, Baker P, et al. Building capacity and capability for patient safety education: a train-the-trainers programme for senior doctors. BMJ…

  12. Systematic error and cognitive bias in obstetric ultrasound. | PSNet

    psnet.ahrq.gov/issue/systematic-error-and-cognitive-bias-obstetric-ultrasound
    December 13, 2023 - Commentary Systematic error and cognitive bias in obstetric ultrasound. Citation Text: Sotiriadis A, Odibo AO. Systematic error and cognitive bias in obstetric ultrasound. Ultrasound Obstet Gynecol. 2019;53(4):431-435. doi:10.1002/uog.20232. Copy Citation Format: DOI Google…

  13. Implementation of an evidence-based extubation checklist to reduce extubation failure in patients with trauma: a pilot study. | PSNet

    psnet.ahrq.gov/issue/implementation-evidence-based-extubation-checklist-reduce-extubation-failure-patients-trauma
    March 07, 2018 - Study Implementation of an evidence-based extubation checklist to reduce extubation failure in patients with trauma: a pilot study. Citation Text: Howie WO, Dutton RP. Implementation of an evidence-based extubation checklist to reduce extubation failure in patients with trauma: a pilot…

  14. Inpatient notes: just what the doctor ordered—checklists to improve diagnosis. | PSNet

    psnet.ahrq.gov/issue/inpatient-notes-just-what-doctor-ordered-checklists-improve-diagnosis
    August 14, 2019 - Commentary Inpatient notes: just what the doctor ordered—checklists to improve diagnosis. Citation Text: Gupta A, Graber ML. Web Exclusive. Annals for Hospitalists Inpatient Notes - Just What the Doctor Ordered-Checklists to Improve Diagnosis. Ann Intern Med. 2019;170(8):HO2-HO3. doi:10.…

  15. Implementing a commercial rule base as a medication order safety net. | PSNet

    psnet.ahrq.gov/issue/implementing-commercial-rule-base-medication-order-safety-net
    January 03, 2017 - Study Implementing a commercial rule base as a medication order safety net. Citation Text: Reichley RM, Seaton TL, Resetar E, et al. Implementing a commercial rule base as a medication order safety net. J Am Med Inform Assoc. 2005;12(4):383-9. Copy Citation Format: Google…

  16. Chasing the 6-sigma: drawing lessons from the cockpit culture. | PSNet

    psnet.ahrq.gov/issue/chasing-6-sigma-drawing-lessons-cockpit-culture
    April 22, 2015 - Commentary Chasing the 6-sigma: drawing lessons from the cockpit culture. Citation Text: Hickey EJ, Halvorsen F, Laussen PC, et al. Chasing the 6-sigma: Drawing lessons from the cockpit culture. J Thorac Cardiovasc Surg. 2017;155(2). doi:10.1016/j.jtcvs.2017.09.097. Copy Citation F…

  17. Full work analysis of resident work hours. | PSNet

    psnet.ahrq.gov/issue/full-work-analysis-resident-work-hours
    June 06, 2018 - Study Full work analysis of resident work hours. Citation Text: Dassinger MS, Eubanks JW, Langham MR. Full work analysis of resident work hours. J Surg Res. 2008;147(2):178-81. doi:10.1016/j.jss.2008.03.010. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X…

  18. Incomplete care—on the trail of flaws in the system. | PSNet

    psnet.ahrq.gov/issue/incomplete-care-trail-flaws-system
    February 17, 2011 - Commentary Incomplete care—on the trail of flaws in the system. Citation Text: Gandhi TK, Zuccotti G, Lee TH. Incomplete care--on the trail of flaws in the system. N Engl J Med. 2011;365(6):486-8. doi:10.1056/NEJMp1106313. Copy Citation Format: DOI Google Scholar PubMed B…

  19. Reducing diagnostic errors worldwide through diagnostic management teams. | PSNet

    psnet.ahrq.gov/issue/reducing-diagnostic-errors-worldwide-through-diagnostic-management-teams
    May 23, 2018 - Review Reducing diagnostic errors worldwide through diagnostic management teams. Citation Text: Verna R, Velazquez AB, Laposata M. Reducing Diagnostic Errors Worldwide Through Diagnostic Management Teams. Ann Lab Med. 2019;39(2):121-124. doi:10.3343/alm.2019.39.2.121. Copy Citation …

  20. Nurses' medication work: what do nurses know? | PSNet

    psnet.ahrq.gov/issue/nurses-medication-work-what-do-nurses-know
    September 20, 2023 - Review Nurses' medication work: what do nurses know? Citation Text: Folkmann L, Rankin J. Nurses' medication work: what do nurses know? J Clin Nurs. 2010;19(21-22):3218-26. doi:10.1111/j.1365-2702.2010.03249.x. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNot…
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