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  1. Implementation and sustainability of a medication reconciliation toolkit: a mixed methods evaluation. | PSNet

    psnet.ahrq.gov/issue/implementation-and-sustainability-medication-reconciliation-toolkit-mixed-methods-evaluation
    May 19, 2021 - Study Implementation and sustainability of a medication reconciliation toolkit: a mixed methods evaluation. Citation Text: Stolldorf DP, Mixon AS, Auerbach AD, et al. Implementation and sustainability of a medication reconciliation toolkit: a mixed methods evaluation. Am J Health Syst Ph…

  2. Implementing strategies to identify and mitigate adverse safety events: a case study with unplanned extubations. | PSNet

    psnet.ahrq.gov/issue/implementing-strategies-identify-and-mitigate-adverse-safety-events-case-study-unplanned
    May 24, 2012 - Study Implementing strategies to identify and mitigate adverse safety events: a case study with unplanned extubations. Citation Text: Hatch D, Rivard M, Bolton J, et al. Implementing Strategies to Identify and Mitigate Adverse Safety Events: A Case Study with Unplanned Extubations. Jt Co…

  3. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. | PSNet

    psnet.ahrq.gov/issue/incidence-adverse-events-and-negligence-hospitalized-patients-results-harvard-medical
    February 18, 2011 - Study Classic Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. Citation Text: Brennan TA, Leape LL, Laird NM, et al. Incidence of Adverse Events and Negligence in Hospitalized Patients. N Eng…

  4. Has improved hand hygiene compliance reduced the risk of hospital-acquired infections among hospitalized patients in Ontario? Analysis of publicly reported patient safety data from 2008 to 2011. | PSNet

    psnet.ahrq.gov/issue/has-improved-hand-hygiene-compliance-reduced-risk-hospital-acquired-infections-among
    July 10, 2024 - Study Has improved hand hygiene compliance reduced the risk of hospital-acquired infections among hospitalized patients in Ontario? Analysis of publicly reported patient safety data from 2008 to 2011. Citation Text: DiDiodato G. Has improved hand hygiene compliance reduced the risk of h…

  5. The effects of patient handoff characteristics on subsequent care: a systematic review and areas for future research. | PSNet

    psnet.ahrq.gov/issue/effects-patient-handoff-characteristics-subsequent-care-systematic-review-and-areas-future
    January 19, 2011 - Review The effects of patient handoff characteristics on subsequent care: a systematic review and areas for future research. Citation Text: Foster S, Manser T. The effects of patient handoff characteristics on subsequent care: a systematic review and areas for future research. Acad Med.…

  6. A descriptive study of nurse-reported missed care in neonatal intensive care units. | PSNet

    psnet.ahrq.gov/issue/descriptive-study-nurse-reported-missed-care-neonatal-intensive-care-units
    January 27, 2019 - Study A descriptive study of nurse-reported missed care in neonatal intensive care units. Citation Text: Tubbs-Cooley HL, Pickler RH, Younger JB, et al. A descriptive study of nurse-reported missed care in neonatal intensive care units. J Adv Nurs. 2015;71(4):813-24. doi:10.1111/jan.1257…

  7. Assessing adverse events among home care clients in three Canadian provinces using chart review. | PSNet

    psnet.ahrq.gov/issue/assessing-adverse-events-among-home-care-clients-three-canadian-provinces-using-chart-review
    June 28, 2017 - Study Assessing adverse events among home care clients in three Canadian provinces using chart review. Citation Text: Blais R, Sears NA, Doran D, et al. Assessing adverse events among home care clients in three Canadian provinces using chart review. BMJ Qual Saf. 2013;22(12):989-997. do…

  8. Analysis of risk of medical errors using structural-equation modelling: a 6-month prospective cohort study. | PSNet

    psnet.ahrq.gov/issue/analysis-risk-medical-errors-using-structural-equation-modelling-6-month-prospective-cohort
    June 10, 2020 - Study Analysis of risk of medical errors using structural-equation modelling: a 6-month prospective cohort study. Citation Text: Tanaka M, Tanaka K, Takano T, et al. Analysis of risk of medical errors using structural-equation modelling: a 6-month prospective cohort study. BMJ Qual Saf…

  9. Clinical deterioration as a nurse sensitive indicator in the out-of-hospital context: a scoping review. | PSNet

    psnet.ahrq.gov/issue/clinical-deterioration-nurse-sensitive-indicator-out-hospital-context-scoping-review
    July 19, 2023 - Review Clinical deterioration as a nurse sensitive indicator in the out-of-hospital context: a scoping review. Citation Text: Mccullough K, Baker M, Bloxsome D, et al. Clinical deterioration as a nurse sensitive indicator in the out‐of‐hospital context: a scoping review. J Clin Nurs. 202…

  10. Development and implementation of a suicide prevention checklist to create a safe environment. | PSNet

    psnet.ahrq.gov/issue/development-and-implementation-suicide-prevention-checklist-create-safe-environment
    August 04, 2021 - Study Development and implementation of a suicide prevention checklist to create a safe environment. Citation Text: Frost DA, Snydeman CK, Lantieri MJ, et al. Development and Implementation of a Suicide Prevention Checklist to Create a Safe Environment. Psychosomatics. 2019;61(2):154-160…

  11. Associations between hospital characteristics, measure reporting, and the Centers for Medicare & Medicaid Services overall hospital quality star ratings. | PSNet

    psnet.ahrq.gov/issue/associations-between-hospital-characteristics-measure-reporting-and-centers-medicare-medicaid
    February 14, 2017 - Study Associations between hospital characteristics, measure reporting, and the Centers for Medicare & Medicaid Services overall hospital quality star ratings. Citation Text: DeLancey JO, Softcheck J, Chung JW, et al. Associations Between Hospital Characteristics, Measure Reporting, and …

  12. Resident supervision and patient safety: do different levels of resident supervision affect the rate of morbidity and mortality cases? | PSNet

    psnet.ahrq.gov/issue/resident-supervision-and-patient-safety-do-different-levels-resident-supervision-affect-rate
    November 16, 2022 - Study Resident supervision and patient safety: do different levels of resident supervision affect the rate of morbidity and mortality cases? Citation Text: Van Leer PE, Lavine EK, Rabrich JS, et al. Resident Supervision and Patient Safety: Do Different Levels of Resident Supervision Affe…

  13. Establishing psychological safety in clinical supervision: multi-professional perspectives. | PSNet

    psnet.ahrq.gov/issue/establishing-psychological-safety-clinical-supervision-multi-professional-perspectives
    October 13, 2021 - Commentary Establishing psychological safety in clinical supervision: multi-professional perspectives. Citation Text: Lee EH, Pitts S, Pignataro S, et al. Establishing psychological safety in clinical supervision: multi‐professional perspectives. Clin Teach. 2022;19(2):71-78. doi:10.1111…

  14. Success in hospital-acquired pressure ulcer prevention: a tale in two data sets. | PSNet

    psnet.ahrq.gov/issue/success-hospital-acquired-pressure-ulcer-prevention-tale-two-data-sets
    May 17, 2018 - Study Success in hospital-acquired pressure ulcer prevention: a tale in two data sets. Citation Text: Smith S, Snyder A, McMahon LF, et al. Success In Hospital-Acquired Pressure Ulcer Prevention: A Tale In Two Data Sets. Health Aff (Millwood). 2018;37(11):1787-1796. doi:10.1377/hlthaff.2…

  15. Improving resident morning sign-out by use of daily events reports. | PSNet

    psnet.ahrq.gov/issue/improving-resident-morning-sign-out-use-daily-events-reports
    March 04, 2020 - Study Improving resident morning sign-out by use of daily events reports. Citation Text: Nabors C, Patel D, Khera S, et al. Improving resident morning sign-out by use of daily events reports. J Patient Saf. 2015;11(1):36-41. doi:10.1097/PTS.0b013e31829e4f56. Copy Citation Format: …

  16. Effect of a comprehensive surgical safety system on patient outcomes. | PSNet

    psnet.ahrq.gov/issue/effect-comprehensive-surgical-safety-system-patient-outcomes
    May 17, 2012 - Study Classic Effect of a comprehensive surgical safety system on patient outcomes. Citation Text: de Vries EN, Prins HA, Crolla RMPH, et al. Effect of a comprehensive surgical safety system on patient outcomes. N Engl J Med. 2010;363(20):1928-37. doi:10.1056/…

  17. Health literacy and systemic racism—using clear communication to reduce health care inequities. | PSNet

    psnet.ahrq.gov/issue/health-literacy-and-systemic-racism-using-clear-communication-reduce-health-care-inequities
    July 19, 2023 - Commentary Health literacy and systemic racism—using clear communication to reduce health care inequities. Citation Text: Coleman C, Birk S, DeVoe J. Health literacy and systemic racism—using clear communication to reduce health care inequities. JAMA Intern Med. 2023;183(8):753-754. doi:…

  18. The dilemma of patient safety work: perceptions of hospital middle managers. | PSNet

    psnet.ahrq.gov/issue/dilemma-patient-safety-work-perceptions-hospital-middle-managers
    February 03, 2015 - Study The dilemma of patient safety work: perceptions of hospital middle managers. Citation Text: Sanner M, Halford C, Vengberg S, et al. The dilemma of patient safety work: Perceptions of hospital middle managers. J Healthc Risk Manag. 2018;38(2):47-55. doi:10.1002/jhrm.21325. Copy Ci…

  19. Multiple patient safety events within a single hospitalization: a national profile in US hospitals. | PSNet

    psnet.ahrq.gov/issue/multiple-patient-safety-events-within-single-hospitalization-national-profile-us-hospitals
    November 13, 2009 - Study Multiple patient safety events within a single hospitalization: a national profile in US hospitals. Citation Text: Yu H, Greenberg MD, Haviland AM, et al. Multiple patient safety events within a single hospitalization: a national profile in US hospitals. Am J Med Qual. 2012;27(6)…

  20. Eight CT lessons that we learned the hard way: an analysis of current patterns of radiological error and discrepancy with particular emphasis on CT. | PSNet

    psnet.ahrq.gov/issue/eight-ct-lessons-we-learned-hard-way-analysis-current-patterns-radiological-error-and
    September 24, 2018 - Study Eight CT lessons that we learned the hard way: an analysis of current patterns of radiological error and discrepancy with particular emphasis on CT. Citation Text: McCreadie G, Oliver TB. Eight CT lessons that we learned the hard way: an analysis of current patterns of radiologic…
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