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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50780/psn-pdf
    January 08, 2020 - An ethnography of parents' perceptions of patient safety in the neonatal intensive care unit. January 8, 2020 Ottosen MJ, Engebretson J, Etchegaray J, et al. An Ethnography of Parents' Perceptions of Patient Safety in the Neonatal Intensive Care Unit. Adv Neonatal Care. 2019;19(6):500-508. doi:10.1097/anc.00000000…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45160/psn-pdf
    May 18, 2016 - Clues to better health care from old malpractice lawsuits. May 18, 2016 Landro L. https://psnet.ahrq.gov/issue/clues-better-health-care-old-malpractice-lawsuits Closed claims have been considered a source for adverse event data for years, and recently such data has been utilized to inform safety improvement work. …

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46199/psn-pdf
    September 27, 2017 - The development and implementation of checklists in obstetrics. September 27, 2017 Medicine S for M-F, Bernstein PS, Combs A, et al. The development and implementation of checklists in obstetrics. Am J Obstet Gynecol. 2017;217(2):B2-B6. doi:10.1016/j.ajog.2017.05.032. https://psnet.ahrq.gov/issue/development-and-i…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46736/psn-pdf
    December 17, 2018 - Back to basics: the Universal Protocol. December 17, 2018 Spruce L. Back to Basics: The Universal Protocol: 1.4 www.aornjournal.org/content/cme. AORN J. 2018;107(1):116-125. doi:10.1002/aorn.12002. https://psnet.ahrq.gov/issue/back-basics-universal-protocol Wrong-site, wrong-procedure, and wrong-patient errors are…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42965/psn-pdf
    April 20, 2014 - Development of a Web-based surgical booking and informed consent system to reduce the potential for error and improve communication. April 20, 2014 Siracuse JJ, Benoit E, Burke J, et al. Development of a Web-based surgical booking and informed consent system to reduce the potential for error and improve communicat…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44048/psn-pdf
    November 20, 2015 - Clinical handover of the critically ill postoperative patient: an integrative review. November 20, 2015 Gardiner TM, Marshall AP, Gillespie BM. Clinical handover of the critically ill postoperative patient: an integrative review. Aust Crit Care. 2015;28(4):226-34. doi:10.1016/j.aucc.2015.02.001. https://psnet.ahrq…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/862151/psn-pdf
    February 07, 2024 - Taking up the challenge to improve name and role recognition in the operating room. February 7, 2024 Thota B, Rabinowitz A, Guttman OT. Taking up the challenge to improve name and role recognition in the operating room. J Patient Saf. 2024;20(1):45-47. doi:10.1097/pts.0000000000001177. https://psnet.ahrq.gov/issue…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45198/psn-pdf
    January 23, 2017 - Investigating teamwork in the operating room: engaging stakeholders and setting the agenda. January 23, 2017 Frasier LL, Quamme SRP, Becker A, et al. Investigating Teamwork in the Operating Room: Engaging Stakeholders and Setting the Agenda. JAMA Surg. 2017;152(1):109-111. doi:10.1001/jamasurg.2016.3110. https://…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44224/psn-pdf
    June 10, 2015 - To be sued less, doctors should consider talking to patients more. June 10, 2015 Carroll AE. https://psnet.ahrq.gov/issue/be-sued-less-doctors-should-consider-talking-patients-more Reporting on trends associated with medical malpractice, how the same physicians tend to get sued, and reasons patients file claims, …

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41534/psn-pdf
    July 25, 2012 - Protecting patients from an unsafe system: the etiology and recovery of intraoperative deviations in care. July 25, 2012 Hu Y-Y, Arriaga AF, Roth EM, et al. Protecting patients from an unsafe system: the etiology and recovery of intraoperative deviations in care. Ann Surg. 2012;256(2):203-10. doi:10.1097/SLA.0b013e…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41022/psn-pdf
    December 21, 2011 - Key performance outcomes of patient safety curricula: root cause analysis, failure mode and effects analysis, and structured communications skills. December 21, 2011 Fassett WE. Key performance outcomes of patient safety curricula: root cause analysis, failure mode and effects analysis, and structured communicatio…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73668/psn-pdf
    September 01, 2021 - Leadership: an effective human factor during COVID-19. September 1, 2021 Dhahri AA, Refson J. Leadership: an effective human factor during COVID-19. BMJ Leader. 2021;5:203- 205. doi:10.1136/leader-2020-000384. https://psnet.ahrq.gov/issue/leadership-effective-human-factor-during-covid-19 Hierarchy and professional…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38177/psn-pdf
    March 02, 2011 - Violations of behavioral practices revealed in closed claims reviews. March 2, 2011 Griffen FD, Stephens LS, Alexander JB, et al. Violations of behavioral practices revealed in closed claims reviews. Ann Surg. 2008;248(3):468-474. doi:10.1097/sla.0b013e318185e196. https://psnet.ahrq.gov/issue/violations-behavioral…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45070/psn-pdf
    October 03, 2017 - When There's Harm in the Hospital: Can Transparency Replace "Deny and Defend"? October 3, 2017 National Health Policy Forum. Washington, DC: George Washington University. March 11, 2016. https://psnet.ahrq.gov/issue/when-theres-harm-hospital-can-transparency-replace-deny-and-defend This report provides the insight…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50769/psn-pdf
    February 15, 2017 - Cultural Competence and Patient Safety December 27, 2019 Brach C, Hall KK, Fitall E. Cultural Competence and Patient Safety. PSNet [internet]. 2019. https://psnet.ahrq.gov/perspective/cultural-competence-and-patient-safety Background   Culture can be defined as the “personal identification, language, thoughts, co…

  16. A Seasonal Care Transition Failure | PSNet

    psnet.ahrq.gov/web-mm/seasonal-care-transition-failure
    June 01, 2016 - A Seasonal Care Transition Failure Citation Text: Young JQ. A Seasonal Care Transition Failure. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 X…

  17. Add-on Case and the Missing Checklist | PSNet

    psnet.ahrq.gov/web-mm/add-case-and-missing-checklist
    September 01, 2012 - Add-on Case and the Missing Checklist Citation Text: Catchpole K. Add-on Case and the Missing Checklist. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML En…

  18. Safety Problems With Your Child's Medical Device? | PSNet

    psnet.ahrq.gov/issue/safety-problems-your-childs-medical-device
    January 09, 2013 - Fact Sheet/FAQs Safety Problems With Your Child's Medical Device? Citation Text: Safety Problems With Your Child's Medical Device? Consumer Updates. Silver Spring, MD: US Food and Drug Administration; July 16, 2013. Copy Citation Save Save to your library …

  19. Handoffs and fumbles. | PSNet

    psnet.ahrq.gov/issue/handoffs-and-fumbles
    June 12, 2007 - Book/Report Handoffs and fumbles. Citation Text: Handoffs and fumbles. Wachter RM, Shojania KG. Chapter in: Wachter RM, Shojania KG. Internal Bleeding: The Truth Behind America's Terrifying Epidemic of Medical Mistakes. New York, NY: Rugged Land, LLC; 2004. Copy Citation …

  20. The normalization of deviance: what are the perioperative risks? | PSNet

    psnet.ahrq.gov/issue/normalization-deviance-what-are-perioperative-risks
    July 15, 2020 - Commentary The normalization of deviance: what are the perioperative risks? Citation Text: McNamara SA. The normalization of deviance: what are the perioperative risks? AORN J. 2011;93(6):796-801. doi:10.1016/j.aorn.2011.02.009. Copy Citation Format: DOI Google Scholar Pu…
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