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psnet.ahrq.gov/node/37667/psn-pdf
April 02, 2008 - Checklists for assessment and certification of clinical
procedural skills omit essential competencies: a
systematic review.
April 2, 2008
McKinley RK, Strand J, Ward L, et al. Checklists for assessment and certification of clinical procedural
skills omit essential competencies: a systematic review. Med Educ. 2008;…
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psnet.ahrq.gov/node/851204/psn-pdf
July 05, 2023 - Drugmakers are abandoning cheap generics, and now US
cancer patients can’t get meds.
July 5, 2023
Allen A. KFF Health News. June 21, 2023.
https://psnet.ahrq.gov/issue/drugmakers-are-abandoning-cheap-generics-and-now-us-cancer-patients-
cant-get-meds
A variety of supply-chain, quality control, and economic factor…
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psnet.ahrq.gov/node/34674/psn-pdf
December 23, 2008 - Incidence and preventability of adverse drug events in
hospitalized patients.
December 23, 2008
Bates DW, Leape L, Petrycki S. Incidence and preventability of adverse drug events in hospitalized adults.
J Gen Intern Med. 1993;8(6):289-294.
https://psnet.ahrq.gov/issue/incidence-and-preventability-adverse-drug-even…
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psnet.ahrq.gov/node/73332/psn-pdf
May 26, 2021 - An evolving hospital quality star rating system from CMS:
aligning the stars.
May 26, 2021
Bilimoria KY, Barnard C. An evolving hospital quality star rating system from CMS: aligning the stars.
JAMA. 2021;325(21):2151-2152. doi:10.1001/jama.2021.6946.
https://psnet.ahrq.gov/issue/evolving-hospital-quality-star-rat…
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psnet.ahrq.gov/node/38663/psn-pdf
May 27, 2009 - Prevention of retained surgical sponges: a decision-
analytic model predicting relative cost-effectiveness.
May 27, 2009
Regenbogen SE, Greenberg CC, Resch SC, et al. Prevention of retained surgical sponges: a decision-
analytic model predicting relative cost-effectiveness. Surgery. 2009;145(5):527-35.
doi:10.1016…
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psnet.ahrq.gov/node/38301/psn-pdf
February 15, 2011 - Defining the incidence of cardiorespiratory instability in
patients in step-down units using an electronic integrated
monitoring system.
February 15, 2011
Hravnak M, Edwards L, Clontz A, et al. Defining the incidence of cardiorespiratory instability in patients in
step-down units using an electronic integrated mon…
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psnet.ahrq.gov/node/855436/psn-pdf
November 15, 2023 - Medication Safety for Look-alike, Sound-alike Medicines.
November 15, 2023
Galappatthy P, Mair A, Dhingra-Kumar N et al. Geneva, Switzerland: World Health Organization; 2023.
ISBN 9789240058897.
https://psnet.ahrq.gov/issue/medication-safety-look-alike-sound-alike-medicines
Look-alike, sound-alike (LASA) medicines…
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psnet.ahrq.gov/node/45094/psn-pdf
May 04, 2016 - Actions Needed to Improve Newly Enrolled Veterans'
Access to Primary Care.
May 4, 2016
Washington, DC: United States Government Accountability Office; March 18, 2016. Publication GAO-16-
328.
https://psnet.ahrq.gov/issue/actions-needed-improve-newly-enrolled-veterans-access-primary-care
This analysis found that s…
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psnet.ahrq.gov/node/40308/psn-pdf
April 22, 2011 - Improving patient safety: the comparative views of
patient-safety specialists, workforce staff and managers.
April 22, 2011
Braithwaite J, Westbrook MT, Robinson M, et al. Improving patient safety: the comparative views of patient-
safety specialists, workforce staff and managers. BMJ Qual Saf. 2011;20(5):424-31.
…
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psnet.ahrq.gov/node/46501/psn-pdf
March 20, 2018 - Blind obedience and an unnecessary workup for
hypoglycemia: a teachable moment.
March 20, 2018
Wang EY, Patrick L, Connor DM. Blind Obedience and an Unnecessary Workup for Hypoglycemia: A
Teachable Moment. JAMA Intern Med. 2018;178(2):279-280. doi:10.1001/jamainternmed.2017.7104.
https://psnet.ahrq.gov/issue/blind…
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psnet.ahrq.gov/node/47681/psn-pdf
January 30, 2019 - Infection prevention in the operating room anesthesia
work area.
January 30, 2019
Munoz-Price S, Bowdle A, Johnston L, et al. Infection prevention in the operating room anesthesia work
area. Infect Control Hosp Epidemiol. 2018:1-17. doi:10.1017/ice.2018.303.
https://psnet.ahrq.gov/issue/infection-prevention-operat…
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psnet.ahrq.gov/node/862613/psn-pdf
February 14, 2024 - Standardizing medication reconciliation in a pediatric
emergency department.
February 14, 2024
Sheth S, Bialostozky M, Hollenbach K, et al. Standardizing medication reconciliation in a pediatric
emergency department. Pediatrics. 2024;153(2):e2023061964. doi:10.1542/peds.2023-061964.
https://psnet.ahrq.gov/issue/st…
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psnet.ahrq.gov/node/865667/psn-pdf
April 24, 2024 - Impact of short-notice accreditation assessments on
hospitals' patient safety and quality culture--a scoping
review.
April 24, 2024
Scanlan R, Flenady T, Judd J. Impact of short?notice accreditation assessments on hospitals' patient
safety and quality culture- a scoping review. J Adv Nurs. 2024;80(10):3965-3976. d…
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psnet.ahrq.gov/node/46650/psn-pdf
July 12, 2018 - Towards a more patient-centered approach to medication
safety.
July 12, 2018
Lee JL, Dy SM, Gurses AP, et al. Towards a More Patient-Centered Approach to Medication Safety. J
Patient Exp. 2018;5(2):83-87. doi:10.1177/2374373517727532.
https://psnet.ahrq.gov/issue/towards-more-patient-centered-approach-medication-s…
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psnet.ahrq.gov/node/44918/psn-pdf
April 13, 2016 - National Reporting and Learning System Research and
Development.
April 13, 2016
Mayer E, Flott K, Callahan R, Darzi A. London, UK: NIHR Imperial Patient Safety Translational Research
Centre; 2016.
https://psnet.ahrq.gov/issue/national-reporting-and-learning-system-research-and-development
Incident reporting has a…
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psnet.ahrq.gov/node/47662/psn-pdf
February 21, 2024 - Lucian Leape Patient Safety Fellowship Award.
February 21, 2024
International Society for Quality in Health Care
https://psnet.ahrq.gov/issue/lucian-leape-patient-safety-fellowship-award
Inspired by the work and leadership of Dr. Lucian Leape, this award is a mentoring program to develop
physicians and leaders see…
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psnet.ahrq.gov/node/836856/psn-pdf
April 06, 2022 - To what extent are patients involved in researching safety
in acute mental healthcare?
April 6, 2022
Brierley-Jones L, Ramsey L, Canvin K, et al. To what extent are patients involved in researching safety in
acute mental healthcare? Res Involv Engagem. 2022;8(1):8. doi:10.1186/s40900-022-00337-x.
https://psnet.ahr…
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psnet.ahrq.gov/node/45184/psn-pdf
June 01, 2016 - Measuring patient safety in primary care: the
development and validation of the "Patient Reported
Experiences and Outcomes of Safety in Primary Care"
(PREOS-PC).
June 1, 2016
Ricci-Cabello I, Avery A, Reeves D, et al. Measuring Patient Safety in Primary Care: The Development and
Validation of the "Patient Reporte…
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psnet.ahrq.gov/node/43030/psn-pdf
March 26, 2014 - Recommendations for practitioners and manufacturers to
address system-based causes of vaccine errors.
March 26, 2014
ISMP Medication Safety Alert! Acute care edition. March 13, 2014;19:1-2,4-5.
https://psnet.ahrq.gov/issue/recommendations-practitioners-and-manufacturers-address-system-based-
causes-vaccine-…
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psnet.ahrq.gov/node/43861/psn-pdf
July 01, 2016 - Misdiagnosis and missed diagnoses in foster and
adopted children with prenatal alcohol exposure.
July 1, 2016
Chasnoff IJ, Wells AM, King L. Misdiagnosis and missed diagnoses in foster and adopted children with
prenatal alcohol exposure. Pediatrics. 2015;135(2):264-70. doi:10.1542/peds.2014-2171.
https://psnet.ahr…