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psnet.ahrq.gov/node/50854/psn-pdf
January 29, 2020 - Association of state opioid duration limits with
postoperative opioid prescribing.
January 29, 2020
Agarwal S, Bryan JD, Hu HM, et al. Association of State Opioid Duration Limits With Postoperative Opioid
Prescribing. JAMA Netw Open. 2019;2(12):e1918361. doi:10.1001/jamanetworkopen.2019.18361.
https://psnet.ahrq.g…
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psnet.ahrq.gov/node/838309/psn-pdf
October 12, 2022 - Duplicate medication order errors: safety gaps and
recommendations for improvement.
October 12, 2022
Bocknek L, Kim T, Spaar P, et al. Duplicate medication order errors: safety gaps and recommendations for
improvement. Patient Safety. 2022;4(3):39-47. doi:10.33940/data/2022.9.6.
https://psnet.ahrq.gov/issue/duplic…
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psnet.ahrq.gov/node/50375/psn-pdf
September 25, 2019 - Medical error in the care of the unrepresented: disclosure
and apology for a vulnerable patient population.
September 25, 2019
Byju AS, Mayo K. Medical error in the care of the unrepresented: disclosure and apology for a vulnerable
patient population. J Med Ethics. 2019;45(12):821-823. doi:10.1136/medethics-2019-10…
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psnet.ahrq.gov/node/46428/psn-pdf
November 01, 2017 - Translating staff experience into organisational
improvement: the HEADS-UP stepped wedge, cluster
controlled, non-randomised trial.
November 1, 2017
Pannick S, Athanasiou T, Long SJ, et al. Translating staff experience into organisational improvement: the
HEADS-UP stepped wedge, cluster controlled, non-randomised …
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psnet.ahrq.gov/node/48033/psn-pdf
July 17, 2019 - Doctors' perceived working conditions and the quality of
patient care: a systematic review.
July 17, 2019
Teoh K, Hassard J, Cox T. Doctors’ perceived working conditions and the quality of patient care: a
systematic review. Work Stress. 2019;33(4):385-413. doi:10.1080/02678373.2019.1598514.
https://psnet.ahrq.gov/…
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psnet.ahrq.gov/node/839316/psn-pdf
January 01, 2023 - Patient voices in hospital safety during the COVID-19
pandemic.
November 2, 2022
Groves PS, Bunch JL, Hanrahan KM, et al. Patient voices in hospital safety during the COVID-19
pandemic. Clin Nurs Res. 2023;32(1):105-114. doi:10.1177/10547738221129711.
https://psnet.ahrq.gov/issue/patient-voices-hospital-safety-dur…
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psnet.ahrq.gov/node/50833/psn-pdf
January 29, 2020 - Linking transformational leadership, patient safety culture
and work engagement in home care services.
January 29, 2020
Ree E, Wiig S. Linking transformational leadership, patient safety culture and work engagement in home
care services. Nurs Open. 2020;7(1):256-264. doi:10.1002/nop2.386.
https://psnet.ahrq.gov/is…
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psnet.ahrq.gov/node/73501/psn-pdf
July 14, 2021 - Deficiencies in Emergency Preparedness for Veterans
Health Administration Telemental Health Care at VA Clinic
Locations Prior to the Pandemic.
July 14, 2021
Washington, DC: Department of Veterans Affairs, Office of Inspector General. June 24, 2021. Report No.
19-09808-171.
https://psnet.ahrq.gov/issue/deficiencie…
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psnet.ahrq.gov/node/47405/psn-pdf
January 27, 2019 - Robotic dispensing improves patient safety, inventory
management, and staff satisfaction in an outpatient
hospital pharmacy.
January 27, 2019
Rodriguez-Gonzalez CG, Herranz-Alonso A, Escudero-Vilaplana V, et al. Robotic dispensing improves
patient safety, inventory management, and staff satisfaction in an outpatie…
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psnet.ahrq.gov/node/47992/psn-pdf
January 01, 2020 - Understanding the heterogeneity of labor and delivery
units: using design thinking methodology to assess
environmental factors that contribute to safety in
childbirth.
May 8, 2019
Sherman J, Hedli LC, Kristensen-Cabrera AI, et al. Understanding the Heterogeneity of Labor and Delivery
Units: Using Design Thinking …
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psnet.ahrq.gov/node/34687/psn-pdf
February 10, 2011 - The costs of adverse drug events in hospitalized patients.
February 10, 2011
Bates DW, Spell N, Cullen DJ, et al. The costs of adverse drug events in hospitalized patients. Adverse
Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.
https://psnet.ahrq.gov/issue/costs-adverse-drug-events-hospitalized-patie…
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psnet.ahrq.gov/node/45691/psn-pdf
January 11, 2017 - Qualitative study about the experiences of colleagues of
health professionals involved in an adverse event.
January 11, 2017
Ferrús L, Silvestre C, Olivera G, et al. Qualitative Study About the Experiences of Colleagues of Health
Professionals Involved in an Adverse Event. J Patient Saf. 2016;17(1):36-43.
doi:10.1…
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psnet.ahrq.gov/node/47450/psn-pdf
March 27, 2019 - A qualitative evaluation of healthcare professionals'
perceptions of adverse events focusing on
communication and teamwork in maternity care.
March 27, 2019
Rönnerhag M, Severinsson E, Haruna M, et al. A qualitative evaluation of healthcare professionals'
perceptions of adverse events focusing on communication and…
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psnet.ahrq.gov/node/47823/psn-pdf
March 13, 2019 - Greater Focus on Credentialing Needed to Prevent
Disqualified Providers From Delivering Patient Care.
March 13, 2019
Washington, DC: United States Government Accountability Office; February 2019. Publication GAO-19-6.
https://psnet.ahrq.gov/issue/greater-focus-credentialing-needed-prevent-disqualified-providers-del…
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psnet.ahrq.gov/node/863208/psn-pdf
February 28, 2024 - Exploring clinical lessons learned by experienced
hospitalists from diagnostic errors and successes.
February 28, 2024
Kotwal S, Howell M, Zwaan L, et al. Exploring clinical lessons learned by experienced hospitalists from
diagnostic errors and successes. J Gen Intern Med. 2024;39(8):1386-1392. doi:10.1007/s11606-0…
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psnet.ahrq.gov/node/47541/psn-pdf
March 04, 2019 - Health outcomes of deprescribing interventions among
older residents in nursing homes: a systematic review
and meta-analysis.
March 4, 2019
Kua C-H, Mak VSL, Lee SWH. Health Outcomes of Deprescribing Interventions Among Older Residents in
Nursing Homes: A Systematic Review and Meta-analysis. J Amer Med Direct Asso…
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psnet.ahrq.gov/node/845347/psn-pdf
March 01, 2023 - Race differences in a malpractice event database in a
large healthcare system.
March 1, 2023
Thomas AD, Pandit C, Krevat S. Race differences in a malpractice event database in a large healthcare
system. J Patient Saf. 2023;19(2):67-70. doi:10.1097/pts.0000000000001090.
https://psnet.ahrq.gov/issue/race-differences…
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psnet.ahrq.gov/node/47688/psn-pdf
March 19, 2019 - Evaluation of an electronic health record structured
discharge summary to provide real time adverse event
reporting in thoracic surgery.
March 19, 2019
Graham AJ, Ocampo W, Southern DA, et al. Evaluation of an electronic health record structured discharge
summary to provide real time adverse event reporting in tho…
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psnet.ahrq.gov/node/45733/psn-pdf
December 07, 2016 - Global patient outcomes after elective surgery:
prospective cohort study in 27 low-, middle- and high-
income countries.
December 7, 2016
group ISOS. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle-
and high-income countries. Br J Anaesth. 2016;117(5):601-609. doi:10.109…
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psnet.ahrq.gov/node/72643/psn-pdf
January 13, 2021 - Ockenden Report. Emerging Fndings and
Recommendations from the Independent Review of
Maternity Services at the Shrewsbury and Telford
Hospital NHS Trust.
January 13, 2021
London UK: Crown Copyright; December 10, 2020. ISBN: 9781528623049.
https://psnet.ahrq.gov/issue/ockenden-report-emerging-fndings-a…