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psnet.ahrq.gov/node/36134/psn-pdf
February 24, 2011 - Direct reporting of laboratory test results to patients by
mail to enhance patient safety.
February 24, 2011
Sung S, Forman-Hoffman VL, Wilson MC, et al. Direct reporting of laboratory test results to patients by mail
to enhance patient safety. J Gen Intern Med. 2006;21(10):1075-8.
https://psnet.ahrq.gov/issue/dir…
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psnet.ahrq.gov/node/40992/psn-pdf
December 15, 2011 - Should patients get direct access to their laboratory test
results?: An answer with many questions.
December 15, 2011
Giardina TD, Singh H. Should patients get direct access to their laboratory test results? An answer with
many questions. JAMA. 2011;306(22):2502-2503. doi:10.1001/jama.2011.1797.
https://psnet.ahrq…
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psnet.ahrq.gov/node/45059/psn-pdf
July 01, 2016 - An observational study of direct oral anticoagulant
awareness indicating inadequate recognition with
potential for patient harm.
July 1, 2016
Olaiya A, Lurie B, Watt B, et al. An observational study of direct oral anticoagulant awareness indicating
inadequate recognition with potential for patient harm. J Thromb H…
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psnet.ahrq.gov/node/36673/psn-pdf
January 18, 2011 - Patient safety: honoring advanced directives.
January 18, 2011
Tice MA. Patient safety: honoring advanced directives. Home Healthc Nurse. 2007;25(2):79-81.
https://psnet.ahrq.gov/issue/patient-safety-honoring-advanced-directives
The author discusses why failure to follow an advance directive should be considered a …
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psnet.ahrq.gov/node/40074/psn-pdf
July 03, 2014 - Evaluation of consistency in dosing directions and
measuring devices for pediatric nonprescription liquid
medications.
July 3, 2014
Yin S, Wolf MS, Dreyer BP, et al. Evaluation of consistency in dosing directions and measuring devices for
pediatric nonprescription liquid medications. JAMA. 2010;304(23):2595-602. d…
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psnet.ahrq.gov/node/45193/psn-pdf
October 03, 2017 - Choice, transparency, coordination, and quality among
direct-to-consumer telemedicine websites and apps
treating skin disease.
October 3, 2017
Resneck JS, Abrouk M, Steuer M, et al. Choice, Transparency, Coordination, and Quality Among Direct-to-
Consumer Telemedicine Websites and Apps Treating Skin Disease. JAMA …
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psnet.ahrq.gov/node/35674/psn-pdf
June 28, 2010 - Medication errors and adverse drug events in an intensive
care unit: direct observation approach for detection.
June 28, 2010
Kopp BJ, Erstad BL, Allen ME, et al. Medication errors and adverse drug events in an intensive care unit:
direct observation approach for detection. Crit Care Med. 2006;34(2):415-25.
https:…
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psnet.ahrq.gov/node/37457/psn-pdf
February 15, 2011 - Benefits of direct observation in medication
administration to detect errors.
February 15, 2011
Diaz-Navarlaz T, Pronovost P, Beortegui E, et al. Benefits of Direct Observation in Medication
Administration to Detect Errors. J Patient Saf. 2009;3(4). doi:10.1097/pts.0b013e31815b4cc3.
https://psnet.ahrq.gov/issue/be…
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psnet.ahrq.gov/node/39065/psn-pdf
January 03, 2017 - Family alert: implementing direct family activation of a
pediatric rapid response team.
January 3, 2017
Ray EM, Smith R, Massie S, et al. Family alert: implementing direct family activation of a pediatric rapid
response team. Jt Comm J Qual Patient Saf. 2009;35(11):575-580.
https://psnet.ahrq.gov/issue/family-aler…
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psnet.ahrq.gov/node/38425/psn-pdf
January 29, 2010 - Hospitalists as Emerging Leaders in Patient Safety:
lessons learned and future directions.
January 29, 2010
Flanders S, Kaufman SR, Saint S, et al. Hospitalists as emerging leaders in patient safety: lessons learned
and future directions. J Patient Saf. 2009;5(1):3-8. doi:10.1097/PTS.0b013e31819751f2.
https://psne…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.365_slideshow.ppt
January 01, 2016 - PowerPoint Presentation
Spotlight
A Room Without Orders
1
This presentation is based on the January 2016
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Amy Vogelsmeier, PhD, RN, Sinclair School of Nursing; and Laurel Despins, PhD, RN, Sinclair Sc…
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psnet.ahrq.gov/node/44476/psn-pdf
September 26, 2016 - The impact of interruptions on the duration of nursing
interventions: a direct observation study in an academic
emergency department.
September 26, 2016
Cole G, Stefanus D, Gardner H, et al. The impact of interruptions on the duration of nursing interventions: a
direct observation study in an academic emergency de…
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psnet.ahrq.gov/node/43918/psn-pdf
September 27, 2017 - Medication-administration errors in an urban mental
health hospital: a direct observation study.
September 27, 2017
Cottney A, Innes J. Medication-administration errors in an urban mental health hospital: a direct
observation study. Int J Ment Health Nurs. 2015;24(1):65-74. doi:10.1111/inm.12096.
https://psnet.ahr…
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psnet.ahrq.gov/node/43625/psn-pdf
October 29, 2014 - Assessing distractors and teamwork during surgery:
developing an event-based method for direct observation.
October 29, 2014
Seelandt JC, Tschan F, Keller S, et al. Assessing distractors and teamwork during surgery: developing an
event-based method for direct observation. BMJ Qual Saf. 2014;23(11):918-29. doi:10.11…
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psnet.ahrq.gov/node/36788/psn-pdf
August 26, 2011 - Direct observation approach for detecting medication
errors and adverse drug events in a pediatric intensive
care unit.
August 26, 2011
Buckley MS, Erstad BL, Kopp BJ, et al. Direct observation approach for detecting medication errors and
adverse drug events in a pediatric intensive care unit. Pediatr Crit Care Me…
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psnet.ahrq.gov/node/46829/psn-pdf
July 23, 2018 - Quality and variability of patient directions in electronic
prescriptions in the ambulatory care setting.
July 23, 2018
Yang Y, Ward-Charlerie S, Dhavle AA, et al. Quality and Variability of Patient Directions in Electronic
Prescriptions in the Ambulatory Care Setting. J Manag Care Spec Pharm. 2018;24(7):691-699.
…
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psnet.ahrq.gov/node/47006/psn-pdf
October 13, 2018 - Assessment of the safety of discharging select patients
directly home from the intensive care unit: a multicenter
population-based cohort study.
October 13, 2018
Stelfox HT, Soo A, Niven DJ, et al. Assessment of the Safety of Discharging Select Patients Directly Home
From the Intensive Care Unit: A Multicenter Pop…
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psnet.ahrq.gov/node/44368/psn-pdf
September 29, 2017 - A systematic review of the effect of distraction on
surgeon performance: directions for operating room
policy and surgical training.
September 29, 2017
Mentis HM, Chellali A, Manser K, et al. A systematic review of the effect of distraction on surgeon
performance: directions for operating room policy and surgical …
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psnet.ahrq.gov/node/44028/psn-pdf
April 01, 2015 - Alarm system management: evidence-based guidance
encouraging direct measurement of informativeness to
improve alarm response.
April 1, 2015
Rayo MF, Moffatt-Bruce SD. Alarm system management: evidence-based guidance encouraging direct
measurement of informativeness to improve alarm response. BMJ Qual Saf. 2015;24(…
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psnet.ahrq.gov/node/44886/psn-pdf
September 27, 2016 - Direct oral anticoagulants: new drugs with practical
problems. How can nurses help prevent patient harm?
September 27, 2016
Barras MA, Hughes D, Ullner M. Direct oral anticoagulants: New drugs with practical problems. How can
nurses help prevent patient harm? Nurs Health Sci. 2016;18(3):408-11. doi:10.1111/nhs.1226…