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  1. A mediation skills model to manage disclosure of errors and adverse events to patients. | PSNet

    psnet.ahrq.gov/issue/mediation-skills-model-manage-disclosure-errors-and-adverse-events-patients
    May 31, 2017 - Commentary A mediation skills model to manage disclosure of errors and adverse events to patients. Citation Text: Liebman CB, Hyman CS. A Mediation Skills Model To Manage Disclosure Of Errors And Adverse Events To Patients. Health Aff (Millwood). 2004;23(4):22-32. doi:10.1377/hlthaff.2…

  2. Restoring trust in VA health care. | PSNet

    psnet.ahrq.gov/issue/restoring-trust-va-health-care
    June 21, 2016 - Commentary Restoring trust in VA health care. Citation Text: Kizer KW, Jha AK. Restoring trust in VA health care. N Engl J Med. 2014;371(4):295-297. doi:10.1056/NEJMp1406852. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged …

  3. Enteral feeding misconnections: a consortium position statement. | PSNet

    psnet.ahrq.gov/issue/enteral-feeding-misconnections-consortium-position-statement
    June 17, 2009 - Organizational Policy/Guidelines Enteral feeding misconnections: a consortium position statement. Citation Text: Guenter P, Hicks RW, Simmons D, et al. Enteral feeding misconnections: a consortium position statement. Jt Comm J Qual Patient Saf. 2008;34(5):285-92, 245. Copy Citation …

  4. Increasing demands for quality measurement. | PSNet

    psnet.ahrq.gov/issue/increasing-demands-quality-measurement
    November 16, 2022 - Commentary Increasing demands for quality measurement. Citation Text: Panzer RJ, Gitomer RS, Greene WH, et al. Increasing demands for quality measurement. JAMA. 2013;310(18):1971-80. doi:10.1001/jama.2013.282047. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNo…

  5. Theorizing about systems: an ecological task for patient safety research. | PSNet

    psnet.ahrq.gov/issue/theorizing-about-systems-ecological-task-patient-safety-research
    August 20, 2008 - Commentary Theorizing about systems: an ecological task for patient safety research. Citation Text: Marck PB. Theorizing About Systems. Clin Nurs Res. 2005;14(2). doi:10.1177/1054773804274255. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNote 7 XML En…

  6. Latent and active failures perfectly align to allow a preventable adverse event to reach a patient. | PSNet

    psnet.ahrq.gov/issue/latent-and-active-failures-perfectly-align-allow-preventable-adverse-event-reach-patient
    March 14, 2023 - Newspaper/Magazine Article Latent and active failures perfectly align to allow a preventable adverse event to reach a patient. Citation Text: Latent and active failures perfectly align to allow a preventable adverse event to reach a patient. ISMP Medication Safety Alert! Acute care editi…

  7. Airway carts: a systems-based approach to airway safety. | PSNet

    psnet.ahrq.gov/issue/airway-carts-systems-based-approach-airway-safety
    July 21, 2010 - Study Airway carts: a systems-based approach to airway safety. Citation Text: Kane BG, Bond WF, Worrilow CC, et al. Airway Carts. J Patient Saf. 2008;2(3). doi:10.1097/01.jps.0000242995.09037.07. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNote 7 XML…

  8. Developing process-support tools for patient safety: finding the balance between validity and feasibility. | PSNet

    psnet.ahrq.gov/issue/developing-process-support-tools-patient-safety-finding-balance-between-validity-and
    January 20, 2010 - Commentary Developing process-support tools for patient safety: finding the balance between validity and feasibility. Citation Text: Marsteller JA, Holzmueller CG, Makary MA, et al. Developing process-support tools for patient safety: finding the balance between validity and feasibility.…

  9. Nurses: Guilty verdict for dosing mistake could cost lives. | PSNet

    psnet.ahrq.gov/issue/nurses-guilty-verdict-dosing-mistake-could-cost-lives
    April 27, 2022 - Newspaper/Magazine Article Nurses: Guilty verdict for dosing mistake could cost lives. Citation Text: Nurses: Guilty verdict for dosing mistake could cost lives. Loller T. Associated Press. March 30, 2022. Copy Citation Save Save to your library …

  10. Improving hospital performance: culture change is not the answer. | PSNet

    psnet.ahrq.gov/issue/improving-hospital-performance-culture-change-not-answer
    September 27, 2016 - Commentary Improving hospital performance: culture change is not the answer. Citation Text: Leggat SG, Dwyer J. Improving hospital performance: culture change is not the answer. Healthc Q. 2005;8(2):60-6. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML E…

  11. Network of Patient Safety Databases Chartbook. | PSNet

    psnet.ahrq.gov/issue/network-patient-safety-databases-chartbook
    October 23, 2019 - Book/Report Network of Patient Safety Databases Chartbook. Citation Text: Network of Patient Safety Databases Chartbook. Rockville, MD: Agency for Healthcare Research and Quality; September 2023. AHRQ Publication no. 23-0082. Copy Citation Save Save to your libr…

  12. Administration of concentrated potassium chloride for injection during a code: still deadly! | PSNet

    psnet.ahrq.gov/issue/administration-concentrated-potassium-chloride-injection-during-code-still-deadly
    May 02, 2018 - Newspaper/Magazine Article Administration of concentrated potassium chloride for injection during a code: still deadly! Citation Text: Administration of concentrated potassium chloride for injection during a code: still deadly! ISMP Medication Safety Alert! Acute care edition. June …

  13. Advancing Diagnostic Excellence for Maternal Health Care: Proceedings of a Workshop–in Brief. | PSNet

    psnet.ahrq.gov/issue/advancing-diagnostic-excellence-maternal-health-care-proceedings-workshop-brief
    September 12, 2018 - Book/Report Advancing Diagnostic Excellence for Maternal Health Care: Proceedings of a Workshop–in Brief. Citation Text: Advancing Diagnostic Excellence for Maternal Health Care: Proceedings of a Workshop–in Brief. National Academies of Sciences, Engineering, and Medicine. Washington, DC…

  14. EU to tackle issue of patient safety. | PSNet

    psnet.ahrq.gov/issue/eu-tackle-issue-patient-safety
    September 06, 2023 - Newspaper/Magazine Article EU to tackle issue of patient safety. Citation Text: Watson R. EU to tackle issue of patient safety. BMJ (Clinical research ed.). 2005;330(7496):866. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged …

  15. Updated guidance needed for longstanding large volume parenteral (LVP) labeling and packaging problems. | PSNet

    psnet.ahrq.gov/issue/updated-guidance-needed-longstanding-large-volume-parenteral-lvp-labeling-and-packaging
    March 10, 2021 - Newspaper/Magazine Article Updated guidance needed for longstanding large volume parenteral (LVP) labeling and packaging problems. Citation Text: Updated guidance needed for longstanding large volume parenteral (LVP) labeling and packaging problems. ISMP Medication Safety Alert! Acute ca…

  16. Government and industry fail to protect the public when they suggest "carefully following instructions" is enough to prevent vaccine errors. | PSNet

    psnet.ahrq.gov/issue/government-and-industry-fail-protect-public-when-they-suggest-carefully-following
    February 24, 2016 - Newspaper/Magazine Article Government and industry fail to protect the public when they suggest "carefully following instructions" is enough to prevent vaccine errors. Citation Text: Government and industry fail to protect the public when they suggest "carefully following instructions" i…

  17. Cognitive biases associated with medical decisions: a systematic review. | PSNet

    psnet.ahrq.gov/issue/cognitive-biases-associated-medical-decisions-systematic-review
    March 01, 2023 - Review Cognitive biases associated with medical decisions: a systematic review. Citation Text: Saposnik G, Redelmeier DA, Ruff CC, et al. Cognitive biases associated with medical decisions: a systematic review. BMC Med Inform Decis Mak. 2016;16(1):138. Copy Citation Format: …

  18. Patient safety: listen to whistleblowers. | PSNet

    psnet.ahrq.gov/issue/patient-safety-listen-whistleblowers
    May 22, 2019 - Commentary Patient safety: listen to whistleblowers. Citation Text: Kirkup B, Titcombe J. Patient safety: listen to whistleblowers. BMJ. 2023;382:1972. doi:10.1136/bmj.p1972. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedI…

  19. Nursing home workers warned government about safety violations before COVID-19 outbreaks and deaths. | PSNet

    psnet.ahrq.gov/issue/nursing-home-workers-warned-government-about-safety-violations-covid-19-outbreaks-and-deaths
    September 15, 2021 - Newspaper/Magazine Article Nursing home workers warned government about safety violations before COVID-19 outbreaks and deaths. Citation Text: Nursing home workers warned government about safety violations before COVID-19 outbreaks and deaths. Ellis B, Hicken M. CNN. May 14, 2020. Co…

  20. A crisis within a crisis. | PSNet

    psnet.ahrq.gov/issue/crisis-within-crisis
    May 05, 2021 - Newspaper/Magazine Article A crisis within a crisis. Citation Text: A crisis within a crisis. Ellis NT, Broaddus A. CNN. August 25, 2021.  Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter …
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