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psnet.ahrq.gov/node/837338/psn-pdf
June 08, 2022 - Healthcare-related infections within nursing homes
(NHS): a qualitative study of care practices based on a
systemic approach.
June 8, 2022
Lefosse G, Rasero L, Bellandi T, et al. Healthcare-related infections within nursing homes (NHS): A
qualitative study of care practices based on a systemic approach. J Patient …
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psnet.ahrq.gov/node/34921/psn-pdf
February 27, 2009 - A controlled trial of smart infusion pumps to improve
medication safety in critically ill patients.
February 27, 2009
Rothschild JM, Keohane C, Cook F, et al. A controlled trial of smart infusion pumps to improve medication
safety in critically ill patients. Crit Care Med. 2005;33(3):533-540.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/72590/psn-pdf
December 23, 2020 - Effects of night surgery on postoperative mortality and
morbidity: a multicentre cohort study.
December 23, 2020
Althoff FC, Wachtendorf LJ, Rostin P, et al. Effects of night surgery on postoperative mortality and
morbidity: a multicentre cohort study. BMJ Qual Saf. 2020;30(8):678-688. doi:10.1136/bmjqs-2020-011684…
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psnet.ahrq.gov/node/845302/psn-pdf
March 01, 2023 - Reducing preventable adverse events in obstetrics by
improving interprofessional communication skills--results
of an intervention study.
March 1, 2023
Hüner B, Derksen C, Schmiedhofer M, et al. Reducing preventable adverse events in obstetrics by
improving interprofessional communication skills – results of an int…
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psnet.ahrq.gov/node/838913/psn-pdf
October 26, 2022 - Communication during interhospital transfers of
emergency general surgery patients: a qualitative study
of challenges and opportunities.
October 26, 2022
Alagoz E, Saucke M, Arroyo N, et al. Communication during interhospital transfers of emergency general
surgery patients: a qualitative study of challenges and op…
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psnet.ahrq.gov/node/46575/psn-pdf
December 13, 2017 - Economic evaluation of pharmacist-led medication
reviews in residential aged care facilities.
December 13, 2017
Hasan SS, Thiruchelvam K, Kow CS, et al. Economic evaluation of pharmacist-led medication reviews in
residential aged care facilities. Expert Rev Pharmacoecon Outcomes Res. 2017;17(5):431-439.
doi:10.108…
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psnet.ahrq.gov/node/73485/psn-pdf
July 14, 2021 - The RCA ReCAst: a root cause analysis simulation for the
interprofessional clinical learning environment.
July 14, 2021
Ziemba JB, Berns JS, Huzinec JG, et al. The RCA ReCAst: a root cause analysis simulation for the
interprofessional clinical learning environment. Acad Med. 2021;96(7):997-1001.
doi:10.1097/acm.00…
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psnet.ahrq.gov/node/45768/psn-pdf
July 02, 2017 - What patients' complaints and praise tell the health
practitioner: implications for health care quality. A
qualitative research study.
July 2, 2017
Mattarozzi K, Sfrisi F, Caniglia F, et al. What patients' complaints and praise tell the health practitioner:
implications for health care quality. A qualitative resea…
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psnet.ahrq.gov/node/857456/psn-pdf
December 06, 2023 - When mistakes multiply: how inadequate responses to
medical mishaps erode trust in American medicine.
December 6, 2023
Schlesinger M, Grob R. When mistakes multiply: how inadequate responses to medical mishaps erode
trust in American medicine. Hastings Cent Rep. 2023;53(S2):s22-s32. doi:10.1002/hast.1520.
https://…
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psnet.ahrq.gov/node/42626/psn-pdf
October 02, 2013 - Improving patient safety in the ICU by prospective
identification of missing safety barriers using the Bow-Tie
prospective risk analysis model.
October 2, 2013
Kerckhoffs MC, van der Sluijs AF, Binnekade JM, et al. Improving Patient Safety in the ICU by Prospective
Identification of Missing Safety Barriers Using t…
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psnet.ahrq.gov/node/44950/psn-pdf
March 02, 2016 - Providers contextualise care more often when they
discover patient context by asking: meta-analysis of three
primary data sets.
March 2, 2016
Schwartz A, Weiner SJ, Binns-Calvey A, et al. Providers contextualise care more often when they discover
patient context by asking: meta-analysis of three primary data sets.…
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psnet.ahrq.gov/node/46184/psn-pdf
January 01, 2018 - A prospective risk assessment of informal carers'
medication administration errors within the domiciliary
setting.
December 19, 2017
Parand A, Faiella G, Franklin BD, et al. A prospective risk assessment of informal carers' medication
administration errors within the domiciliary setting. Ergonomics. 2018;61(1):104…
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psnet.ahrq.gov/node/844545/psn-pdf
February 15, 2023 - Providers' and patients' perspectives on diagnostic errors
in the acute care setting.
February 15, 2023
Schnock KO, Garber A, Fraser H, et al. Providers' and patients' perspectives on diagnostic errors in the
acute care setting. Jt Comm J Qual Patient Saf. 2023;49(2):89-97. doi:10.1016/j.jcjq.2022.11.009.
https://…
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www.ahrq.gov/evidencenow/tools/health-it-tools.html
April 01, 2022 - Using Health Information Technology (IT) for Primary Care Quality Improvement (QI)
Resource: Using Health Information Technology to Support Quality Improvement in Primary Care (PDF, 795 KB, 25 pages)
Using electronic health records and other types of health information technology improves primary care pract…
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psnet.ahrq.gov/node/838911/psn-pdf
October 26, 2022 - Medication adverse events in the ambulatory setting: a
mixed-methods analysis.
October 26, 2022
Wong J, Lee S-Y, Sarkar U, et al. Medication adverse events in the ambulatory setting: a mixed-methods
analysis. Am J Health Syst Pharm. 2022;79(24):2230-2243. doi:10.1093/ajhp/zxac253.
https://psnet.ahrq.gov/issue/medi…
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psnet.ahrq.gov/node/45518/psn-pdf
January 01, 2021 - Patient safety incidents and adverse events in ambulatory
dental care: a systematic scoping review.
October 5, 2016
Ensaldo-Carrasco E, Suarez-Ortegon MF, Carson-Stevens A, et al. Patient Safety Incidents and Adverse
Events in Ambulatory Dental Care: A Systematic Scoping Review. J Patient Saf. 2021;17(5):381-391.
…
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psnet.ahrq.gov/node/849605/psn-pdf
May 31, 2023 - Identification of patient safety threats in a post-intensive
care clinic.
May 31, 2023
Karlic KJ, Valley TS, Cagino LM, et al. Identification of patient safety threats in a post-intensive care clinic.
Am J Med Qual. 2023;38(3):117-121. doi:10.1097/jmq.0000000000000118.
https://psnet.ahrq.gov/issue/identification-p…
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psnet.ahrq.gov/node/851656/psn-pdf
July 26, 2023 - Investigation of urology intraoperative events leading to
root cause analysis at national VA medical centers.
July 26, 2023
Peard LM, Teplitsky S, Annabathula A, et al. Can J Urol. 2023;30(2):11467-11472.
https://psnet.ahrq.gov/issue/investigation-urology-intraoperative-events-leading-root-cause-analysis-
national…
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psnet.ahrq.gov/node/844046/psn-pdf
February 08, 2023 - Patient safety culture: the impact on workplace violence
and health worker burnout.
February 8, 2023
Kim S, Kitzmiller R, Baernholdt MB, et al. Patient safety culture: the impact on workplace violence and
health worker burnout. Workplace Health Saf. 2022;71(2):78-88. doi:10.1177/21650799221126364.
https://psnet.ah…
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psnet.ahrq.gov/node/865666/psn-pdf
April 24, 2024 - Why do nurses miss nursing care? A qualitative meta-
synthesis.
April 24, 2024
Peng M, Saito S, Mo W, et al. Why do nurses miss nursing care? A qualitative meta?synthesis. Jpn J Nurs
Sci. 2024;21(2):e12578. doi:10.1111/jjns.12578.
https://psnet.ahrq.gov/issue/why-do-nurses-miss-nursing-care-qualitative-meta-synthe…