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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/838030/psn-pdf
    September 07, 2022 - Rethinking use of air-safety principles to reduce fatal hospital errors. September 7, 2022 Rethinking use of air-safety principles to reduce fatal hospital errors. doi:10.1377/forefront.20220824.965364. https://psnet.ahrq.gov/issue/rethinking-use-air-safety-principles-reduce-fatal-hospital-errors The safety of co…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50561/psn-pdf
    October 16, 2019 - Patient Safety Organizations: Hospital Participation, Value, and Challenges. October 16, 2019 US Department of Health and Human Services; Office of the Inspector General, September 2019. OIG Report No. OEI-01-17-00420.  https://psnet.ahrq.gov/issue/patient-safety-organizations-hospital-participation-value-and…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837626/psn-pdf
    July 06, 2022 - Frailty, gaps in care coordination, and preventable adverse events. July 6, 2022 Akinyelure OP, Colvin CL, Sterling MR, et al. Frailty, gaps in care coordination, and preventable adverse events. BMC Geriatr. 2022;22(1):476. doi:10.1186/s12877-022-03164-7. https://psnet.ahrq.gov/issue/frailty-gaps-care-coordination…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47060/psn-pdf
    April 25, 2018 - Patient safety vulnerabilities for children with intellectual disability in hospital: a systematic review and narrative synthesis. April 25, 2018 Mimmo L, Harrison R, Hinchcliff R. Patient safety vulnerabilities for children with intellectual disability in hospital: a systematic review and narrative synthesis. BMJ…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46699/psn-pdf
    March 20, 2018 - Disclosure of harmful medical error to patients: a review with recommendations for pathologists. March 20, 2018 Heher YK, Dintzis SM. Disclosure of Harmful Medical Error to Patients: A Review With Recommendations for Pathologists. Adv Anat Pathol. 2018;25(2):124-130. doi:10.1097/PAP.0000000000000181. https://psnet…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46716/psn-pdf
    January 10, 2018 - Toolkit to Engage High-Risk Patients in Safe Transitions Across Ambulatory Settings. January 10, 2018 Davis K, Collier S, Situ J, et al. Rockville, MD: Agency for Healthcare Research and Quality; December 2017. AHRQ Publication No. 1800051EF. https://psnet.ahrq.gov/issue/toolkit-engage-high-risk-patients-safe-tran…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/859347/psn-pdf
    December 20, 2023 - Making surgery as safe as it should be: a qualitative study. December 20, 2023 Robinson DJ, Beaumont G. Making surgery as safe as it should be: a qualitative study. Am J Med Qual. 2023;38(5):238-244. doi:10.1097/jmq.0000000000000139. https://psnet.ahrq.gov/issue/making-surgery-safe-it-should-be-qualitative-study …

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46973/psn-pdf
    June 25, 2018 - Balancing innovation and safety when integrating digital tools into health care. June 25, 2018 Auerbach AD, Neinstein A, Khanna R. Balancing Innovation and Safety When Integrating Digital Tools Into Health Care. Ann Intern Med. 2018;168(10):733-734. doi:10.7326/M17-3108. https://psnet.ahrq.gov/issue/balancing-inno…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837140/psn-pdf
    May 18, 2022 - Nursing surveillance: a concept analysis May 18, 2022 Halverson CC, Scott Tilley D. Nursing surveillance: a concept analysis. Nurs Forum. 2022;57(3):454-460. doi:10.1111/nuf.12702. https://psnet.ahrq.gov/issue/nursing-surveillance-concept-analysis Nursing surveillance is an intervention for maintaining patient saf…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50925/psn-pdf
    February 19, 2020 - Report of the Independent Inquiry into the Issues Raised by Paterson. February 19, 2020 James G. House Commons Report 31. Department of Health and Social Care. London, England: Crown Copyright; 2020. ISBN 9781528617284. https://psnet.ahrq.gov/issue/report-independent-inquiry-issues-raised-paterson Shari…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867049/psn-pdf
    October 30, 2024 - National Review of Maternity Services in England 2022 to 2024. October 30, 2024 National Review Of Maternity Services In England 2022 To 2024. Newcastle Upon Tyne, UK: Care Quality Commission; September 2024. https://psnet.ahrq.gov/issue/national-review-maternity-services-england-2022-2024 Maternal safety is a gl…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44736/psn-pdf
    December 16, 2015 - Harms from discharge to primary care: mixed methods analysis of incident reports. December 16, 2015 Williams H, Edwards A, Hibbert P, et al. Harms from discharge to primary care: mixed methods analysis of incident reports. Br J Gen Pract. 2015;65(641):e829-e837. doi:10.3399/bjgp15X687877. https://psnet.ahrq.gov/is…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43776/psn-pdf
    March 17, 2015 - Impact of anesthetic handover on mortality and morbidity in cardiac surgery: a cohort study. March 17, 2015 Hudson CCC, McDonald B, Hudson JKC, et al. Impact of anesthetic handover on mortality and morbidity in cardiac surgery: a cohort study. J Cardiothorac Vasc Anesth. 2015;29(1):11-6. doi:10.1053/j.jvca.2014.05…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/850929/psn-pdf
    June 21, 2023 - Requirements for implementing a 'just culture' within healthcare organisations: an integrative review. June 21, 2023 Murray JS, Lee J, Larson S, et al. Requirements for implementing a ‘just culture’ within healthcare organisations: an integrative review. BMJ Open Qual. 2023;12(2):e002237. doi:10.1136/bmjoq-2022- 0…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47810/psn-pdf
    March 13, 2019 - Debriefing in the OR: a quality improvement project. March 13, 2019 Finch EP, Langston M, Erickson D, et al. Debriefing in the OR: A Quality Improvement Project. AORN J. 2019;109(3):336-344. doi:10.1002/aorn.12616. https://psnet.ahrq.gov/issue/debriefing-or-quality-improvement-project Debriefing has emerged as a s…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74067/psn-pdf
    November 10, 2021 - Conflict resolution: applying aviation crew resource management in healthcare. November 10, 2021 Braverman A. Conflict resolution: applying aviation crew resource management in healthcare. Nurs Manage. 2021;52(9):30-34. doi:10.1097/01.numa.0000771740.79361.1c. https://psnet.ahrq.gov/issue/conflict-resolution-apply…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60688/psn-pdf
    July 15, 2020 - The COVID-19 pandemic: resilient organisational response to a low-chance, high-impact event. July 15, 2020 Lloyd-Smith MK. The COVID-19 pandemic: resilient organisational response to a low-chance, high-impact event. BMJ Leader. 2020;4:109-112. doi:10.1136/leader-2020-000245. https://psnet.ahrq.gov/issue/covid-19-p…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866411/psn-pdf
    July 31, 2024 - Simulation to Improve Patient Safety: Getting Started. July 31, 2024 Deutsch ES, Bajaj K. Simulation To Improve Patient Safety: Getting Started. Rockville, MD: Agency for Healthcare Research and Quality; July 2024. Publication No. 24-0055. https://psnet.ahrq.gov/issue/simulation-improve-patient-safety-getting-start…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60016/psn-pdf
    March 04, 2020 - The influence of bullying on nursing practice errors: a systematic review. March 4, 2020 Johnson AH, Benham?Hutchins M. The Influence of Bullying on Nursing Practice Errors: A Systematic Review. AORN J. 2020;111(2). doi:10.1002/aorn.12923. https://psnet.ahrq.gov/issue/influence-bullying-nursing-practice-errors-sys…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47341/psn-pdf
    August 29, 2018 - AORN Position Statement on Criminalization of Human Errors in the Perioperative Setting. August 29, 2018 AORN Position Statement on Criminalization of Human Errors in the Perioperative Setting. AORN J. 2018;108(1):64-65. doi:10.1002/aorn.12292. https://psnet.ahrq.gov/issue/aorn-position-statement-criminalization-h…
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