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  1. The Second Victim Experience and Support Tool: validation of an organizational resource for assessing second victim effects and the quality of support resources. | PSNet

    psnet.ahrq.gov/issue/second-victim-experience-and-support-tool-validation-organizational-resource-assessing-second
    September 19, 2016 - Study The Second Victim Experience and Support Tool: validation of an organizational resource for assessing second victim effects and the quality of support resources. Citation Text: Burlison JD, Scott SD, Browne EK, et al. The Second Victim Experience and Support Tool: validation of an …

  2. Perspectives on perioperative team-based morbidity and mortality conferences: a mixed-methods study. | PSNet

    psnet.ahrq.gov/issue/perspectives-perioperative-team-based-morbidity-and-mortality-conferences-mixed-methods-study
    October 11, 2023 - Study Perspectives on perioperative team-based morbidity and mortality conferences: a mixed-methods study. Citation Text: Samost-Williams A, Rosen R, Cummins E, et al. Perspectives on Perioperative Team-Based Morbidity and Mortality Conferences: A Mixed Methods Study. Jt Comm J Qual Pati…

  3. “I made a mistake!”: a narrative analysis of experienced physicians' stories of preventable error. | PSNet

    psnet.ahrq.gov/issue/i-made-mistake-narrative-analysis-experienced-physicians-stories-preventable-error
    September 26, 2016 - Study “I made a mistake!”: a narrative analysis of experienced physicians' stories of preventable error. Citation Text: Kandasamy S, Vanstone M, Colvin E, et al. “I made a mistake!”: a narrative analysis of experienced physicians' stories of preventable error. J Eval Clin Pract. 2021;27(…

  4. Learning from experience: a qualitative study of surgeons' perspectives on reporting and dealing with serious adverse events. | PSNet

    psnet.ahrq.gov/issue/learning-experience-qualitative-study-surgeons-perspectives-reporting-and-dealing-serious
    June 12, 2024 - Study Learning from experience: a qualitative study of surgeons' perspectives on reporting and dealing with serious adverse events. Citation Text: Øyri SF, Søreide K, Søreide E, et al. Learning from experience: a qualitative study of surgeons’ perspectives on reporting and dealing with s…

  5. When clinicians drop out and start over after adverse events. | PSNet

    psnet.ahrq.gov/issue/when-clinicians-drop-out-and-start-over-after-adverse-events
    May 18, 2022 - Study When clinicians drop out and start over after adverse events. Citation Text: Rodriquez J, Scott SD. When Clinicians Drop Out and Start Over after Adverse Events. Jt Comm J Qual Patient Saf. 2018;44(3):137-145. doi:10.1016/j.jcjq.2017.08.008. Copy Citation Format: DOI …

  6. The combined effect of psychological and social capital in registered nurses experiencing second victimization: a structural equation model. | PSNet

    psnet.ahrq.gov/issue/combined-effect-psychological-and-social-capital-registered-nurses-experiencing-second
    December 15, 2021 - Study The combined effect of psychological and social capital in registered nurses experiencing second victimization: a structural equation model. Citation Text: Hinkley T‐L. The combined effect of psychological and social capital in registered nurses experiencing second victimization: a…

  7. Intraoperative sentinel events in the era of surgical safety checklists: results of a national survey. | PSNet

    psnet.ahrq.gov/issue/intraoperative-sentinel-events-era-surgical-safety-checklists-results-national-survey
    August 04, 2021 - Study Intraoperative sentinel events in the era of surgical safety checklists: results of a national survey. Citation Text: Cramer JD, Balakrishnan K, Roy S, et al. Intraoperative sentinel events in the era of surgical safety checklists: results of a national survey. OTO Open. 2020;4(4):…

  8. Anatomic pathology databases and patient safety. | PSNet

    psnet.ahrq.gov/issue/anatomic-pathology-databases-and-patient-safety
    April 08, 2008 - Study Anatomic pathology databases and patient safety. Citation Text: Raab SS, Grzybicki DM, Zarbo RJ, et al. Anatomic pathology databases and patient safety. Arch Pathol Lab Med. 2005;129(10):1246-1251. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML En…

  9. Modifications to medical emergency team activation criteria and implications for patient safety: a point prevalence study. | PSNet

    psnet.ahrq.gov/issue/modifications-medical-emergency-team-activation-criteria-and-implications-patient-safety
    July 20, 2022 - Study Modifications to medical emergency team activation criteria and implications for patient safety: a point prevalence study. Citation Text: Sprogis SK, Street M, Currey J, et al. Modifications to medical emergency team activation criteria and implications for patient safety: a point …

  10. Survey of nurses' experiences applying The Joint Commission's medication management titration standards. | PSNet

    psnet.ahrq.gov/issue/survey-nurses-experiences-applying-joint-commissions-medication-management-titration
    September 15, 2021 - Study Survey of nurses' experiences applying The Joint Commission's medication management titration standards. Citation Text: Davidson JE, Doran N, Petty A, et al. Survey of nurses' experiences applying The Joint Commission's medication management titration standards. Am J Crit Care. 202…

  11. The impact of rationing nursing care on patient safety: a systematic review. | PSNet

    psnet.ahrq.gov/issue/impact-rationing-nursing-care-patient-safety-systematic-review
    December 06, 2023 - Review The impact of rationing nursing care on patient safety: a systematic review. Citation Text: Uchmanowicz I, Lisiak M, Wleklik M, et al. The impact of rationing nursing care on patient safety: a systematic review. Med Sci Monit. 2024;30:e942031. doi:10.12659/msm.942031. Copy Citat…

  12. Do emergency physicians attribute drug-related emergency department visits to medication-related problems? | PSNet

    psnet.ahrq.gov/issue/do-emergency-physicians-attribute-drug-related-emergency-department-visits-medication-related
    April 22, 2011 - Study Do emergency physicians attribute drug-related emergency department visits to medication-related problems? Citation Text: Hohl CM, Zed PJ, Brubacher JR, et al. Do emergency physicians attribute drug-related emergency department visits to medication-related problems? Ann Emerg Med…

  13. Why studying human behavior is a critical component of patient safety. | PSNet

    psnet.ahrq.gov/issue/why-studying-human-behavior-critical-component-patient-safety
    January 15, 2020 - Commentary Why studying human behavior is a critical component of patient safety. Citation Text: Su L. Why Studying Human Behavior is a Critical Component of Patient Safety. Curr Probl Pediatr Adolesc Health Care. 2015;45(12):367-9. doi:10.1016/j.cppeds.2015.10.004. Copy Citation F…

  14. Is detection of adverse events affected by record review methodology? An evaluation of the "Harvard Medical Practice Study" method and the "Global Trigger Tool." | PSNet

    psnet.ahrq.gov/issue/detection-adverse-events-affected-record-review-methodology-evaluation-harvard-medical
    August 05, 2020 - Study Is detection of adverse events affected by record review methodology? An evaluation of the "Harvard Medical Practice Study" method and the "Global Trigger Tool." Citation Text: Unbeck M, Schildmeijer K, Henriksson P, et al. Is detection of adverse events affected by record review …

  15. Large-scale deployment of the Global Trigger Tool across a large hospital system: refinements for the characterisation of adverse events to support patient safety learning opportunities. | PSNet

    psnet.ahrq.gov/issue/large-scale-deployment-global-trigger-tool-across-large-hospital-system-refinements
    November 23, 2014 - Study Large-scale deployment of the Global Trigger Tool across a large hospital system: refinements for the characterisation of adverse events to support patient safety learning opportunities. Citation Text: Good VS, Saldaña M, Gilder R, et al. Large-scale deployment of the Global Trig…

  16. Good people who try their best can have problems: recognition of human factors and how to minimise error. | PSNet

    psnet.ahrq.gov/issue/good-people-who-try-their-best-can-have-problems-recognition-human-factors-and-how-minimise
    October 29, 2017 - Review Good people who try their best can have problems: recognition of human factors and how to minimise error. Citation Text: Brennan PA, Mitchell DA, Holmes S, et al. Good people who try their best can have problems: recognition of human factors and how to minimise error. Br J Oral Ma…

  17. Non-intercepted dose errors in prescribing antineoplastic treatment: a prospective, comparative cohort study. | PSNet

    psnet.ahrq.gov/issue/non-intercepted-dose-errors-prescribing-antineoplastic-treatment-prospective-comparative
    June 18, 2013 - Study Non-intercepted dose errors in prescribing antineoplastic treatment: a prospective, comparative cohort study. Citation Text: Mattsson TO, Holm B, Michelsen H, et al. Non-intercepted dose errors in prescribing anti-neoplastic treatment: a prospective, comparative cohort study. Ann O…

  18. Technology-related safety event analysis in community clinical informatics: a case study. | PSNet

    psnet.ahrq.gov/issue/technology-related-safety-event-analysis-community-clinical-informatics-case-study
    April 03, 2024 - Commentary Technology-related safety event analysis in community clinical informatics: a case study. Citation Text: Recsky C, Stowe M, Rush KL, et al. Technology-related safety event analysis in community clinical informatics: a case study. Stud Health Technol Inform. 2024;315:452-457. d…

  19. Leading causes of anesthesia-related liability claims in ambulatory surgery centers. | PSNet

    psnet.ahrq.gov/issue/leading-causes-anesthesia-related-liability-claims-ambulatory-surgery-centers
    December 16, 2020 - Study Leading causes of anesthesia-related liability claims in ambulatory surgery centers. Citation Text: Ranum D, Beverly A, Shapiro FE, et al. Leading causes of anesthesia-related liability claims in ambulatory surgery centers. J Patient Saf. 2021;17(7):513-521. doi:10.1097/pts.0000000…

  20. Exploring physician perspectives of residency holdover handoffs: a qualitative study to understand an increasingly important type of handoff. | PSNet

    psnet.ahrq.gov/issue/exploring-physician-perspectives-residency-holdover-handoffs-qualitative-study-understand
    April 27, 2015 - Study Exploring physician perspectives of residency holdover handoffs: a qualitative study to understand an increasingly important type of handoff. Citation Text: Duong JA, Jensen TP, Morduchowicz S, et al. Exploring Physician Perspectives of Residency Holdover Handoffs: A Qualitative St…
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