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psnet.ahrq.gov/issue/adverse-drug-events-elderly
April 21, 2011 - Review
Adverse drug events in the elderly.
Citation Text:
Cresswell KM, Fernando B, McKinstry B, et al. Adverse drug events in the elderly. Br Med Bull. 2007;83(1). doi:10.1093/bmb/ldm016.
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psnet.ahrq.gov/issue/2-year-study-patient-safety-competency-assessment-29-clinical-laboratories
December 14, 2016 - Study
A 2-year study of patient safety competency assessment in 29 clinical laboratories.
Citation Text:
Reed RC, Kim S, Farquharson K, et al. A 2-Year Study of Patient Safety Competency Assessment in 29 Clinical Laboratories. Am J Clin Pathol. 2008;129(6). doi:10.1309/bm8jje1auca408tq…
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psnet.ahrq.gov/issue/investigating-improvement-five-strategies-ensure-national-patient-safety-investigations
February 28, 2024 - Commentary
Investigating for improvement? Five strategies to ensure national patient safety investigations improve patient safety.
Citation Text:
Macrae C. Investigating for improvement? Five strategies to ensure national patient safety investigations improve patient safety. J R Soc Med.…
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psnet.ahrq.gov/issue/assessing-impact-teaching-patient-safety-principles-medical-students-during-surgical
November 27, 2012 - Study
Assessing the impact of teaching patient safety principles to medical students during surgical clerkships.
Citation Text:
Stahl K, Augenstein J, Schulman C, et al. Assessing the impact of teaching patient safety principles to medical students during surgical clerkships. J Surg Re…
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www.ahrq.gov/hai/tools/ambulatory-surgery/sections/implementation/implementation-guide/app-m.html
May 01, 2017 - Appendix M. Endoscopy Infographic - Implementation Guide
Preventing Infections in Endoscopic Procedures
More than 20 million gastrointestinal (GI) endoscopic procedures are performed annually in the United States. While rare, patients have acquired infections from these procedures due to:
Poor…
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psnet.ahrq.gov/issue/core-principles-quality-improvement-and-patient-safety
August 01, 2018 - Review
Core principles of quality improvement and patient safety.
Citation Text:
Bartman T, McClead RE. Core Principles of Quality Improvement and Patient Safety. Pediatr Rev. 2016;37(10):407-417.
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psnet.ahrq.gov/issue/designing-safer-process-prevent-retained-surgical-sponges-healthcare-failure-mode-and-effect
April 27, 2019 - Study
Designing a safer process to prevent retained surgical sponges: a healthcare failure mode and effect analysis.
Citation Text:
Steelman VM, Cullen JJ. Designing a safer process to prevent retained surgical sponges: a healthcare failure mode and effect analysis. AORN J. 2011;94(2):1…
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psnet.ahrq.gov/issue/abc-handover-impact-shift-handover-emergency-department
June 17, 2010 - Study
'The ABC of Handover': impact on shift handover in the emergency department.
Citation Text:
Farhan M, Brown R, Vincent CA, et al. The ABC of handover: impact on shift handover in the emergency department. Emerg Med J. 2012;29(12):947-53. doi:10.1136/emermed-2011-200201.
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psnet.ahrq.gov/issue/navigating-towards-improved-surgical-safety-using-aviation-based-strategies
January 04, 2011 - Review
Navigating towards improved surgical safety using aviation-based strategies.
Citation Text:
Kao LS, Thomas EJ. Navigating towards improved surgical safety using aviation-based strategies. J Surg Res. 2008;145(2):327-35.
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psnet.ahrq.gov/issue/kadcyla-ado-trastuzumab-emtansine-drug-safety-communication-potential-medication-errors
October 09, 2013 - Press Release/Announcement
Kadcyla (ado-trastuzumab emtansine): drug safety communication—potential medication errors resulting from name confusion.
Citation Text:
Kadcyla (ado-trastuzumab emtansine): drug safety communication—potential medication errors resulting from name confusion. …
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psnet.ahrq.gov/issue/reliability-ahrq-common-format-harm-scales-rating-patient-safety-events
January 23, 2017 - Study
The reliability of AHRQ Common Format Harm Scales in rating patient safety events.
Citation Text:
Williams TL, Szekendi MK, Pavkovic S, et al. The reliability of AHRQ Common Format Harm Scales in rating patient safety events. J Patient Saf. 2015;11(1):52-59. doi:10.1097/PTS.0b013e3…
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psnet.ahrq.gov/issue/certain-uncertainties-modes-patient-safety-healthcare
April 04, 2011 - Study
Certain uncertainties: modes of patient safety in healthcare.
Citation Text:
Jerak-Zuiderent S. Certain uncertainties: modes of patient safety in healthcare. Soc Stud Sci. 2012;42(5):732-52.
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psnet.ahrq.gov/issue/mary-lanning-memorial-hospital-communication-key
July 16, 2015 - Award Recipient
Mary Lanning Memorial Hospital: communication is key.
Citation Text:
Lindblad B, Chilcott J, Rolls L. Mary Lanning Memorial Hospital: communication is key. Joint Commission journal on quality and safety. 2004;30(10):551-8.
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psnet.ahrq.gov/issue/shifting-learning-curve
March 09, 2009 - Commentary
Shifting the learning curve.
Citation Text:
Reynolds T, Kong M-L. Shifting the learning curve. BMJ. 2010;341:c6260. doi:10.1136/bmj.c6260.
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psnet.ahrq.gov/issue/automated-electronic-reminders-prevent-miscommunication-among-primary-medical-surgical-and
August 16, 2017 - Commentary
Automated electronic reminders to prevent miscommunication among primary medical, surgical and anaesthesia providers: a root cause analysis.
Citation Text:
Freundlich RE, Grondin L, Tremper KK, et al. Automated electronic reminders to prevent miscommunication among primary m…
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psnet.ahrq.gov/issue/unprofessional-workplace-conductdefining-and-defusing-it
November 12, 2014 - Commentary
Unprofessional workplace conduct...defining and defusing it.
Citation Text:
MacLean L, Coombs C, Breda K. Unprofessional workplace conduct..defining and defusing it. Nurs Manage. 2016;47(9):30-34. doi:10.1097/01.NUMA.0000491126.68354.be.
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psnet.ahrq.gov/issue/role-south-north-partnerships-promoting-shared-learning-and-knowledge-transfer
July 29, 2020 - Commentary
The role of South--North partnerships in promoting shared learning and knowledge transfer.
Citation Text:
Basu L, Pronovost P, Molello NE, et al. The role of South-North partnerships in promoting shared learning and knowledge transfer. Global Health. 2017;13(1):64. doi:10.1186…
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www.ahrq.gov/hai/cauti-tools/archived-webinars/aseptic-catheter-insertion-practices-ed-slides.html
December 01, 2017 - Aseptic Catheter Insertion Practices in the ED: A Focus on Engagement
Slide Presentation
Slide 1
Aseptic Catheter Insertion Practices in the ED: A Focus on Engagement
Milisa Manojlovich PhD, RN, CCRN
Associate Professor
University of Michigan, School of Nursing
Slide 2
Learning Objectives
Di…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/aseptic-catheter-insertion-practices-ed.pptx
June 02, 2025 - PowerPoint Presentation
Aseptic catheter insertion practices in the ED: A Focus on Engagement
Milisa Manojlovich PhD, RN, CCRN
Associate Professor
University of Michigan, School of Nursing
1
1
Learning Objectives
Discuss barriers to ED staff engagement
Describe strategies to engage ED staff in aseptic ins…
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psnet.ahrq.gov/issue/safety-journal-lessons-learned-error-reporting-tool-stimulate-systems-thinking
January 21, 2019 - Study
The safety journal: lessons learned with an error reporting tool to stimulate systems thinking.
Citation Text:
Singh R, Naughton B, Singh A, et al. The Safety Journal. J Patient Saf. 2007;3(3):135-141. doi:10.1097/0b013e31814258db.
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