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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44093/psn-pdf
    April 29, 2015 - South Carolina medication error bill is dangerously off target. April 29, 2015 ISMP Medication Safety Alert! Acute Care Edition. April 9, 2015;20:1,4. https://psnet.ahrq.gov/issue/south-carolina-medication-error-bill-dangerously-target This newsletter article reports on issues related to a legislation, drafted in …
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43677/psn-pdf
    November 19, 2014 - Reporting and Learning Systems for Medication Errors: The Role of Pharmacovigilance Centres. November 19, 2014 Bencheikh SR, Cousins D, Benabdallah G, et al. Geneva, Switzerland: World Health Organization; October 2014. ISBN: 9789241507943. https://psnet.ahrq.gov/issue/reporting-and-learning-systems-medication-err…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42991/psn-pdf
    March 12, 2014 - Medication errors in hospitalised children. March 12, 2014 Manias E, Kinney S, Cranswick N, et al. Medication errors in hospitalised children. J Paediatr Child Health. 2014;50(1):71-7. doi:10.1111/jpc.12412. https://psnet.ahrq.gov/issue/medication-errors-hospitalised-children Consistent with findings from prior st…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46688/psn-pdf
    January 01, 2018 - New solutions to reduce wrong route medication errors. December 18, 2017 Litman RS, Smith VI, Mainland P. New solutions to reduce wrong route medication errors. Paediatr Anaesth. 2018;28(1):8-12. doi:10.1111/pan.13279. https://psnet.ahrq.gov/issue/new-solutions-reduce-wrong-route-medication-errors Tubing misconnec…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43066/psn-pdf
    December 10, 2014 - Reminder: pay attention to the appearance of your medicines. December 10, 2014 ISMP Canada. SafeMedicationUse Newsletter. December 2, 2014;5:1-2. https://psnet.ahrq.gov/issue/reminder-pay-attention-appearance-your-medicines This newsletter article describes an incident involving a patient who noticed that the tabl…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50383/psn-pdf
    September 25, 2019 - Epidemiology of adverse events and medical errors in the care of cardiology patients. September 25, 2019 Ohta Y, Miki I, Kimura T, et al. Epidemiology of Adverse Events and Medical Errors in the Care of Cardiology Patients. J Patient Saf. 2019;15(3):251-256. doi:10.1097/PTS.0000000000000291. https://psnet.ahrq.gov…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41633/psn-pdf
    January 01, 2013 - Determinants of success of quality improvement collaboratives: what does the literature show? December 31, 2012 Hulscher M, Schouten LMT, Grol R, et al. Determinants of success of quality improvement collaboratives: what does the literature show? BMJ Qual Saf. 2013;22(1):19-31. doi:10.1136/bmjqs-2011-000651. https…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/48001/psn-pdf
    May 22, 2019 - Medicines safety in anaesthetic practice. May 22, 2019 Mackay E, Jennings J, Webber S. Medicines safety in anaesthetic practice. BJA Edu. 2019;19(5):151-157. doi:10.1016/j.bjae.2019.01.001. https://psnet.ahrq.gov/issue/medicines-safety-anaesthetic-practice Human factors affect medication delivery in the operating …
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46854/psn-pdf
    June 20, 2018 - FDA Safety Communication: recommendations to reduce surgical fires and related patient injury. June 20, 2018 MedWatch Safety Alert. Silver Spring, MD: US Food and Drug Administration. May 29, 2018. https://psnet.ahrq.gov/issue/fda-safety-communication-recommendations-reduce-surgical-fires-and-related- patient-inju…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44729/psn-pdf
    January 07, 2016 - The morbidity and mortality meeting: time for a different approach? January 7, 2016 Fraser J. The morbidity and mortality meeting: time for a different approach? Arch Dis Child. 2016;101(1):4- 8. doi:10.1136/archdischild-2015-309536. https://psnet.ahrq.gov/issue/morbidity-and-mortality-meeting-time-different-appro…
  11. www.ahrq.gov/evidencenow/heart-health/smoking/treatment.html
    August 01, 2018 - Treating Tobacco Use and Dependence: 2008 Update by HHS Panel Resource title: Treating Tobacco Use and Dependence: 2008 Update Resource description: This update to a previous guideline by the Tobacco Use and Dependence Guideline Panel contains strategies and recommendations for effective treatments for tob…
  12. integrationacademy.ahrq.gov/sites/default/files/2021-10/Rack_Card_10.25.11.pdf
    January 01, 2021 - Integrated Care: Physical & Emotional Heath (Rack card) Integrated Care: Physical & Emotional Health Are you struggling with an emotional issue and not sure how to get help? We’re here for you. Integrated Care: Physical & Emotional Health Integrated Care combines car…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41776/psn-pdf
    January 30, 2013 - Comparison of traditional trigger tool to data warehouse based screening for identifying hospital adverse events. January 30, 2013 O'Leary KJ, Devisetty VK, Patel AR, et al. Comparison of traditional trigger tool to data warehouse based screening for identifying hospital adverse events. BMJ Qual Saf. 2013;22(2):130…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42544/psn-pdf
    December 18, 2013 - Communicating medication changes to community pharmacy post-discharge: the good, the bad, and the improvements. December 18, 2013 Urban R, Paloumpi E, Rana N, et al. Communicating medication changes to community pharmacy post- discharge: the good, the bad, and the improvements. Int J Clin Pharm. 2013;35(5):813-20.…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837703/psn-pdf
    July 20, 2022 - Family safety reporting in hospitalized children with medical complexity. July 20, 2022 Mercer AN, Mauskar S, Baird JD, et al. Family safety reporting in hospitalized children with medical complexity. Pediatrics. 2022;150(2):e2021055098. doi:10.1542/peds.2021-055098. https://psnet.ahrq.gov/issue/family-safety-repo…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41928/psn-pdf
    January 30, 2013 - Perceived causes of prescribing errors by junior doctors in hospital inpatients: a study from the PROTECT programme. January 30, 2013 Ross S, Ryan C, Duncan EM, et al. Perceived causes of prescribing errors by junior doctors in hospital inpatients: a study from the PROTECT programme. BMJ Qual Saf. 2013;22(2):97-10…
  17. www.ahrq.gov/sites/default/files/wysiwyg/data/infographics/hac-interim-data-graphic-2014.pdf
    January 01, 2014 - Patients Safer as Hospital-Acquired Conditions Decline (Data Graphic) REDUCTION IN HACs REDUCTION IN HACs 17%17% LIVES SAVEDLIVES SAVED 87,00087,000 $$$ IN COSTS AVERTEDIN COSTS AVERTED $19.8 BILLION $19.8 BILLION INSTANCES OF HACs AVOIDED INSTANCES OF HACs AVOIDED 2.1 MILLION 2.1 MILLION From 2010–2014, 1…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49771/psn-pdf
    July 01, 2016 - addition, the commentary does not include information regarding investigational or off-label use of pharmaceuticalproducts or medical devices.
  19. www.ahrq.gov/sites/default/files/2024-02/jones-report.pdf
    January 01, 2024 - use process; 85%, by type of error; 50%, by cause of error; and 20%, by therapeutic class of the drugs … 22 Phase (node) of medication use process in which error originated 11 Cause of the error 14 Drugs … double check opioids prior to administration 0 7 9 3 1 2 0 5 Written policy to double check chemotherapy drugs
  20. www.ahrq.gov/sites/default/files/publications2/files/hac-cost-report2017.pdf
    November 01, 2017 - Draft Final Report Estimating the Additional Hospital Inpatient Cost and Mortality Associated with Selected Hospital Acquired Conditions FINAL REPORT Estimating the Additional Hospital Inpatient Cost and Mortality Associated With Selected Hospital-Acquired Conditions PREPARED FOR: Agency for Healthcare Resear…