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psnet.ahrq.gov/node/49591/psn-pdf
October 01, 2009 - Difficult Encounters: A CMO and CNO Respond
October 1, 2009
Ring EJ, Hirsch JE. Difficult Encounters: A CMO and CNO Respond. PSNet [internet]. 2009.
https://psnet.ahrq.gov/web-mm/difficult-encounters-cmo-and-cno-respond
Case Objectives
Appreciate the risk of disruptive behavior and understand institutional respons…
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psnet.ahrq.gov/node/49553/psn-pdf
January 01, 2008 - Contaminated or Not? Guidelines for Interpretation of
Positive Blood Cultures
January 1, 2008
Weinstein MP. Contaminated or Not? Guidelines for Interpretation of Positive Blood Cultures. PSNet
[internet]. 2008.
https://psnet.ahrq.gov/web-mm/contaminated-or-not-guidelines-interpretation-positive-blood-cultures
The…
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psnet.ahrq.gov/node/49721/psn-pdf
December 01, 2014 - Ebola: Are We Ready?
December 1, 2014
Barsuk JH, Barnard C. Ebola: Are We Ready? PSNet [internet]. 2014.
https://psnet.ahrq.gov/web-mm/ebola-are-we-ready
The Case
A 28-year-old man, well-appearing but pale, walked into the emergency department (ED) on a Wednesday
afternoon at 3 PM complaining of nausea, vomiting,…
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psnet.ahrq.gov/node/43511/psn-pdf
September 10, 2014 - Re-finding the 'human side' of human factors in nursing:
helping student nurses to combine person-centred care
with the rigours of patient safety.
September 10, 2014
Fawcett TJN, Rhynas SJ. Re-finding the 'human side' of human factors in nursing: helping student nurses
to combine person-centred care with the rigou…
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psnet.ahrq.gov/node/46376/psn-pdf
December 07, 2017 - User-centered collaborative design and development of
an inpatient safety dashboard.
December 7, 2017
Mlaver E, Schnipper JL, Boxer RB, et al. User-Centered Collaborative Design and Development of an
Inpatient Safety Dashboard. Jt Comm J Qual Patient Saf. 2017;43(12):676-685.
doi:10.1016/j.jcjq.2017.05.010.
https…
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psnet.ahrq.gov/node/44801/psn-pdf
June 22, 2016 - Safety for all: integrated design for inpatient units.
June 22, 2016
Hunt JM, Sine DM. Patient Saf Qual Healthc. May/June 2016;13:20-28.
https://psnet.ahrq.gov/issue/safety-all-integrated-design-inpatient-units
Design is emerging as an important tactic to augment safe care delivery. Hospitals that provide care for
…
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psnet.ahrq.gov/node/36118/psn-pdf
September 24, 2010 - Implementing patient safety practices in small ambulatory
care settings.
September 24, 2010
Schauberger CW, Larson P. Implementing patient safety practices in small ambulatory care settings. Jt
Comm J Qual Patient Saf. 2006;32(8):419-425.
https://psnet.ahrq.gov/issue/implementing-patient-safety-practices-small-amb…
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psnet.ahrq.gov/node/47212/psn-pdf
July 11, 2018 - Medicine and the rise of the robots: a qualitative review of
recent advances of artificial intelligence in health.
July 11, 2018
Loh E. BMJ Leader. 2018;2(2):59-63.
https://psnet.ahrq.gov/issue/medicine-and-rise-robots-qualitative-review-recent-advances-artificial-
intelligence-health
Artificial intelligence (AI)…
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psnet.ahrq.gov/web-mm/transfer-or-not-transfer
November 23, 2016 - Stable patients may request transfer to a particular in-zone hospital (consideration is given to where
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psnet.ahrq.gov/node/38400/psn-pdf
February 11, 2009 - The impact of clinically undiagnosed injuries on survival
estimates.
February 11, 2009
Gedeborg R, Thiblin I, Byberg L, et al. The impact of clinically undiagnosed injuries on survival estimates.
Crit Care Med. 2009;37(2). doi:10.1097/ccm.0b013e318194b164.
https://psnet.ahrq.gov/issue/impact-clinically-undiagnosed…
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psnet.ahrq.gov/node/44459/psn-pdf
October 06, 2016 - Examining the Relationship Between Health IT and
Ambulatory Care Workflow Redesign.
October 6, 2016
Zheng K, Ciemins EL, Lanham HJ, et al. Rockville, MD: Agency for Healthcare Research and Quality; July
2015. AHRQ Publication No. 15-0058-EF.
https://psnet.ahrq.gov/issue/examining-relationship-between-health-it-and…
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psnet.ahrq.gov/node/41868/psn-pdf
January 07, 2015 - Changes in end-user satisfaction with computerized
provider order entry over time among nurses and
providers in intensive care units.
January 7, 2015
Hoonakker P, Carayon P, Brown RL, et al. Changes in end-user satisfaction with Computerized Provider
Order Entry over time among nurses and providers in intensive ca…
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psnet.ahrq.gov/node/45029/psn-pdf
April 20, 2016 - Threats to safety during sedation outside of the operating
room and the death of Michael Jackson.
April 20, 2016
Webster CS, Mason KP, Shafer SL. Threats to safety during sedation outside of the operating room and
the death of Michael Jackson. Curr Opin Anaesthesiol. 2016;29 Suppl 1:S36-47.
doi:10.1097/ACO.0000000…
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psnet.ahrq.gov/issue/quality-safety-research-group
August 17, 2005 - Tools/Toolkit
Toolkit
Published August 17, 2005
Quality & Safety Research Group.
Topics
Approach to Improving Safety
Quality Improvement Strategies
Health Literacy Improvement
Education an…
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psnet.ahrq.gov/node/43957/psn-pdf
June 21, 2015 - Enhancing the effectiveness of team debriefings in
medical simulation: more best practices.
June 21, 2015
Lyons R, Lazzara EH, Benishek LE, et al. Enhancing the effectiveness of team debriefings in medical
simulation: more best practices. Jt Comm J Qual Patient Saf. 2015;41(3):115-125.
https://psnet.ahrq.gov/issue…
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psnet.ahrq.gov/node/38517/psn-pdf
February 17, 2011 - Use of electronic health records in US hospitals.
February 17, 2011
Jha AK, DesRoches CM, Campbell EG, et al. Use of electronic health records in U.S. hospitals.
doi:10.1056/NEJMsa0900592.
https://psnet.ahrq.gov/issue/use-electronic-health-records-us-hospitals
Increasing the use of electronic health records (EHRs)…
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psnet.ahrq.gov/node/42432/psn-pdf
August 07, 2013 - Adoption of electronic health records grows rapidly, but
fewer than half of US hospitals had at least a basic
system in 2012.
August 7, 2013
DesRoches CM, Charles D, Furukawa MF, et al. Adoption of electronic health records grows rapidly, but
fewer than half of US hospitals had at least a basic system in 2012. Hea…
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psnet.ahrq.gov/node/41591/psn-pdf
November 26, 2014 - "Did I do as best as the system would let me?" Healthcare
professional views on hospital to home care transitions.
November 26, 2014
Davis MM, Devoe M, Kansagara D, et al. "Did I do as best as the system would let me?" Healthcare
professional views on hospital to home care transitions. J Gen Intern Med. 2012;27(12)…
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psnet.ahrq.gov/node/43068/psn-pdf
May 29, 2014 - Patient safety incidents in home hospice care: the
experiences of hospice interdisciplinary team members.
May 29, 2014
Smucker DR, Regan S, Elder NC, et al. Patient safety incidents in home hospice care: the experiences of
hospice interdisciplinary team members. J Palliat Med. 2014;17(5):540-4. doi:10.1089/jpm.2013…
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psnet.ahrq.gov/node/46732/psn-pdf
June 07, 2018 - The SAGES Fundamental Use of Surgical Energy program
(FUSE): history, development, and purpose.
June 7, 2018
Fuchshuber P, Schwaitzberg S, Jones D, et al. The SAGES Fundamental Use of Surgical Energy program
(FUSE): history, development, and purpose. Surg Endosc. 2018;32(6):2583-2602. doi:10.1007/s00464-
017-5933-…