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psnet.ahrq.gov/issue/development-tool-within-electronic-medical-record-facilitate-medication-reconciliation-after
June 09, 2011 - Study
Development of a tool within the electronic medical record to facilitate medication reconciliation after hospital discharge.
Citation Text:
Schnipper JL, Liang CL, Hamann C, et al. Development of a tool within the electronic medical record to facilitate medication reconciliation …
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psnet.ahrq.gov/issue/user-centered-collaborative-design-and-development-inpatient-safety-dashboard
July 24, 2017 - Commentary
User-centered collaborative design and development of an inpatient safety dashboard.
Citation Text:
Mlaver E, Schnipper JL, Boxer RB, et al. User-Centered Collaborative Design and Development of an Inpatient Safety Dashboard. Jt Comm J Qual Patient Saf. 2017;43(12):676-685. do…
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psnet.ahrq.gov/issue/search-common-ground-handoff-documentation-intensive-care-unit
March 23, 2011 - Study
In search of common ground in handoff documentation in an intensive care unit.
Citation Text:
Collins S, Mamykina L, Jordan D, et al. In search of common ground in handoff documentation in an Intensive Care Unit. J Biomed Inform. 2012;45(2):307-15. doi:10.1016/j.jbi.2011.11.007. …
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psnet.ahrq.gov/issue/multidisciplinary-approaches-reducing-error-and-risk-patient-care-setting
January 05, 2017 - Study
Classic
Multidisciplinary approaches to reducing error and risk in a patient care setting.
Citation Text:
Connor M, Ponte PR, Conway JB. Multidisciplinary approaches to reducing error and risk in a patient care setting. Crit Care Nurs Clin North Am. 2002…
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psnet.ahrq.gov/web-mm/mixup-beyond-medication-label
June 01, 2014 - Despite extensive diagnostic workup during the current admission, physicians could not identify the cause
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psnet.ahrq.gov/web-mm/walking-patient-missing-drain
April 01, 2006 - A stat CT scan was ordered, which revealed extensive hydrocephalus.
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psnet.ahrq.gov/node/33860/psn-pdf
June 01, 2018 - Safety Considerations in Building a Point-of-Care
Ultrasound Program
June 1, 2018
Moore C. Safety Considerations in Building a Point-of-Care Ultrasound Program. PSNet [internet]. 2018.
https://psnet.ahrq.gov/perspective/safety-considerations-building-point-care-ultrasound-program
Perspective
At the American Colle…
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psnet.ahrq.gov/web-mm/under-pressure-delayed-diagnosis-compartment-syndrome-after-lower-leg-fracture
November 25, 2020 - muscles in the anterior compartment of the patient’s leg were gray, had no contractility, and required extensive … or reporting their symptoms (e.g., patients with altered mental status, pre-verbal children). 1 An extensive
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psnet.ahrq.gov/node/73334/psn-pdf
August 01, 2024 - An Inadvertent Bolus of Norepinephrine.
May 26, 2021
Fazio S, Blackmon E, Doroy A, et al. An Inadvertent Bolus of Norepinephrine. PSNet [internet]. 2021.
https://psnet.ahrq.gov/web-mm/inadvertent-bolus-norepinephrine
Disclosure of Relevant Financial Relationships: As a provider accredited by the Accreditation Counc…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.329_slideshow.ppt
August 01, 2014 - pathology
Systemic signs of NF may not correlate with the cutaneous signs and vice versa; patients with extensive
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psnet.ahrq.gov/node/49794/psn-pdf
May 01, 2017 - After extensive discussion, his family eventually decided to pursue comfort measures
only, and he died
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psnet.ahrq.gov/issue/hierarchy-and-medical-error-speaking-when-witnessing-error
April 14, 2011 - Review
Emerging Classic
Hierarchy and medical error: speaking up when witnessing an error.
Citation Text:
Peadon R (R), Hurley J, Hutchinson M. Hierarchy and medical error: speaking up when witnessing an error. Safety Sci. 2020;125:104648. doi:10.1016/j.ssci.202…
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psnet.ahrq.gov/issue/exploring-mediating-effects-between-nursing-leadership-and-patient-safety-person-centred
October 08, 2016 - Study
Exploring mediating effects between nursing leadership and patient safety from a person-centred perspective: a literature review.
Citation Text:
Wang M, Dewing J. Exploring mediating effects between nursing leadership and patient safety from a person‐centred perspective: a literatu…
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psnet.ahrq.gov/issue/world-health-organization-field-trial-assessing-proposed-icd-11-framework-classifying-patient
December 29, 2014 - Study
A World Health Organization field trial assessing a proposed ICD-11 framework for classifying patient safety events.
Citation Text:
Forster AJ, Bernard B, Drösler SE, et al. A World Health Organization field trial assessing a proposed ICD-11 framework for classifying patient safety…
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psnet.ahrq.gov/issue/are-we-heeding-warning-signs-examining-providers-overrides-computerized-drug-drug-interaction
September 01, 2016 - Study
Are we heeding the warning signs? Examining providers' overrides of computerized drug–drug interaction alerts in primary care.
Citation Text:
Slight SP, Seger DL, Nanji KC, et al. Are we heeding the warning signs? Examining providers' overrides of computerized drug-drug interaction…
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psnet.ahrq.gov/issue/how-guiding-coalitions-promote-positive-culture-change-hospitals-longitudinal-mixed-methods
February 21, 2018 - Study
How guiding coalitions promote positive culture change in hospitals: a longitudinal mixed methods interventional study.
Citation Text:
Bradley EH, Brewster AL, McNatt Z, et al. How guiding coalitions promote positive culture change in hospitals: a longitudinal mixed methods interve…
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psnet.ahrq.gov/issue/computerized-surveillance-adverse-drug-events-hospital-patients
March 27, 2005 - Study
Classic
Computerized surveillance of adverse drug events in hospital patients.
Citation Text:
Classen DC, Pestotnik SL, Evans RS, et al. Computerized surveillance of adverse drug events in hospital patients. JAMA. 1991;266(20):2847-51.
Copy Citation
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psnet.ahrq.gov/issue/weekend-effect-hospital-mortality-ischemic-and-hemorrhagic-stroke-us-rural-and-urban
January 19, 2022 - Study
Weekend effect on in-hospital mortality for ischemic and hemorrhagic stroke in US rural and urban hospitals.
Citation Text:
Mekonnen B, Wang G, Rajbhandari-Thapa J, et al. Weekend effect on in-hospital mortality for ischemic and hemorrhagic stroke in US rural and urban hospitals. J…
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psnet.ahrq.gov/node/72517/psn-pdf
November 25, 2020 - She
underwent a hysterectomy, bilateral salpingo-oophorectomy, and extensive resection of soft tissue … This patient had several other reasonable explanations for
hypotension, such as extensive intra-operative
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psnet.ahrq.gov/perspective/revising-teamstepps-evolution-patient-safety-teamwork-training
February 28, 2024 - We also conducted an extensive literature review.