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psnet.ahrq.gov/node/44569/psn-pdf
October 21, 2015 - Continuing education in patient safety: massive open
online courses as a new training tool.
October 21, 2015
Sarabia-Cobo CM, Torres-Manrique B, Ortego-Mate MC, et al. Continuing Education in Patient Safety:
Massive Open Online Courses as a New Training Tool. J Contin Educ Nurs. 2015;46(10):439-447.
doi:10.3928/00…
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psnet.ahrq.gov/node/857452/psn-pdf
December 06, 2023 - Improving patient safety governance and systems
through learning from successes and failures: qualitative
surveys and interviews with international experts.
December 6, 2023
Hibbert PD, Stewart S, Wiles LK, et al. Improving patient safety governance and systems through learning
from successes and failures: qualita…
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psnet.ahrq.gov/node/44322/psn-pdf
June 21, 2016 - Emotional harm from disrespect: the neglected
preventable harm.
June 21, 2016
Sokol-Hessner L, Folcarelli P, Sands KEF. Emotional harm from disrespect: the neglected preventable
harm. BMJ Qual Saf. 2015;24(9):550-3. doi:10.1136/bmjqs-2015-004034.
https://psnet.ahrq.gov/issue/emotional-harm-disrespect-neglected-pre…
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psnet.ahrq.gov/node/45106/psn-pdf
August 16, 2017 - The 'go-between' study: a simulation study comparing the
'Traffic Lights' and 'SBAR' tools as a means of
communication between anaesthetic staff.
August 16, 2017
MacDougall-Davis SR, Kettley L, Cook TM. The 'go-between' study: a simulation study comparing the
'Traffic Lights' and 'SBAR' tools as a means of communi…
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psnet.ahrq.gov/node/837062/psn-pdf
May 11, 2022 - Moving on after critical incidents in health care: a
qualitative study of the perspectives and experiences of
second victims
May 11, 2022
Buhlmann M, Ewens B, Rashidi A. Moving on after critical incidents in health care: a qualitative study of the
perspectives and experiences of second victims. J Adv Nurs. 2022;78…
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psnet.ahrq.gov/node/60614/psn-pdf
June 24, 2020 - A systems approach to analyzing and preventing hospital
adverse events.
June 24, 2020
Leveson N, Samost A, Dekker SWA, et al. A systems approach to analyzing and preventing hospital
adverse events. J Patient Saf. 2020;16(2):162-167. doi:10.1097/pts.0000000000000263.
https://psnet.ahrq.gov/issue/systems-approach-an…
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psnet.ahrq.gov/node/44805/psn-pdf
January 27, 2016 - NHS Safety Thermometer Reports.
January 27, 2016
Leeds, UK: Clinical Support Audit Unit, Health and Social Care Information Centre. 2012-2017.
https://psnet.ahrq.gov/issue/nhs-safety-thermometer-report-patient-harms-and-harm-free-care-november-
2014-november-2015
The NHS Safety Thermometer was a tool developed by …
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psnet.ahrq.gov/node/46739/psn-pdf
January 24, 2019 - Symptom–Disease Pair Analysis of Diagnostic Error
(SPADE): a conceptual framework and methodological
approach for unearthing misdiagnosis-related harms
using big data.
January 24, 2019
Liberman AL, Newman-Toker DE. Symptom-Disease Pair Analysis of Diagnostic Error (SPADE): a
conceptual framework and methodologica…
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psnet.ahrq.gov/node/46606/psn-pdf
July 10, 2019 - Implementation of a mock root cause analysis to provide
simulated patient safety training.
July 10, 2019
Murphy M, Duff J, Whitney J, et al. Implementation of a mock root cause analysis to provide simulated
patient safety training. BMJ Open Qual. 2017;6(2). doi:10.1136/bmjoq-2017-000096.
https://psnet.ahrq.gov/iss…
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psnet.ahrq.gov/node/836710/psn-pdf
March 09, 2022 - Implementation of an antibiotic stewardship program in
long-term care facilities across the US.
March 9, 2022
doi:http://www.doi.org/10.1001/jamanetworkopen.2022.0181.
https://psnet.ahrq.gov/issue/implementation-antibiotic-stewardship-program-long-term-care-facilities-
across-us
Overuse of antibiotics has been co…
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psnet.ahrq.gov/node/46467/psn-pdf
October 18, 2017 - The Role of Clinical Learning Environments in Preparing
New Clinicians to Engage in Patient Safety.
October 18, 2017
Disch J, Kilo CM, Passiment M, Wagner R, Weiss KB; National Collaborative for Improving the Clinical
Learning Environment. Chicago, IL: Accreditation Council for Graduate Medical Education; 2017.
ht…
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psnet.ahrq.gov/node/72483/psn-pdf
November 18, 2020 - ACGME Summary Report: The Pursuing Excellence
Pathway Leaders Patient Safety Collaborative.
November 18, 2020
Passiment M, Wagner R, Weiss KB for the Pursuing Excellence in Clinical Learning Environments:
Pathway Leaders Patient Safety Collaborative. Chicago, IL: Accreditation Council for Graduate Medical
Educatio…
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psnet.ahrq.gov/node/837681/psn-pdf
September 11, 2023 - Compendium of Strategies to Prevent HAIs in Acute Care
Hospitals 2022.
September 11, 2023
Infect Control Hosp Epidemiol. 2022-2023.
https://psnet.ahrq.gov/issue/compendium-strategies-prevent-hais-acute-care-hospitals-2022
Health care–associated infections (HAIs) affect patients both during and after hospitalizatio…
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psnet.ahrq.gov/node/838075/psn-pdf
September 14, 2022 - Crisis recovery in surgery: error management and
problem solving in safety-critical situations.
September 14, 2022
Gogalniceanu P, Kunduzi B, Ruckley C, et al. Crisis recovery in surgery: error management and problem
solving in safety-critical situations. Surgery. 2022;172(2):537-545. doi:10.1016/j.surg.2022.03.007…
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psnet.ahrq.gov/node/45103/psn-pdf
October 06, 2016 - Use of personal electronic devices by nurse anesthetists
and the effects on patient safety.
October 6, 2016
Snoots LR, Wands BA. Use of Personal Electronic Devices by Nurse Anesthetists and the Effects on
Patient Safety. AANA J. 2016;84(2):114-119.
https://psnet.ahrq.gov/issue/use-personal-electronic-devices-nurse…
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psnet.ahrq.gov/node/46044/psn-pdf
December 21, 2017 - Addressing the opioid epidemic in the United States:
lessons from the Department of Veterans Affairs.
December 21, 2017
Gellad WF, Good CB, Shulkin DJ. Addressing the Opioid Epidemic in the United States: Lessons From the
Department of Veterans Affairs. AMA Intern Med. 2017;177(5):611-612.
doi:10.1001/jamainternme…
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psnet.ahrq.gov/node/854248/psn-pdf
October 04, 2023 - Reduced postdischarge incidents after implementation of
a hospital-to-home transition intervention for children
with medical complexity.
October 4, 2023
Huth K, Hotz A, Emara N, et al. Reduced postdischarge incidents after implementation of a hospital-to-
home transition intervention for children with medical comp…
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psnet.ahrq.gov/node/60892/psn-pdf
September 09, 2020 - Applying thematic synthesis to interpretation and
commentary in epidemiological studies: identifying what
contributes to successful interventions to promote hand
hygiene in patient care.
September 9, 2020
Drey N, Gould D, Purssell E, et al. Applying thematic synthesis to interpretation and commentary in
epidemiol…
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psnet.ahrq.gov/node/859340/psn-pdf
December 20, 2023 - Validation and use of the Second Victim Experience and
Support Tool questionnaire: a scoping review.
December 20, 2023
Dato Md Yusof YJ, Ng QX, Teoh SE, et al. Validation and use of the Second Victim Experience and
Support Tool questionnaire: a scoping review. Public Health. 2023;223:183-192.
doi:10.1016/j.puhe.20…
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psnet.ahrq.gov/node/43678/psn-pdf
April 22, 2015 - 'Connecting the dots': leveraging visual analytics to make
sense of patient safety event reports.
April 22, 2015
Ratwani RM, Fong A. 'Connecting the dots': leveraging visual analytics to make sense of patient safety
event reports. J Am Med Inform Assoc. 2015;22(2):312-7. doi:10.1136/amiajnl-2014-002963.
https://ps…