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psnet.ahrq.gov/node/837983/psn-pdf
August 31, 2022 - Identifying and Understanding Ways to Address the
Impact of Racism on Patient Safety in Health Care
Settings.
August 31, 2022
Schulson LB, Thomas AD, Tsuei J, et al. Santa Monica, CA: RAND Corporation; 2022
https://psnet.ahrq.gov/issue/identifying-and-understanding-ways-address-impact-racism-patient-safety-
…
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psnet.ahrq.gov/node/44406/psn-pdf
December 04, 2016 - Drug manufacturers' delayed disclosure of serious and
unexpected adverse events to the US Food and Drug
Administration.
December 4, 2016
Ma P, Marinovic I, Karaca-Mandic P. Drug Manufacturers' Delayed Disclosure of Serious and Unexpected
Adverse Events to the US Food and Drug Administration. JAMA Intern Med. 2015;…
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psnet.ahrq.gov/node/44490/psn-pdf
September 16, 2015 - Implementation of a custom alert to prevent medication-
timing errors associated with computerized prescriber
order entry.
September 16, 2015
Idemoto LM, Williams BL, Ching JM, et al. Implementation of a custom alert to prevent medication-timing
errors associated with computerized prescriber order entry. Am J Heal…
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psnet.ahrq.gov/node/854830/psn-pdf
January 01, 2024 - The effect of evidence in crisis learning: based on a
perspective integration framework.
October 25, 2023
Wang B, Li D, Wang Y. The effect of evidence in crisis learning: based on a perspective integration
framework. J Contingencies Crisis Manag. 2024;32(1):e12506. doi:10.1111/1468-5973.12506.
https://psnet.ahrq.g…
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psnet.ahrq.gov/node/838146/psn-pdf
September 21, 2022 - HSIB Maternity Investigation Programme Year in Review
2021/22. Summary of Highlights, Themes and Future
Work.
September 21, 2022
Farnborough, UK: Healthcare Safety Investigation Branch; 2022.
https://psnet.ahrq.gov/issue/hsib-maternity-investigation-programme-year-review-202122-summary-
highlights-themes-and
Thi…
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psnet.ahrq.gov/node/46496/psn-pdf
October 11, 2017 - Lessons learned for reducing the negative impact of
adverse events on patients, health professionals and
healthcare organizations.
October 11, 2017
Mira JJ, Lorenzo S, Carrillo I, et al. Lessons learned for reducing the negative impact of adverse events on
patients, health professionals and healthcare organization…
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psnet.ahrq.gov/node/837060/psn-pdf
May 11, 2022 - Clinician distress and inappropriate antibiotic prescribing
for acute respiratory tract infections: a retrospective
cohort study.
May 11, 2022
Brady KJS, Barlam TF, Trockel MT, et al. Clinician distress and inappropriate antibiotic prescribing for
acute respiratory tract infections: a retrospective cohort study. J…
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psnet.ahrq.gov/node/44156/psn-pdf
November 10, 2015 - Exploring the role of communications in quality
improvement: a case study of the 1000 Lives Campaign in
NHS Wales.
November 10, 2015
Cooper A, Gray J, Willson A, et al. Exploring the role of communications in quality improvement: A case
study of the 1000 Lives Campaign in NHS Wales. J Commun Healthc. 2015;8(1):76-…
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psnet.ahrq.gov/node/74169/psn-pdf
December 08, 2021 - Pointing fingers: verbosity of patient safety narratives is
associated with attribution of blame.
December 8, 2021
Ackerman RS, Patel SY, Costache M, et al. Anesthesiology News. November 21, 2021.
https://psnet.ahrq.gov/issue/pointing-fingers-verbosity-patient-safety-narratives-associated-attribution-
bl…
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psnet.ahrq.gov/node/47837/psn-pdf
May 11, 2019 - Association of hospital employee satisfaction with patient
safety and satisfaction within Veterans Affairs medical
centers.
May 11, 2019
Kang R, Kunkel ST, Columbo JA, et al. Association of Hospital Employee Satisfaction with Patient Safety
and Satisfaction within Veterans Affairs Medical Centers. Am J Med. 2019;1…
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psnet.ahrq.gov/node/37077/psn-pdf
October 03, 2011 - Sensemaking, safety, and cooperative work in the
intensive care unit.
October 3, 2011
Albolino S, Cook RI, O’Connor M. Sensemaking, safety, and cooperative work in the intensive care unit.
Cog Tech Work. 2006;9(3):131-137. doi:10.1007/s10111-006-0057-5.
https://psnet.ahrq.gov/issue/sensemaking-safety-and-cooperati…
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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/48094/psn-pdf
June 19, 2019 - New persistent opioid use after postoperative intensive
care in US veterans.
June 19, 2019
Karamchandani K, Pyati S, Bryan W, et al. New Persistent Opioid Use After Postoperative Intensive Care
in US Veterans. JAMA Surg. 2019;154(8):778-780. doi:10.1001/jamasurg.2019.0899.
https://psnet.ahrq.gov/issue/new-persiste…
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psnet.ahrq.gov/node/837306/psn-pdf
June 01, 2022 - Mortality due to hospital-acquired infection after cardiac
surgery.
June 1, 2022
Massart N, Mansour A, Ross JT, et al. Mortality due to hospital-acquired infection after cardiac surgery. J
Thorac Cardiovasc Surg. 2022;163(6):2131-2140.e3. doi:10.1016/j.jtcvs.2020.08.094.
https://psnet.ahrq.gov/issue/mortality-due-…
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psnet.ahrq.gov/node/44536/psn-pdf
November 11, 2015 - Healthcare system intervention for safer use of medicines
in elderly patients in primary care—a qualitative study of
the participants' perceptions of self-assessment, peer
review, feedback and agreement for change.
November 11, 2015
Lenander C, Bondesson Å, Midlöv P, et al. Healthcare system intervention for safer…
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www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-prophylaxis-myocardial-infarction-preventive-medication-1996
January 01, 1996 - Share to Facebook
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Final Recommendation Statement
Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication, 1996
January 01, 1996
Recommendations …
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psnet.ahrq.gov/node/49729/psn-pdf
April 01, 2015 - Dissecting the Presentation
April 1, 2015
Suat-Ooi SB. Dissecting the Presentation. PSNet [internet]. 2015.
https://psnet.ahrq.gov/web-mm/dissecting-presentation
Case Objectives
Define aortic dissection.
Describe the epidemiology of acute aortic dissection.
State the common and uncommon presentation of acute aor…
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www.ahrq.gov/sites/default/files/2024-10/mchugh-report.pdf
January 01, 2024 - Final Progress Report: Nurse Staffing Policy, Hospital Occupancy, Market Structure, and Patient Outcomes
Final Progress Report
Title: Nurse Staffing Policy, Hospital Occupancy, Market Structure, and Patient Outcomes
Principal Investigator: Matthew D. McHugh
Team Members: Linda H. Aiken (primary mentor); Jeffrey H.…
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psnet.ahrq.gov/curated-library/organizational-learning
August 11, 2025 - Breadcrumb
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Created By: Lorri Zipperer, Cybrarian, AHRQ PSNet Team…
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psnet.ahrq.gov/primer/simulation-training
September 15, 2024 - Simulation Training
Citation Text:
Edward JJ, Nichols A, Bakerjian D. Simulation Training. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2023.
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