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  1. A new infusion syringe label system designed to reduce task complexity during drug preparation. | PSNet

    psnet.ahrq.gov/issue/new-infusion-syringe-label-system-designed-reduce-task-complexity-during-drug-preparation
    February 13, 2019 - Study A new infusion syringe label system designed to reduce task complexity during drug preparation. Citation Text: Merry AF, Webster CS, Connell H. A new infusion syringe label system designed to reduce task complexity during drug preparation. Anaesthesia. 2007;62(5). doi:10.1111/j.1…

  2. Using the patient safety huddle as a tool for high reliability. | PSNet

    psnet.ahrq.gov/issue/using-patient-safety-huddle-tool-high-reliability
    March 01, 2023 - Commentary Using the patient safety huddle as a tool for high reliability. Citation Text: Brass SD, Olney G, Glimp R, et al. Using the Patient Safety Huddle as a Tool for High Reliability. Jt Comm J Qual Patient Saf. 2018;44(4):219-226. doi:10.1016/j.jcjq.2017.10.004. Copy Citation …

  3. Influence of perceived difficulty of cases on student osteopaths' diagnostic reasoning: a cross sectional study. | PSNet

    psnet.ahrq.gov/issue/influence-perceived-difficulty-cases-student-osteopaths-diagnostic-reasoning-cross-sectional
    February 03, 2011 - Study Influence of perceived difficulty of cases on student osteopaths' diagnostic reasoning: a cross sectional study. Citation Text: Noyer AL, Esteves JE, Thomson OP. Influence of perceived difficulty of cases on student osteopaths' diagnostic reasoning: a cross sectional study. Chiropr…

  4. Resident duty-hour reform associated with increased morbidity following hip fracture. | PSNet

    psnet.ahrq.gov/issue/resident-duty-hour-reform-associated-increased-morbidity-following-hip-fracture
    October 19, 2022 - Study Resident duty-hour reform associated with increased morbidity following hip fracture. Citation Text: Browne JA, Cook C, Olson SA, et al. Resident duty-hour reform associated with increased morbidity following hip fracture. J Bone Joint Surg Am. 2009;91(9):2079-85. doi:10.2106/JBJ…

  5. Intensive care unit readmissions in U.S. hospitals: patient characteristics, risk factors, and outcomes. | PSNet

    psnet.ahrq.gov/issue/intensive-care-unit-readmissions-us-hospitals-patient-characteristics-risk-factors-and
    August 04, 2021 - Study Intensive care unit readmissions in U.S. hospitals: patient characteristics, risk factors, and outcomes. Citation Text: Kramer AA, Higgins TL, Zimmerman JE. Intensive care unit readmissions in U.S. hospitals: patient characteristics, risk factors, and outcomes. Crit Care Med. 201…

  6. The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program. | PSNet

    psnet.ahrq.gov/issue/use-report-cards-and-outcome-measurements-improve-safety-surgical-care-american-college
    May 26, 2016 - Review The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program. Citation Text: Maggard-Gibbons M. The use of report cards and outcome measurements to improve the safety of surg…

  7. Patient identification error among prostate needle core biopsy specimens—are we ready for a DNA time-out? | PSNet

    psnet.ahrq.gov/issue/patient-identification-error-among-prostate-needle-core-biopsy-specimens-are-we-ready-dna
    March 12, 2025 - Study Patient identification error among prostate needle core biopsy specimens—are we ready for a DNA time-out? Citation Text: Suba EJ, Pfeifer JD, Raab SS. Patient identification error among prostate needle core biopsy specimens--are we ready for a DNA time-out? J Urol. 2007;178(4 Pt …

  8. The effect of bedrails on falls and injury: a systematic review of clinical studies. | PSNet

    psnet.ahrq.gov/issue/effect-bedrails-falls-and-injury-systematic-review-clinical-studies
    March 15, 2016 - Review The effect of bedrails on falls and injury: a systematic review of clinical studies. Citation Text: Healey F, Oliver D, Milne A, et al. The effect of bedrails on falls and injury: a systematic review of clinical studies. Age Ageing. 2008;37(4):368-78. doi:10.1093/ageing/afn112. …

  9. Prevalence and sources of duplicate information in the electronic medical record. | PSNet

    psnet.ahrq.gov/issue/prevalence-and-sources-duplicate-information-electronic-medical-record
    October 21, 2020 - Study Prevalence and sources of duplicate information in the electronic medical record. Citation Text: Steinkamp J, Kantrowitz JJ, Airan-Javia S. Prevalence and sources of duplicate information in the electronic medical record. JAMA Netw Open. 2022;5(9):e2233348. doi:10.1001/jamanetworko…

  10. Role of remediation in cases of serious misconduct before UK healthcare regulators: a qualitative study. | PSNet

    psnet.ahrq.gov/issue/role-remediation-cases-serious-misconduct-uk-healthcare-regulators-qualitative-study
    June 02, 2021 - Study Role of remediation in cases of serious misconduct before UK healthcare regulators: a qualitative study. Citation Text: Price T, Reynolds E, O’Brien T, et al. Role of remediation in cases of serious misconduct before UK healthcare regulators: a qualitative study. BMJ Qual Saf. 2025…

  11. A computer alert system to prevent injury from adverse drug events: development and evaluation in a community teaching hospital. | PSNet

    psnet.ahrq.gov/issue/computer-alert-system-prevent-injury-adverse-drug-events-development-and-evaluation-community
    November 01, 2016 - Study Classic A computer alert system to prevent injury from adverse drug events: development and evaluation in a community teaching hospital. Citation Text: Raschke RA, Gollihare B, Wunderlich TA, et al. A Computer Alert System to Prevent Injury From Adverse …

  12. The medical emergency team system: a two hospital comparison. | PSNet

    psnet.ahrq.gov/issue/medical-emergency-team-system-two-hospital-comparison
    January 15, 2009 - Study The medical emergency team system: a two hospital comparison. Citation Text: Young L, Donald M, Parr M, et al. The Medical Emergency Team system: a two hospital comparison. Resuscitation. 2008;77(2):180-8. doi:10.1016/j.resuscitation.2007.11.016. Copy Citation Format: …

  13. Implementation of computerized prescriber order entry in four academic medical centers. | PSNet

    psnet.ahrq.gov/issue/implementation-computerized-prescriber-order-entry-four-academic-medical-centers
    May 18, 2022 - Commentary Implementation of computerized prescriber order entry in four academic medical centers. Citation Text: Cooley TW, May D, Alwan M, et al. Implementation of computerized prescriber order entry in four academic medical centers. Am J Health Syst Pharm. 2012;69(24):2166-73. doi:1…

  14. How should medication errors be defined? Development and test of a definition. | PSNet

    psnet.ahrq.gov/issue/how-should-medication-errors-be-defined-development-and-test-definition
    June 27, 2011 - Study How should medication errors be defined? Development and test of a definition. Citation Text: Lisby M, Nielsen LP, Brock B, et al. How should medication errors be defined? Development and test of a definition. Scand J Public Health. 2012;40(2):203-10. doi:10.1177/1403494811435489.…

  15. Communication gaps and readmissions to hospital for patients aged 75 years and older: observational study. | PSNet

    psnet.ahrq.gov/issue/communication-gaps-and-readmissions-hospital-patients-aged-75-years-and-older-observational
    July 19, 2023 - Study Communication gaps and readmissions to hospital for patients aged 75 years and older: observational study. Citation Text: Witherington EMA, Pirzada OM, Avery A. Communication gaps and readmissions to hospital for patients aged 75 years and older: observational study. Qual Saf Hea…

  16. Decision support and patient safety: the time has come. | PSNet

    psnet.ahrq.gov/issue/decision-support-and-patient-safety-time-has-come
    December 04, 2024 - Review Decision support and patient safety: the time has come. Citation Text: Hasley SK. Decision support and patient safety: the time has come. Am J Obstet Gynecol. 2011;204(6):461-5. doi:10.1016/j.ajog.2010.10.901. Copy Citation Format: DOI Google Scholar PubMed BibTeX …

  17. Right medication, right dose, right patient, right time, and right route: how do we select the right patient-controlled analgesia (PCA) device? | PSNet

    psnet.ahrq.gov/issue/right-medication-right-dose-right-patient-right-time-and-right-route-how-do-we-select-right
    March 02, 2016 - Commentary Right medication, right dose, right patient, right time, and right route: how do we select the right patient-controlled analgesia (PCA) device? Citation Text: Ladak SSJ, Chan VWS, Easty T, et al. Right medication, right dose, right patient, right time, and right route: how d…

  18. Improving quality through effective implementation of information technology in healthcare. | PSNet

    psnet.ahrq.gov/issue/improving-quality-through-effective-implementation-information-technology-healthcare
    October 17, 2016 - Study Improving quality through effective implementation of information technology in healthcare. Citation Text: Øvretveit J, Scott T, Rundall TG, et al. Improving quality through effective implementation of information technology in healthcare. Int J Qual Health Care. 2007;19(5):259-6…

  19. Current approaches to punitive action for medication errors by boards of pharmacy. | PSNet

    psnet.ahrq.gov/issue/current-approaches-punitive-action-medication-errors-boards-pharmacy
    May 26, 2011 - Study Current approaches to punitive action for medication errors by boards of pharmacy. Citation Text: Holdsworth M, Wittstrom K, Yeitrakis T. Current approaches to punitive action for medication errors by boards of pharmacy. Ann Pharmacother. 2013;47(4):475-81. doi:10.1345/aph.1R668. …

  20. Introduction of an obstetric-specific medical emergency team for obstetric crises: implementation and experience. | PSNet

    psnet.ahrq.gov/issue/introduction-obstetric-specific-medical-emergency-team-obstetric-crises-implementation-and
    October 19, 2022 - Study Introduction of an obstetric-specific medical emergency team for obstetric crises: implementation and experience. Citation Text: Gosman GG, Baldisseri MR, Stein KL, et al. Introduction of an obstetric-specific medical emergency team for obstetric crises: implementation and experi…
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