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Showing results for "failures".

  1. psnet.ahrq.gov/issue/usage-and-accuracy-medication-data-nationwide-health-information-exchange-quebec-canada
    June 17, 2020 - Study Usage and accuracy of medication data from nationwide health information exchange in Quebec, Canada. Citation Text: Motulsky A, Weir DL, Couture I, et al. Usage and accuracy of medication data from nationwide health information exchange in Quebec, Canada. J Am Med Inform Assoc. 201…
  2. psnet.ahrq.gov/issue/how-improve-delivery-medication-alerts-within-computerized-physician-order-entry-systems
    October 30, 2013 - Study How to improve the delivery of medication alerts within computerized physician order entry systems: an international Delphi study. Citation Text: Riedmann D, Jung M, Hackl WO, et al. How to improve the delivery of medication alerts within computerized physician order entry systems:…
  3. psnet.ahrq.gov/issue/randomized-controlled-trial-pictogram-based-intervention-reduce-liquid-medication-dosing
    June 04, 2014 - Study Randomized controlled trial of a pictogram-based intervention to reduce liquid medication dosing errors and improve adherence among caregivers of young children.  Citation Text: Yin S, Dreyer BP, van Schaick L, et al. Randomized controlled trial of a pictogram-based intervention …
  4. psnet.ahrq.gov/issue/systematic-review-strategies-reporting-neonatal-hospital-acquired-bloodstream-infections
    January 09, 2018 - Review A systematic review of strategies for reporting of neonatal hospital–acquired bloodstream infections. Citation Text: Folgori L, Bielicki J, Sharland M. A systematic review of strategies for reporting of neonatal hospital-acquired bloodstream infections. Arch Dis Child Fetal Neon…
  5. psnet.ahrq.gov/issue/assigning-team-based-pager-call-physicians-reduces-paging-errors-large-academic-hospital
    April 26, 2023 - Study Assigning a team-based pager for on-call physicians reduces paging errors in a large academic hospital. Citation Text: Shieh L, Chi J, Kulik C, et al. Assigning a team-based pager for on-call physicians reduces paging errors in a large academic hospital. Jt Comm J Qual Patient Saf.…
  6. psnet.ahrq.gov/issue/we-cant-get-along-without-each-other-qualitative-interviews-physicians-about-device-industry
    March 07, 2018 - Study "We can't get along without each other": qualitative interviews with physicians about device industry representatives, conflict of interest and patient safety. Citation Text: Gagliardi AR, Lehoux P, Ducey A, et al. "We can't get along without each other": Qualitative interviews wit…
  7. psnet.ahrq.gov/issue/medication-misadventures-resulting-emergency-department-visits-hmo-medical-center
    March 16, 2022 - Study Classic Medication misadventures resulting in emergency department visits at an HMO medical center. Citation Text: Medication misadventures resulting in emergency department visits at an HMO medical center. Schneitman-McIntire O, Farnen TA, Gordon N, et al…
  8. psnet.ahrq.gov/issue/activation-medical-emergency-team-using-electronic-medical-recording-based-screening-system
    September 06, 2017 - Study Activation of a medical emergency team using an electronic medical recording–based screening system. Citation Text: Huh JW, Lim C-M, Koh Y, et al. Activation of a medical emergency team using an electronic medical recording-based screening system*. Crit Care Med. 2014;42(4):801-8. …
  9. psnet.ahrq.gov/issue/systematic-review-evaluate-accuracy-electronic-adverse-drug-event-detection
    October 05, 2011 - Study A systematic review to evaluate the accuracy of electronic adverse drug event detection. Citation Text: Forster AJ, Jennings A, Chow C, et al. A systematic review to evaluate the accuracy of electronic adverse drug event detection. J Am Med Inform Assoc. 2012;19(1):31-8. doi:10.113…
  10. psnet.ahrq.gov/issue/patient-safety-orthopedic-surgery-prioritizing-key-areas-iatrogenic-harm-through-analysis
    December 18, 2013 - Study Patient safety in orthopedic surgery: prioritizing key areas of iatrogenic harm through an analysis of 48,095 incidents reported to a national database of errors. Citation Text: Panesar S, Carson-Stevens A, Salvilla SA, et al. Patient safety in orthopedic surgery: prioritizing ke…
  11. psnet.ahrq.gov/issue/wolf-crying-operating-room-patient-monitor-and-anesthesia-workstation-alarming-patterns
    April 17, 2013 - Study The wolf is crying in the operating room: patient monitor and anesthesia workstation alarming patterns during cardiac surgery. Citation Text: Schmid F, Goepfert MS, Kuhnt D, et al. The wolf is crying in the operating room: patient monitor and anesthesia workstation alarming patte…
  12. psnet.ahrq.gov/issue/emotional-harm-radiology-department-analysis-underrecognized-preventable-error
    March 06, 2019 - Study Emotional harm in the radiology department: analysis of an underrecognized preventable error. Citation Text: Siewert B, Swedeen S, Brook OR, et al. Emotional harm in the radiology department: analysis of an underrecognized preventable error. Radiology. 2022;302(3):613-619. doi:10.1…
  13. psnet.ahrq.gov/issue/electronic-checklist-improves-transfer-and-retention-critical-information-intraoperative
    July 21, 2021 - Study An electronic checklist improves transfer and retention of critical information at intraoperative handoff of care. Citation Text: Agarwala A, Firth PG, Albrecht MA, et al. An electronic checklist improves transfer and retention of critical information at intraoperative handoff of c…
  14. psnet.ahrq.gov/issue/using-data-matrix-coded-sponge-counting-system-across-surgical-practice-impact-after-18
    January 02, 2017 - Study Using a data-matrix–coded sponge counting system across a surgical practice: impact after 18 months. Citation Text: Cima RR, Kollengode A, Clark J, et al. Using a data-matrix-coded sponge counting system across a surgical practice: impact after 18 months. Jt Comm J Qual Patient S…
  15. psnet.ahrq.gov/issue/coordinating-care-across-diseases-settings-and-clinicians-key-role-generalist-practice
    July 01, 2020 - Review Coordinating care across diseases, settings, and clinicians: a key role for the generalist in practice. Citation Text: Stille CJ, Jerant A, Bell D, et al. Coordinating care across diseases, settings, and clinicians: a key role for the generalist in practice. Ann Intern Med. 2005…
  16. psnet.ahrq.gov/issue/we-thought-we-would-be-perfect-medication-errors-and-after-initiation-computerized-physician
    September 18, 2019 - Study We thought we would be perfect: medication errors before and after the initiation of computerized physician order entry. Citation Text: Schwartzberg D, Ivanovic S, Patel S, et al. We thought we would be perfect: medication errors before and after the initiation of Computerized Phys…
  17. psnet.ahrq.gov/issue/impact-computerized-physician-order-entry-system-compliance-prescription-accuracy
    May 27, 2011 - Study Impact of a computerized physician order entry system on compliance with prescription accuracy requirements. Citation Text: Mir C, Gadri A, Zelger GL, et al. Impact of a computerized physician order entry system on compliance with prescription accuracy requirements. Pharm World Sc…
  18. psnet.ahrq.gov/issue/we-need-talk-primary-care-provider-communication-discharge-era-shared-electronic-medical
    October 13, 2018 - Study We need to talk: primary care provider communication at discharge in the era of a shared electronic medical record. Citation Text: Sheu L, Fung K, Mourad M, et al. We need to talk: Primary care provider communication at discharge in the era of a shared electronic medical record. J …
  19. psnet.ahrq.gov/issue/novel-analysis-clinically-relevant-diagnostic-errors-point-care-devices
    June 21, 2016 - Study Novel analysis of clinically relevant diagnostic errors in point-of-care devices. Citation Text: Shermock KM, Streiff MB, Pinto BL, et al. Novel analysis of clinically relevant diagnostic errors in point-of-care devices. J Thromb Haemost. 2011;9(9):1769-1775. doi:10.1111/j.1538-7…
  20. psnet.ahrq.gov/issue/reasons-repeat-rapid-response-team-calls-and-associations-hospital-mortality
    March 03, 2020 - Study Reasons for repeat rapid response team calls, and associations with in-hospital mortality. Citation Text: Chalwin R, Giles L, Salter A, et al. Reasons for Repeat Rapid Response Team Calls, and Associations with In-Hospital Mortality. Jt Comm J Qual Patient Saf. 2019;45(4):268-275. …