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psnet.ahrq.gov/node/73206/psn-pdf
May 05, 2021 - Treatment patterns and clinical outcomes after the
introduction of the Medicare Sepsis Performance Measure
(SEP-1).
May 5, 2021
Barbash IJ, Davis BS, Yabes JG, et al. Treatment patterns and clinical outcomes after the introduction of
the Medicare Sepsis Performance Measure (SEP-1). Ann Intern Med. 2021;174(7):927-…
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psnet.ahrq.gov/node/838305/psn-pdf
October 12, 2022 - Hospital-acquired conditions reduction program, racial
and ethnic diversity, and Magnet designation in the
United States.
October 12, 2022
Boamah SA, Hamadi HY, Spaulding AC. Hospital-acquired conditions reduction program, racial and ethnic
diversity, and Magnet designation in the United States. J Patient Saf. 202…
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psnet.ahrq.gov/node/42588/psn-pdf
September 18, 2013 - Cognitive debiasing; part 1 and part 2.
September 18, 2013
Croskerry P, Singhal G, Mamede S. Cognitive debiasing 1: origins of bias and theory of debiasing. BMJ
Qual Saf. 2013;22 Suppl 2:ii58-ii64. doi:10.1136/bmjqs-2012-001712.
https://psnet.ahrq.gov/issue/cognitive-debiasing-part-1-and-part-2
Experienced diagnos…
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psnet.ahrq.gov/node/865876/psn-pdf
May 15, 2024 - Systematic review on the frequency and quality of
reporting patient and public involvement in patient safety
research.
May 15, 2024
Hammoud S, Alsabek L, Rogers L, et al. Systematic review on the frequency and quality of reporting
patient and public involvement in patient safety research. BMC Health Serv Res. 2024…
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psnet.ahrq.gov/node/842760/psn-pdf
January 18, 2023 - Self-reported gaps in care coordination and preventable
adverse outcomes among older adults receiving home
health care.
January 18, 2023
Sterling MR, Lau J, Rajan M, et al. Self?reported gaps in care coordination and preventable adverse
outcomes among older adults receiving home health care. J Am Geriatr Soc. 2023…
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psnet.ahrq.gov/node/865878/psn-pdf
May 15, 2024 - Testing an intervention to improve health care worker
well-being during the COVID-19 pandemic: a cluster
randomized clinical trial.
May 15, 2024
Meredith LS, Ahluwalia SC, Chen PG, et al. Testing an intervention to improve health care worker well-
being during the COVID-19 pandemic: a cluster randomized clinical t…
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psnet.ahrq.gov/node/42669/psn-pdf
September 27, 2017 - Patient-reported missed nursing care correlated with
adverse events.
September 27, 2017
Kalisch BJ, Xie B, Dabney BW. Patient-reported missed nursing care correlated with adverse events. Am J
Med Qual. 2014;29(5):415-22. doi:10.1177/1062860613501715.
https://psnet.ahrq.gov/issue/patient-reported-missed-nursing-car…
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psnet.ahrq.gov/node/60933/psn-pdf
September 23, 2020 - Seroprevalence of SARS-CoV-2 among frontline health
care personnel in a multistate hospital network--13
academic medical centers, April-June 2020.
September 23, 2020
Self WH, Tenforde MW, Stubblefield WB, et al. Seroprevalence of SARS-CoV-2 among frontline health
care personnel in a multistate hospital network - 1…
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psnet.ahrq.gov/node/43191/psn-pdf
December 12, 2018 - Harnessing implementation science to improve care
quality and patient safety: a systematic review of targeted
literature.
December 12, 2018
Braithwaite J, Marks D, Taylor N. Harnessing implementation science to improve care quality and patient
safety: a systematic review of targeted literature. Int J Qual Health C…
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psnet.ahrq.gov/node/50702/psn-pdf
December 04, 2019 - Smart pumps improve medication safety but increase
alert burden in neonatal care
December 4, 2019
Melton KR, Timmons K, Walsh KE, et al. Smart pumps improve medication safety but increase alert burden
in neonatal care. BMC Medical Inform Decis Mak. 2019;19(1):213. doi:10.1186/s12911-019-0945-2.
https://psnet.ahrq.…
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psnet.ahrq.gov/node/47322/psn-pdf
September 12, 2018 - Crossing the Global Quality Chasm: Improving Health
Care Worldwide.
September 12, 2018
Committee on Improving the Quality of Health Care Globally. National Academies of Sciences,
Engineering, and Medicine. Washington DC: National Academies Press; August 2018. ISBN:
9780309483087.
https://psnet.ahrq.gov/issue/cros…
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psnet.ahrq.gov/node/44965/psn-pdf
February 15, 2017 - Identification and Prioritization of Health IT Patient Safety
Measures.
February 15, 2017
Washington, DC: National Quality Forum; February 2016.
https://psnet.ahrq.gov/issue/identification-and-prioritization-health-it-patient-safety-measures
Health information technology (IT) has transformed health care and improv…
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psnet.ahrq.gov/node/47225/psn-pdf
November 02, 2018 - Preventable adverse drug events among inpatients: a
systematic review.
November 2, 2018
Gates PJ, Meyerson SA, Baysari M, et al. Preventable Adverse Drug Events Among Inpatients: A
Systematic Review. Pediatrics. 2018;142(3):e20180805. doi:10.1542/peds.2018-0805.
https://psnet.ahrq.gov/issue/preventable-adverse-dru…
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psnet.ahrq.gov/node/865344/psn-pdf
March 27, 2024 - Use of computerized physician order entry with clinical
decision support to prevent dose errors in pediatric
medication orders: a systematic review.
March 27, 2024
Ruutiainen H, Holmström A-R, Kunnola E, et al. Use of computerized physician order entry with clinical
decision support to prevent dose errors in pedia…
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psnet.ahrq.gov/node/73064/psn-pdf
March 24, 2021 - Outpatient insulin-related adverse events due to mix-up
errors: findings from two national surveillance systems,
United States, 2012-2017.
March 24, 2021
Geller AI, Conrad AO, Weidle NJ, et al. Outpatient insulin?related adverse events due to mix?up errors:
Findings from two national surveillance systems, United S…
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psnet.ahrq.gov/node/50793/psn-pdf
January 15, 2020 - Association between mobile telephone interruptions and
medication administration errors in a pediatric intensive
care unit.
January 15, 2020
Bonafide CP, Miller JM, Localio AR, et al. Association between mobile telephone interruptions and
medication administration errors in a pediatric intensive care unit. JAMA Pe…
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psnet.ahrq.gov/node/43446/psn-pdf
May 06, 2015 - A qualitative evaluation of the barriers and facilitators
toward implementation of the WHO surgical safety
checklist across hospitals in England: lessons from the
"Surgical Checklist Implementation Project."
May 6, 2015
Russ SJ, Sevdalis N, Moorthy K, et al. A qualitative evaluation of the barriers and facilitator…
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psnet.ahrq.gov/node/73434/psn-pdf
June 30, 2021 - The Consequences of Miscommunication Regarding a
Possible Artifact
June 30, 2021
Gwal K. The Consequences of Miscommunication Regarding a Possible Artifact. PSNet [internet]. 2021.
https://psnet.ahrq.gov/web-mm/consequences-miscommunication-regarding-possible-artifact
Disclosure of Relevant Financial Relationships…
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psnet.ahrq.gov/periodic-issue/periodic-issue-469
December 31, 2024 - January 8, 2025 Weekly Issue
PSNet highlights the latest patient safety literature, news, and expert commentary, including Weekly
Updates, WebM&M, and Perspectives on Safety. The current issue highlights what's new this week in patient
safety literature, news, conferences, reports…
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psnet.ahrq.gov/curated-library/patient-and-family-engagement-long-term-care
April 10, 2024 - Breadcrumb
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Created By: Lorri Zipperer, C…