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psnet.ahrq.gov/issue/frequency-and-nature-communication-and-handoff-failures-medical-malpractice-claims
June 22, 2022 - August 3, 2020
A description of medical malpractice claims involving advanced practice
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psnet.ahrq.gov/issue/insulin-pump-associated-adverse-events-qualitative-descriptive-study-clinical-consequences
May 19, 2018 - Study
Insulin pump-associated adverse events: a qualitative descriptive study of clinical consequences and potential root causes.
Citation Text:
Estock JL, Codario RA, Keddem S, et al. Insulin pump-associated adverse events: a qualitative descriptive study of clinical consequences and po…
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psnet.ahrq.gov/issue/missed-medication-doses-hospitalised-patients-descriptive-account-quality-improvement
October 13, 2018 - Study
Missed medication doses in hospitalised patients: a descriptive account of quality improvement measures and time series analysis.
Citation Text:
Coleman JJ, Hodson J, Brooks HL, et al. Missed medication doses in hospitalised patients: a descriptive account of quality improvement me…
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psnet.ahrq.gov/issue/impact-intraoperative-distractions-patient-safety-prospective-descriptive-study-using
August 18, 2017 - Study
Impact of intraoperative distractions on patient safety: a prospective descriptive study using validated instruments.
Citation Text:
Sevdalis N, Undre S, McDermott J, et al. Impact of intraoperative distractions on patient safety: a prospective descriptive study using validated ins…
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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…
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psnet.ahrq.gov/node/72670/psn-pdf
January 27, 2021 - System issues leading to "found-on-floor" incidents: a
multi-incident analysis.
January 27, 2021
Shaw J, Bastawrous M, Burns S, et al. System Issues Leading to “Found-on-Floor” Incidents: A Multi-
Incident Analysis. J Patient Saf. 2021;17(1):30-35. doi:10.1097/pts.0000000000000294.
https://psnet.ahrq.gov/issue/sys…
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psnet.ahrq.gov/node/38449/psn-pdf
March 04, 2009 - The authors
provide a detailed description of their efforts that achieved near 100% target goals and
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psnet.ahrq.gov/node/41257/psn-pdf
April 22, 2012 - analyze safety incidents in clinical medicine were drawn from a well-known
James Reason book and his description
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psnet.ahrq.gov/issue/stakeholder-perceptions-smart-infusion-pumps-and-drug-library-updates-multisite
March 13, 2019 - Study
Stakeholder perceptions of smart infusion pumps and drug library updates: a multisite, interdisciplinary study.
Citation Text:
DeLaurentis P, Walroth TA, Fritschle AC, et al. Stakeholder perceptions of smart infusion pumps and drug library updates: A multisite, interdisciplinary st…
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psnet.ahrq.gov/issue/descriptive-study-morbidity-and-mortality-conferences-and-their-conformity-medical-incident
September 28, 2010 - Study
A descriptive study of morbidity and mortality conferences and their conformity to medical incident analysis models: results of the morbidity and mortality conference improvement study, phase 1.
Citation Text:
Aboumatar HJ, Blackledge CG, Dickson C, et al. A descriptive study of …
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psnet.ahrq.gov/issue/preventing-critical-failure-can-routinely-collected-data-be-repurposed-predict-avoidable
July 02, 2014 - Study
Preventing critical failure. Can routinely collected data be repurposed to predict avoidable patient harm? A quantitative descriptive study.
Citation Text:
Nowotny BM, Davies-Tuck M, Scott B, et al. Preventing critical failure. Can routinely collected data be repurposed to predict…
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psnet.ahrq.gov/issue/electronic-health-record-nudges-and-health-care-quality-and-outcomes-primary-care-systematic
March 09, 2022 - December 29, 2014
From physician intent to the pharmacy label: prevalence and description
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psnet.ahrq.gov/node/860049/psn-pdf
January 04, 2024 - results were not yet available at the time of transfer, that handoff should have included a clear description … of discharge, the primary care
physician and outpatient neurologist would have only the narrative description … discharge summary template
so that it begins with “Important Comments to Subsequent Providers” before the description
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psnet.ahrq.gov/issue/6-year-thematic-review-reported-incidents-associated-cardiopulmonary-resuscitation-calls
June 15, 2022 - Study
A 6-year thematic review of reported incidents associated with cardiopulmonary resuscitation calls in a United Kingdom hospital.
Citation Text:
Beed M, Hussain S, Woodier N, et al. A 6-year thematic review of reported incidents associated with cardiopulmonary resuscitation calls in…
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psnet.ahrq.gov/issue/insurance-claims-wrong-side-wrong-organ-wrong-procedure-or-wrong-person-surgical-errors
October 20, 2021 - Study
Insurance claims for wrong-side, wrong-organ, wrong-procedure, or wrong-person surgical errors: a retrospective study for 10 years.
Citation Text:
Vacheron C-H, Acker A, Autran M, et al. Insurance claims for wrong-side, wrong-organ, wrong-procedure, or wrong-person surgical errors:…
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psnet.ahrq.gov/node/44933/psn-pdf
March 30, 2016 - Medication competency of nurses according to
theoretical and drug calculation online exams: a
descriptive correlational study.
March 30, 2016
Sneck S, Saarnio R, Isola A, et al. Medication competency of nurses according to theoretical and drug
calculation online exams: A descriptive correlational study. Nurse Educ…
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psnet.ahrq.gov/issue/nursing-strategies-increase-medication-safety-inpatient-settings
September 21, 2016 - September 7, 2022
From physician intent to the pharmacy label: prevalence and description
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psnet.ahrq.gov/issue/surveillance-strategy-improving-patient-safety-acute-and-critical-care-units
September 27, 2016 - Commentary
Surveillance: a strategy for improving patient safety in acute and critical care units.
Citation Text:
Henneman EA, Gawlinski A, Giuliano KK. Surveillance: A strategy for improving patient safety in acute and critical care units. Crit Care Nurse. 2012;32(2):e9-18. doi:10.403…
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psnet.ahrq.gov/issue/top-10-patient-safety-issues-what-more-can-we-do
May 08, 2013 - Commentary
Top 10 patient safety issues: what more can we do?
Citation Text:
Steelman VM, Graling PR. Top 10 patient safety issues: what more can we do? AORN J. 2013;97(6):679-98, quiz 699-701. doi:10.1016/j.aorn.2013.04.012.
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psnet.ahrq.gov/node/60202/psn-pdf
April 08, 2020 - Use of an electronic clinical decision support system in
primary care to assess inappropriate polypharmacy in
young seniors with multimorbidity: observational,
descriptive, cross-sectional study
April 8, 2020
Rogero-Blanco E, Lopez-Rodriguez JA, Sanz-Cuesta T, et al. Use of an electronic clinical decision support
…