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psnet.ahrq.gov/primer/patient-safety-101
January 16, 2025 - Lucian Leape highlighted the issue and presented a framework for error analysis and prevention that is … include: Preventable adverse events: those due to error or failure to apply an accepted strategy for prevention
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psnet.ahrq.gov/node/33861/psn-pdf
July 01, 2018 - The thoracic surgeon said
I "shouldn't fall on my sword" because the delay didn't really change her … We have annual conferences, the 11th is coming up
this fall in New Orleans.
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psnet.ahrq.gov/web-mm/pains-chronic-opioid-usage
April 04, 2018 - serious adverse effects including death.( 1,19 ) In 2012, the Centers for Disease Control and Prevention … Patients with concurrent substance abuse and high risk for abusing the prescription opiates fall under … Centers for Disease Control and Prevention. … Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. … Centers for Disease Control and Prevention.
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psnet.ahrq.gov/node/846171/psn-pdf
July 26, 2022 - .16,17
Due to the high incidence of delirium among hospitalized patients, strategies for surveillance, prevention … ,
and management should be implemented for older adults.16,17 Delirium prevention and care bundles, … delirium or worsening agitation.19
Currently, there are no recommended pharmacologic treatments for prevention
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psnet.ahrq.gov/node/33798/psn-pdf
January 01, 2015 - patients believe clinicians should be held accountable for basic safety practices, such as
hand hygiene, fall … Nevertheless, the scope of behaviors that fall under individual accountability is still controversial
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psnet.ahrq.gov/node/49581/psn-pdf
March 21, 2009 - Organizations often develop error prevention strategies following a serious event that focus solely on … The
error occurs when individuals fall victim to the flaws within the system and mistakes are made.
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psnet.ahrq.gov/node/866217/psn-pdf
July 10, 2024 - We are interested in whole healthcare, quality of life, patient experience, and
prevention of patient … As we all experience healthcare, we consider how we can minimize unplanned care and
maximize prevention … Healthcare Effectiveness Data
and Information Set (HEDIS) measures that we use, including chronic care prevention
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psnet.ahrq.gov/node/33734/psn-pdf
August 01, 2012 - In Conversation With… Nicholas G. Castle, MHA, PhD
August 1, 2012
In Conversation With… Nicholas G. Castle, MHA, PhD. PSNet [internet]. 2012.
https://psnet.ahrq.gov/perspective/conversation-nicholas-g-castle-mha-phd
Editor's note: The topic of patient safety in long-term care facilities has not received the attent…
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psnet.ahrq.gov/node/33824/psn-pdf
January 01, 2016 - This year, the Centers for Disease Control and Prevention (CDC) reported a 200% increase
in opioid overdose
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psnet.ahrq.gov/issue/assessment-patient-medication-adherence-medical-record-accuracy-and-medication-blood
April 15, 2019 - August 4, 2021
A randomized trial of a multifactorial strategy to prevent serious fall
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psnet.ahrq.gov/issue/effect-distractions-operative-performance-and-ability-multitask-case-deliberate-practice
September 15, 2010 - Study
Effect of distractions on operative performance and ability to multitask—a case for deliberate practice.
Citation Text:
Ahmed A, Ahmad M, Stewart M, et al. Effect of distractions on operative performance and ability to multitask--a case for deliberate practice. Laryngoscope. 2015;1…
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psnet.ahrq.gov/issue/simulation-based-clinical-systems-testing-healthcare-spaces-intake-through-implementation
April 10, 2024 - Commentary
Emerging Classic
Simulation-based clinical systems testing for healthcare spaces: from intake through implementation.
Citation Text:
Colman N, Doughty C, Arnold J, et al. Simulation-based clinical systems testing for healthcare spaces: from intake thr…
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psnet.ahrq.gov/issue/err-human-disclosure-must-be-taught-simulation-based-assessment-study
August 04, 2021 - August 4, 2021
A randomized trial of a multifactorial strategy to prevent serious fall
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psnet.ahrq.gov/issue/handoff-tool-improves-transitions-operating-room-neonatal-intensive-care-unit
November 16, 2022 - January 15, 2025
A randomized trial of a multifactorial strategy to prevent serious fall
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psnet.ahrq.gov/issue/mobile-situ-obstetric-emergency-simulation-and-teamwork-training-improve-maternal-fetal
July 09, 2008 - December 19, 2018
A randomized trial of a multifactorial strategy to prevent serious fall
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psnet.ahrq.gov/issue/review-patient-safety-incidents-submitted-critical-care-units-england-wales-uk-national
July 16, 2008 - Study
Review of patient safety incidents submitted from critical care units in England & Wales to the UK National Patient Safety Agency.
Citation Text:
Thomas AN, Panchagnula U, Taylor RJ. Review of patient safety incidents submitted from Critical Care Units in England & Wales to the U…
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psnet.ahrq.gov/issue/how-many-too-many-using-cognitive-load-theory-determine-maximum-safe-number-inpatient
October 19, 2022 - March 15, 2023
A randomized trial of a multifactorial strategy to prevent serious fall
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psnet.ahrq.gov/issue/influence-standardisation-and-task-load-team-coordination-patterns-during-anaesthesia
November 05, 2008 - August 4, 2021
A randomized trial of a multifactorial strategy to prevent serious fall
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psnet.ahrq.gov/issue/utilization-role-based-head-covering-system-decrease-misidentification-operating-room
September 23, 2020 - September 23, 2020
A randomized trial of a multifactorial strategy to prevent serious fall
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psnet.ahrq.gov/issue/relationship-staff-information-sharing-and-advice-networks-patient-safety-outcomes
June 22, 2011 - Study
Relationship of staff information sharing and advice networks to patient safety outcomes.
Citation Text:
Brewer BB, Carley KM, Benham-Hutchins MM, et al. Relationship of Staff Information Sharing and Advice Networks to Patient Safety Outcomes. J Nurs Adm. 2018;48(9):437-444. doi:10…