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psnet.ahrq.gov/node/43532/psn-pdf
June 23, 2017 - The Second Victim Experience and Support Tool:
validation of an organizational resource for assessing
second victim effects and the quality of support
resources.
June 23, 2017
Burlison JD, Scott SD, Browne EK, et al. The Second Victim Experience and Support Tool: validation of an
organizational resource for asses…
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psnet.ahrq.gov/node/43093/psn-pdf
August 12, 2014 - Identifying systems failures in the pathway to a
catastrophic event: an analysis of national incident report
data relating to vinca alkaloids.
August 12, 2014
Franklin BD, Panesar S, Vincent CA, et al. Identifying systems failures in the pathway to a catastrophic
event: an analysis of national incident report data…
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psnet.ahrq.gov/node/44186/psn-pdf
November 10, 2015 - A comprehensive method to develop a checklist to
increase safety of intra-hospital transport of critically ill
patients.
November 10, 2015
Brunsveld-Reinders AH, Arbous S, Kuiper SG, et al. A comprehensive method to develop a checklist to
increase safety of intra-hospital transport of critically ill patients. Crit…
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psnet.ahrq.gov/node/45745/psn-pdf
August 02, 2017 - Emergency diagnosis of cancer and previous general
practice consultations: insights from linked patient
survey data.
August 2, 2017
Abel GA, Mendonca SC, McPhail S, et al. Emergency diagnosis of cancer and previous general practice
consultations: insights from linked patient survey data. Br J Gen Pract. 2017;67(65…
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psnet.ahrq.gov/node/47012/psn-pdf
August 01, 2018 - Trigger alerts associated with laboratory abnormalities on
identifying potentially preventable adverse drug events in
the intensive care unit and general ward.
August 1, 2018
Buckley MS, Rasmussen JR, Bikin DS, et al. Trigger alerts associated with laboratory abnormalities on
identifying potentially preventable ad…
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psnet.ahrq.gov/node/44130/psn-pdf
May 13, 2015 - Recent Evidence That Health IT Improves Patient Safety:
Issue Brief.
May 13, 2015
Banger A, Graber ML. Washington, DC: Office of the National Coordinator for Health Information
Technology; February 2015.
https://psnet.ahrq.gov/issue/recent-evidence-health-it-improves-patient-safety-issue-brief
Rapid implementatio…
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psnet.ahrq.gov/node/867046/psn-pdf
October 30, 2024 - The future of safety and quality in radiation oncology.
October 30, 2024
Talcott W, Covington E, Bazan J, et al. The future of safety and quality in radiation oncology. Semin Radiat
Oncol. 2024;34(4):433-440. doi:10.1016/j.semradonc.2024.07.008.
https://psnet.ahrq.gov/issue/future-safety-and-quality-radiation-oncol…
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psnet.ahrq.gov/node/60353/psn-pdf
May 20, 2020 - Adverse events after transition from ICU to hospital ward:
a multicenter cohort study.
May 20, 2020
Sauro KM, Soo A, de Grood C, et al. Adverse Events After Transition From ICU to Hospital Ward: A
Multicenter Cohort Study*. Crit Care Med. 2020;48(7):946-953. doi:10.1097/ccm.0000000000004327.
https://psnet.ahrq.gov…
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psnet.ahrq.gov/node/73568/psn-pdf
August 04, 2021 - Coping strategies in health care providers as second
victims: a systematic review.
August 4, 2021
Kappes M, Romero?García M, Delgado?Hito P. Coping strategies in health care providers as second
victims: a systematic review. Int Nurs Rev. 2021;68(4):471-481. doi:10.1111/inr.12694.
https://psnet.ahrq.gov/issue/copin…
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psnet.ahrq.gov/node/47638/psn-pdf
February 06, 2019 - Decreasing surgical site infections by developing a high
reliability culture.
February 6, 2019
Pettis AM. Decreasing Surgical Site Infections by Developing a High Reliability Culture. AORN J.
2018;108(6):644-650. doi:10.1002/aorn.12416.
https://psnet.ahrq.gov/issue/decreasing-surgical-site-infections-developing-hi…
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psnet.ahrq.gov/node/44664/psn-pdf
May 30, 2016 - Ventilator-related adverse events: a taxonomy and
findings from 3 incident reporting systems.
May 30, 2016
Pham JC, Williams TL, Sparnon EM, et al. Ventilator-Related Adverse Events: A Taxonomy and Findings
From 3 Incident Reporting Systems. Respir Care. 2016;61(5):621-31. doi:10.4187/respcare.04151.
https://psnet…
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psnet.ahrq.gov/node/43665/psn-pdf
November 20, 2015 - Patient safety education to change medical students'
attitudes and sense of responsibility.
November 20, 2015
Roh H, Park SJ, Kim T. Patient safety education to change medical students' attitudes and sense of
responsibility. Med Teach. 2015;37(10):908-14. doi:10.3109/0142159X.2014.970988.
https://psnet.ahrq.gov/is…
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psnet.ahrq.gov/node/46047/psn-pdf
May 17, 2017 - Medicare failed to investigate suspicious infection cases
from 96 hospitals.
May 17, 2017
Jewett C. Kaiser Health News. May 9, 2017.
https://psnet.ahrq.gov/issue/medicare-failed-investigate-suspicious-infection-cases-96-hospitals
The Centers for Medicare and Medicaid Services decision to withhold payment for certa…
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psnet.ahrq.gov/node/60676/psn-pdf
July 15, 2020 - Northeastern University Hospital Surge Capacity Planning
Model: Bed, Ventilator, and PPE 1-30 Day Demand.
July 15, 2020
Rockville, MD; Agency for Healthcare Research and Quality: 2020.
https://psnet.ahrq.gov/issue/northeastern-university-hospital-surge-capacity-planning-model-bed-ventilator-
and-ppe-1-30
The COVI…
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psnet.ahrq.gov/node/866728/psn-pdf
September 18, 2024 - ROI for a fall prevention intervention: invest a little, save a
lot.
September 18, 2024
Cooper AS. ROI for a fall prevention intervention: invest a little, save a lot. Nurs Adm Q. 2024;48(3):248-
252. doi:10.1097/naq.0000000000000647.
https://psnet.ahrq.gov/issue/roi-fall-prevention-intervention-invest-little-save…
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psnet.ahrq.gov/node/41423/psn-pdf
January 03, 2017 - Improving documentation of a beta-blocker quality
measure through an anesthesia information management
system and real-time notification of documentation
errors.
January 3, 2017
Nair BG, Peterson GN, Newman S-F, et al. Improving documentation of a beta-blocker quality measure
through an anesthesia information man…
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psnet.ahrq.gov/node/73345/psn-pdf
June 02, 2021 - An estimate of missed pediatric sepsis in the emergency
department.
June 2, 2021
Cifra CL, Westlund E, Ten Eyck P, et al. An estimate of missed pediatric sepsis in the emergency
department. Diagnosis (Berl). 2020;8(2):193-198. doi:10.1515/dx-2020-0023.
https://psnet.ahrq.gov/issue/estimate-missed-pediatric-sepsis-…
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psnet.ahrq.gov/node/42362/psn-pdf
July 10, 2013 - How to improve change of shift handovers and
collaborative grounding and what role does the electronic
patient record system play? Results of a systematic
literature review.
July 10, 2013
Flemming D, Hübner U. How to improve change of shift handovers and collaborative grounding and what
role does the electronic p…
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psnet.ahrq.gov/node/47924/psn-pdf
June 05, 2019 - Effect of a central call center on employee perceptions of
safety culture within community pharmacies in an
academic health system.
June 5, 2019
Bowden A, Mullin S, Tak C, et al. Effect of a central call center on employee perceptions of safety culture
within community pharmacies in an academic health system. Am J…
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psnet.ahrq.gov/node/45935/psn-pdf
September 29, 2017 - Radiology research in quality and safety: current trends
and future needs.
September 29, 2017
Zygmont ME, Itri JN, Rosenkrantz AB, et al. Radiology Research in Quality and Safety: Current Trends and
Future Needs. Acad Radiol. 2017;24(3):263-272. doi:10.1016/j.acra.2016.07.021.
https://psnet.ahrq.gov/issue/radiolog…