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psnet.ahrq.gov/node/50652/psn-pdf
January 01, 2020 - Preventable adverse drug events: descriptive
epidemiology.
November 13, 2019
Woo SA, Cragg A, Wickham ME, et al. Preventable adverse drug events: Descriptive epidemiology. Br J
Clin Pharmacol. 2020;86(2):291-302. doi:10.1111/bcp.14139.
https://psnet.ahrq.gov/issue/preventable-adverse-drug-events-descriptive-epidem…
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digital.ahrq.gov/location/usa-il-evanston
January 01, 2023 - USA, IL, Evanston
Preventing Wrong-Drug and Wrong-Patient Errors With Indication Alerts in CPOE Systems
Description
This research implemented indication alerts, which occur when an ordered or prescribed medication lacks a corresponding problem on the patient’s problem list. Th…
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psnet.ahrq.gov/node/43967/psn-pdf
November 16, 2015 - Equipped: overcoming barriers to change to improve
quality of care (theories of change).
November 16, 2015
Lachman P, Runnacles J, Dudley J, et al. Equipped: overcoming barriers to change to improve quality of
care (theories of change). Arch Dis Child Educ Pract Ed. 2015;100(1):13-8. doi:10.1136/archdischild-2013-
…
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psnet.ahrq.gov/node/43404/psn-pdf
August 06, 2014 - 'Even now it makes me angry': health care students'
professionalism dilemma narratives.
August 6, 2014
Monrouxe L, Rees CE, Endacott R, et al. 'Even now it makes me angry': health care students'
professionalism dilemma narratives. Med Educ. 2014;48(5):502-17. doi:10.1111/medu.12377.
https://psnet.ahrq.gov/issue/ev…
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psnet.ahrq.gov/node/44265/psn-pdf
January 22, 2016 - How surgical trainees handle catastrophic errors: a
qualitative study.
January 22, 2016
Balogun JA, Bramall AN, Bernstein M. How Surgical Trainees Handle Catastrophic Errors: A Qualitative
Study. J Surg Educ. 2015;72(6):1179-84. doi:10.1016/j.jsurg.2015.05.003.
https://psnet.ahrq.gov/issue/how-surgical-trainees-ha…
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psnet.ahrq.gov/node/41718/psn-pdf
October 03, 2012 - Duty hours, quality of care, and patient safety: general
surgery resident perceptions.
October 3, 2012
Borman KR, Jones AT, Shea JA. Duty hours, quality of care, and patient safety: general surgery resident
perceptions. J Am Coll Surg. 2012;215(1):70-7; discussion 77-9. doi:10.1016/j.jamcollsurg.2012.02.010.
https…
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psnet.ahrq.gov/node/44554/psn-pdf
November 20, 2015 - Hospice diagnosis: polypharmacy—a teachable moment.
November 20, 2015
Larson CK, Kao H. Hospice Diagnosis: Polypharmacy: A Teachable Moment. JAMA Intern Med.
2015;175(11):1750-1751. doi:10.1001/jamainternmed.2015.5253.
https://psnet.ahrq.gov/issue/hospice-diagnosis-polypharmacy-teachable-moment
Overprescribing can…
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psnet.ahrq.gov/node/40598/psn-pdf
August 10, 2011 - An inpatient fall prevention initiative in a tertiary care
hospital.
August 10, 2011
Weinberg J, Proske D, Szerszen A, et al. An inpatient fall prevention initiative in a tertiary care hospital. Jt
Comm J Qual Patient Saf. 2011;37(7):317-325.
https://psnet.ahrq.gov/issue/inpatient-fall-prevention-initiative-tertia…
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psnet.ahrq.gov/node/44204/psn-pdf
June 17, 2015 - Effectiveness of interventions to improve patient
handover in surgery: a systematic review.
June 17, 2015
Pucher PH, Johnston MJ, Aggarwal R, et al. Effectiveness of interventions to improve patient handover in
surgery: A systematic review. Surgery. 2015;158(1):85-95. doi:10.1016/j.surg.2015.02.017.
https://psnet.…
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psnet.ahrq.gov/node/42997/psn-pdf
May 28, 2014 - Exploring perinatal shift-to-shift handover communication
and process: an observational study.
May 28, 2014
Poot EP, de Bruijne M, Wouters MGAJ, et al. Exploring perinatal shift-to-shift handover communication and
process: an observational study. J Eval Clin Pract. 2014;20(2):166-75. doi:10.1111/jep.12103.
https:/…
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psnet.ahrq.gov/node/60265/psn-pdf
January 01, 2019 - Quality Improvement and Patient Safety Competencies
Across the Learning Continuum.
January 1, 2019
AAMC New and Emerging Areas in Medicine Series. Washington, DC: Association of American Medical
Colleges; 2019. ISBN: 9781577541882.
https://psnet.ahrq.gov/issue/quality-improvement-and-patient-safety-competencies-ac…
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psnet.ahrq.gov/node/74185/psn-pdf
January 01, 2022 - The aspects of healthcare quality that are important to
health professionals and patients: a qualitative study.
December 15, 2021
Hannawa AF, Wu AW, Kolyada A, et al. The aspects of healthcare quality that are important to health
professionals and patients: a qualitative study. Patient Educ Couns. 2022;105(6):1561-…
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psnet.ahrq.gov/node/844793/psn-pdf
September 11, 2019 - PC standards for maternal safety.
September 11, 2019
The Joint Commission. R3 Report. August 21, 2019;24:1-6.
https://psnet.ahrq.gov/issue/pc-standards-maternal-safety
Maternal safety in the United States is gaining momentum as a system-level patient safety concern. This
report reviews the new Joint Commission Pro…
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psnet.ahrq.gov/node/39490/psn-pdf
November 02, 2010 - How RNs rescue patients: a qualitative study of RNs'
perceived involvement in rapid response teams.
November 2, 2010
Leach LS, Mayo A, O'Rourke M. How RNs rescue patients: a qualitative study of RNs' perceived
involvement in rapid response teams. Qual Saf Health Care. 2010;19(5):e13.
doi:10.1136/qshc.2008.030494.
…
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psnet.ahrq.gov/node/43633/psn-pdf
November 05, 2014 - An integrative review: fatigue among nurses in acute care
settings.
November 5, 2014
Smith-Miller CA, Shaw-Kokot J, Curro B, et al. An integrative review: fatigue among nurses in acute care
settings. J Nurs Adm. 2014;44(9):487-94. doi:10.1097/NNA.0000000000000104.
https://psnet.ahrq.gov/issue/integrative-review-fa…
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psnet.ahrq.gov/node/73298/psn-pdf
May 19, 2021 - The Future of Nursing 2020-2030: Charting a Path to
Achieve Health Equity.
May 19, 2021
National Academies of Sciences, Engineering, and Medicine. Washington DC: National
Academies Press; 2021. ISBN: 9780309685061.
https://psnet.ahrq.gov/issue/future-nursing-2020-2030-charting-path-achieve-he…
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psnet.ahrq.gov/node/47801/psn-pdf
May 11, 2019 - Opioid prescribing trends and the physician’s role in
responding to the public health crisis.
May 11, 2019
Adams JM, Giroir BP. Opioid Prescribing Trends and the Physician's Role in Responding to the Public
Health Crisis. JAMA Intern Med. 2019;179(4):476-478. doi:10.1001/jamainternmed.2018.7934.
https://psnet.ahrq…
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psnet.ahrq.gov/node/850929/psn-pdf
June 21, 2023 - Requirements for implementing a 'just culture' within
healthcare organisations: an integrative review.
June 21, 2023
Murray JS, Lee J, Larson S, et al. Requirements for implementing a ‘just culture’ within healthcare
organisations: an integrative review. BMJ Open Qual. 2023;12(2):e002237. doi:10.1136/bmjoq-2022-
0…
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psnet.ahrq.gov/node/44667/psn-pdf
March 15, 2016 - Incorporating metacognition into morbidity and mortality
rounds: the next frontier in quality improvement.
March 15, 2016
Katz D, Detsky AS. Incorporating metacognition into morbidity and mortality rounds: The next frontier in
quality improvement. J Hosp Med. 2016;11(2):120-2. doi:10.1002/jhm.2505.
https://psnet.a…
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cds.ahrq.gov/sites/default/files/cds/artifact/18/2024_CDS_Connect_IG_Statin_CVD_Clinician_Facing.pdf
January 01, 2024 - During the subsequent
appointment, the primary care clinician provides educational information to the … The information found in the health app provides educational topics for Ms. … The information in the patient portal also provides educational materials for Mr. … Educational links to relevant recommendation statements, original references to the
guideline, shared