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psnet.ahrq.gov/node/39604/psn-pdf
November 23, 2016 - Improving the patient, family, and clinician experience
after harmful events: the "When Things Go Wrong"
curriculum.
November 23, 2016
Bell SK, Moorman D, Delbanco T. Improving the patient, family, and clinician experience after harmful
events: the "when things go wrong" curriculum. Acad Med. 2010;85(6):1010-1017.…
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psnet.ahrq.gov/node/40725/psn-pdf
October 16, 2012 - Association of ICU or hospital admission with
unintentional discontinuation of medications for chronic
diseases.
October 16, 2012
Bell CM, Brener SS, Gunraj N, et al. Association of ICU or hospital admission with unintentional
discontinuation of medications for chronic diseases. JAMA. 2011;306(8):840-7.
doi:10.10…
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psnet.ahrq.gov/node/42612/psn-pdf
July 05, 2016 - Delivering High-Quality Cancer Care: Charting a New
Course for a System in Crisis.
July 5, 2016
Levit L, Balogh E, Nass S, Ganz PA, eds. Committee on Improving the Quality of Cancer Care: Addressing
the Challenges of an Aging Population, Institute of Medicine. Washington, DC: National Academies Press;
2013. ISBN: …
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psnet.ahrq.gov/node/39948/psn-pdf
December 21, 2014 - Wrong-site and wrong-patient procedures in the Universal
Protocol era: analysis of a prospective database of
physician self-reported occurrences.
December 21, 2014
Stahel PF, Sabel A, Victoroff MS, et al. Wrong-site and wrong-patient procedures in the universal protocol
era: analysis of a prospective database of p…
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psnet.ahrq.gov/node/39566/psn-pdf
January 03, 2017 - Impact of the Comprehensive Unit-Based Safety Program
(CUSP) on safety culture in a surgical inpatient unit.
January 3, 2017
Timmel J, Kent P, Holzmueller CG, et al. Impact of the Comprehensive Unit-based Safety Program (CUSP)
on safety culture in a surgical inpatient unit. Jt Comm J Qual Saf. 2010;36(6):252-260.
…
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psnet.ahrq.gov/node/40800/psn-pdf
December 09, 2014 - 'Tempos' management in primary care: a key factor for
classifying adverse events, and improving quality and
safety.
December 9, 2014
Amalberti R, Brami J. 'Tempos' management in primary care: a key factor for classifying adverse events,
and improving quality and safety. BMJ Qual Saf. 2012;21(9):729-36. doi:10.1136…
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psnet.ahrq.gov/node/73526/psn-pdf
July 28, 2021 - Medication Errors in Retail Pharmacies: Wrong Patient,
Wrong Instructions.
July 28, 2021
Li C, Marquez K. Medication Errors in Retail Pharmacies: Wrong Patient, Wrong Instructions. PSNet
[internet]. 2021.
https://psnet.ahrq.gov/web-mm/medication-errors-retail-pharmacies-wrong-patient-wrong-instructions
The Case
…
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psnet.ahrq.gov/node/33771/psn-pdf
August 22, 2014 - Beyond the Hospital: the New Frontier of Patient Safety
August 22, 2014
Plews-Ogan M. Beyond the Hospital: the New Frontier of Patient Safety. PSNet [internet]. 2014.
https://psnet.ahrq.gov/perspective/beyond-hospital-new-frontier-patient-safety
Perspective
The frontier of patient safety outside the hospital has y…
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psnet.ahrq.gov/node/33583/psn-pdf
March 01, 2023 - Simulation Training
March 1, 2023
Edward JJ, Nichols A, Bakerjian D. Simulation Training. PSNet [internet]. 2023.
https://psnet.ahrq.gov/primer/simulation-training
Originally published in 2014 by researchers at the University of California, San Francisco. Updated in
March 2023, by Jennifer J. Edwards, MS, RN, CHSE…
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psnet.ahrq.gov/sites/default/files/2022-08/final_spotlight_case_mesenteric_ischemia_08.05.2022.pdf
January 01, 2022 - Spotlight
Spotlight
Delayed Diagnosis of Mesenteric Ischemia
Source and Credits
• This presentation is based on the August 2022 AHRQ WebM&M
Spotlight Case
o See the full article at https://psnet.ahrq.gov/webmm
o CME credit is available
o Commentary by: Anamaria Robles, MD, and Garth Utter, MD, MSc
o AHRQ WebM&M…
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psnet.ahrq.gov/node/74252/psn-pdf
January 12, 2022 - In Conversation With... Poonam Sharma, MD, MPH, the
Senior Clinical Data Analyst at Atrium Health, and Rhonda
Dickman, MSN, RN, CPHQ, the Director of the Tennessee
Hospital Association PSO
January 12, 2022
In Conversation With.. Poonam Sharma, MD, MPH, the Senior Clinical Data Analyst at Atrium Health, and
Rhonda…
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psnet.ahrq.gov/node/49861/psn-pdf
May 01, 2019 - Updates in the Management of High-Risk Pulmonary
Embolism
May 1, 2019
Kabrhel C, Aaronson E. Updates in the Management of High-Risk Pulmonary Embolism. PSNet [internet].
2019.
https://psnet.ahrq.gov/web-mm/updates-management-high-risk-pulmonary-embolism
Case Objectives
Review common risk factors, typical present…
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psnet.ahrq.gov/node/49765/psn-pdf
August 21, 2016 - Cognitive Overload in the ICU
August 21, 2016
Patel VL, Buchman TG. Cognitive Overload in the ICU. PSNet [internet]. 2016.
https://psnet.ahrq.gov/web-mm/cognitive-overload-icu
Case Objectives
Identify the role of cognitive overload—especially interruptions—in compromising quality of care and
patient safety.
List…
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psnet.ahrq.gov/innovation/abcdef-bundle-data-literacy-training-performance-measurement-tracking-and-performance
September 23, 2024 - ABCDEF Bundle + Data Literacy Training, Performance Measurement Tracking, and Performance Feedback
Save
Save to your library
Print
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February 28, 2024
Innovation
Conta…
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psnet.ahrq.gov/node/49648/psn-pdf
March 01, 2012 - Postdischarge Follow-Up Phone Call
March 1, 2012
Mourad M, Rennke S. Postdischarge Follow-Up Phone Call. PSNet [internet]. 2012.
https://psnet.ahrq.gov/web-mm/postdischarge-follow-phone-call
Case Objectives
Understand why preventing readmissions through postdischarge phone calls is important.
Describe evidence su…
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psnet.ahrq.gov/web-mm/bad-writing-wrong-medication
March 01, 2015 - SPOTLIGHT CASE
Bad Writing, Wrong Medication
Citation Text:
Devine B. Bad Writing, Wrong Medication. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2010.
Copy Citation
Format:
Google Scholar BibTeX EndNote X3…
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psnet.ahrq.gov/curated-library/nurse-wellbeing-and-patient-safety
August 30, 2023 - Breadcrumb
Home
The PSNet Collection
Curated Libraries
Subscribed
Nurse Wellbeing and Patient Safety
Download
Share
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Subscribe
Created By: Lorri Zipperer, Cybrarian, AHRQ…
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psnet.ahrq.gov/web-mm/pregnant-danger
January 12, 2011 - Pregnant With Danger
Citation Text:
Pearlman MD, Desmond JS. Pregnant With Danger. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005.
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psnet.ahrq.gov/issue/acog-committee-opinion-508-disruptive-behavior
September 04, 2024 - Commentary
ACOG Committee Opinion #508: disruptive behavior.
Citation Text:
ACOG Committee Opinion No. 508: disruptive behavior. Obstet Gynecol. 2011;118(4):970-2. doi:10.1097/AOG.0b013e3182358acc.
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DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNot…
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psnet.ahrq.gov/node/43972/psn-pdf
November 03, 2015 - National hospital ratings systems share few common
scores and may generate confusion instead of clarity.
November 3, 2015
Austin M, Jha AK, Romano PS, et al. National hospital ratings systems share few common scores and may
generate confusion instead of clarity. Health Aff (Millwood). 2015;34(3):423-430.
doi:10.13…