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5941. Implementing the World Health Organization surgical safety checklist: a model for future perioperative initiatives. | PSNet
      psnet.ahrq.gov/issue/implementing-world-health-organization-surgical-safety-checklist-model-future-perioperative
      March 30, 2022 - Commentary Implementing the World Health Organization surgical safety checklist: a model for future perioperative initiatives. Citation Text: Styer KA, Ashley SW, Schmidt I, et al. Implementing the World Health Organization surgical safety checklist: a model for future perioperative in…

5942. Five new ways to advance diagnostic safety in your clinical practice. | PSNet
      psnet.ahrq.gov/issue/five-new-ways-advance-diagnostic-safety-your-clinical-practice
      June 30, 2021 - Commentary Five new ways to advance diagnostic safety in your clinical practice. Citation Text: Five new ways to advance diagnostic safety in your clinical practice. Bradford A, Goeschel C, Shofer M, et al. Am Fam Physician. 2023;108(1):14-16. Copy Citation Save …

5943. Adolescent use of insulin and patient-controlled analgesia pump technology: a 10-year Food and Drug Administration retrospective study of adverse events. | PSNet
      psnet.ahrq.gov/issue/adolescent-use-insulin-and-patient-controlled-analgesia-pump-technology-10-year-food-and-drug
      February 13, 2008 - Study Adolescent use of insulin and patient-controlled analgesia pump technology: a 10-year Food and Drug Administration retrospective study of adverse events. Citation Text: Cope JU, Morrison AE, Samuels-Reid J. Adolescent use of insulin and patient-controlled analgesia pump technolog…

5944. Adverse event protocol for interventional pain medicine: the importance of an organized response. | PSNet
      psnet.ahrq.gov/issue/adverse-event-protocol-interventional-pain-medicine-importance-organized-response
      January 12, 2022 - Study Adverse event protocol for interventional pain medicine: the importance of an organized response. Citation Text: Sitzman BT. Adverse Event Protocol for Interventional Pain Medicine: The Importance of an Organized Response. Pain Medicine. 2008;9(suppl 1). doi:10.1111/j.1526-4637.2…

5945. Medical students' experiences with medical errors: an analysis of medical student essays. | PSNet
      psnet.ahrq.gov/issue/medical-students-experiences-medical-errors-analysis-medical-student-essays
      June 22, 2022 - Study Medical students' experiences with medical errors: an analysis of medical student essays. Citation Text: Martinez W, Lo B. Medical students' experiences with medical errors: an analysis of medical student essays. Med Educ. 2008;42(7):733-41. doi:10.1111/j.1365-2923.2008.03109.x. …

5946. Residual anaesthesia drugs in intravenous lines—a silent threat? | PSNet
      psnet.ahrq.gov/issue/residual-anaesthesia-drugs-intravenous-lines-silent-threat
      July 13, 2010 - Commentary Residual anaesthesia drugs in intravenous lines—a silent threat? Citation Text: Bowman S, Raghavan K, Walker IA. Residual anaesthesia drugs in intravenous lines--a silent threat? Anaesthesia. 2013;68(6):557-61. doi:10.1111/anae.12287. Copy Citation Format: DOI G…

5947. Characteristics of patients misdiagnosed with Alzheimer's disease and their medication use: an analysis of the NACC-UDS database. | PSNet
      psnet.ahrq.gov/issue/characteristics-patients-misdiagnosed-alzheimers-disease-and-their-medication-use-analysis
      June 16, 2011 - Study Characteristics of patients misdiagnosed with Alzheimer's disease and their medication use: an analysis of the NACC-UDS database. Citation Text: Gaugler JE, Ascher-Svanum H, Roth DL, et al. Characteristics of patients misdiagnosed with Alzheimer's disease and their medication use:…

5948. Using the ABCs of situational awareness for patient safety. | PSNet
      psnet.ahrq.gov/issue/using-abcs-situational-awareness-patient-safety
      November 16, 2022 - Commentary Using the ABCs of situational awareness for patient safety. Citation Text: Cohen NL. Using the ABCs of situational awareness for patient safety. Nursing (Brux). 2013;43(4):64-5. doi:10.1097/01.NURSE.0000428332.23978.82. Copy Citation Format: DOI Google Scholar…

5949. From heroism to safe design: leveraging technology. | PSNet
      psnet.ahrq.gov/issue/heroism-safe-design-leveraging-technology
      August 17, 2017 - Commentary From heroism to safe design: leveraging technology. Citation Text: Pronovost P, Bo-Linn GW, Sapirstein A. From heroism to safe design: leveraging technology. Anesthesiology. 2014;120(3):526-9. doi:10.1097/ALN.0000000000000127. Copy Citation Format: DOI Google S…

5950. Evaluating a handheld decision support device in pediatric intensive care settings. | PSNet
      psnet.ahrq.gov/issue/evaluating-handheld-decision-support-device-pediatric-intensive-care-settings
      January 18, 2023 - Study Evaluating a handheld decision support device in pediatric intensive care settings. Citation Text: Evaluating a handheld decision support device in pediatric intensive care settings. Reynolds TL, DeLucia PR, Esquibel KA, et al. JAMIA Open. 2019;2:49-61. Copy Citation …

5951. Trends in anesthesia-related liability and lessons learned. | PSNet
      psnet.ahrq.gov/issue/trends-anesthesia-related-liability-and-lessons-learned
      August 22, 2018 - Review Trends in anesthesia-related liability and lessons learned. Citation Text: Mora JC, Kaye AD, Romankowski ML, et al. Trends in Anesthesia-Related Liability and Lessons Learned. Adv Anesth. 2018;36(1):231-249. doi:10.1016/j.aan.2018.07.009. Copy Citation Format: DOI Go…

5952. The organizational and intraorganizational development of disasters. | PSNet
      psnet.ahrq.gov/issue/organizational-and-intraorganizational-development-disasters
      May 12, 2021 - Review Classic The organizational and intraorganizational development of disasters. Citation Text: Turner BA. The Organizational and Interorganizational Development of Disasters. Adm Sci Q. 1976;21(3):378. doi:10.2307/2391850. Copy Citation Format: …

5953. Reducing administrative harm in medicine - clinicians and administrators together. | PSNet
      psnet.ahrq.gov/issue/reducing-administrative-harm-medicine-clinicians-and-administrators-together
      February 23, 2022 - Commentary Reducing administrative harm in medicine - clinicians and administrators together. Citation Text: O’Donnell WJ. Reducing administrative harm in medicine - clinicians and administrators together. N Engl J Med. 2022;386(25):2429-2432. doi:10.1056/nejmms2202174. Copy Citation …

5954. Adult Non-ICUs | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/cusp/clabsi-final-companion/clabsicomp4a.html
      January 01, 2013 - Eliminating CLABSI, A National Patient Safety Imperative: Final Report Companion Guide Adult Non-ICUs Previous Page Next Page Table of Contents Eliminating CLABSI, A National Patient Safety Imperative: Final Report Companion Guide Preface Methods Participation Outcomes Adult Non-ICUs Ped…

5955. The simulated ward: ideal for training clinical clerks in an era of patient safety. | PSNet
      psnet.ahrq.gov/issue/simulated-ward-ideal-training-clinical-clerks-era-patient-safety
      July 27, 2022 - Study The simulated ward: ideal for training clinical clerks in an era of patient safety. Citation Text: Mollo EA, Reinke CE, Nelson C, et al. The simulated ward: ideal for training clinical clerks in an era of patient safety. J Surg Res. 2012;177(1):e1-6. doi:10.1016/j.jss.2012.03.050…

5956. Weekend versus weekday admission and mortality from myocardial infarction. | PSNet
      psnet.ahrq.gov/issue/weekend-versus-weekday-admission-and-mortality-myocardial-infarction
      February 18, 2011 - Study Weekend versus weekday admission and mortality from myocardial infarction. Citation Text: Kostis WJ, Demissie K, Marcella SW, et al. Weekend versus Weekday Admission and Mortality from Myocardial Infarction. New England Journal of Medicine. 2007;356(11). doi:10.1056/nejmoa063355.…

5957. Pressure Ulcer Prevention Toolkit (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module5/putoolkit_module5_tools.docx
      June 02, 2025 - Pressure Ulcer Prevention Toolkit Pressure Ulcer Prevention Toolkit Module 5 Tools Action Plan Tool to Measure Pressure Ulcer Rates and Pressure Ulcer Prevention Practices Tool 5C: Assessing Comprehensive Skin Assessment Tool 5D: Assessing Standardized Risk Assessment Tool 5E: Assessing Care Planning AHRQ Pressure…

5958. Interruptions and medication administration in critical care. | PSNet
      psnet.ahrq.gov/issue/interruptions-and-medication-administration-critical-care
      December 08, 2021 - Review Interruptions and medication administration in critical care. Citation Text: Bower R, Jackson C, Manning JC. Interruptions and medication administration in critical care. Nurs Crit Care. 2015;20(4):183-95. doi:10.1111/nicc.12185. Copy Citation Format: DOI Google Scho…

5959. Unintentionally retained guidewires: a descriptive study of 73 sentinel events. | PSNet
      psnet.ahrq.gov/issue/unintentionally-retained-guidewires-descriptive-study-73-sentinel-events
      April 27, 2019 - Study Unintentionally retained guidewires: a descriptive study of 73 sentinel events. Citation Text: Steelman VM, Thenuwara K, Shaw C, et al. Unintentionally Retained Guidewires: A Descriptive Study of 73 Sentinel Events. Jt Comm J Qual Saf. 2019;45(2):81-90. doi:10.1016/j.jcjq.2018.08.0…

5960. Detection and measurement of rotator cuff tears with sonography: analysis of diagnostic errors. | PSNet
      psnet.ahrq.gov/issue/detection-and-measurement-rotator-cuff-tears-sonography-analysis-diagnostic-errors
      December 31, 2014 - Study Detection and measurement of rotator cuff tears with sonography: analysis of diagnostic errors. Citation Text: Teefey SA, Middleton WD, Payne WT, et al. Detection and measurement of rotator cuff tears with sonography: analysis of diagnostic errors. AJR Am J Roentgenol. 2005;184(6…