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8461. Drug errors are dangerous but preventable. | PSNet
      psnet.ahrq.gov/issue/drug-errors-are-dangerous-preventable
      March 27, 2024 - Newspaper/Magazine Article Drug errors are dangerous but preventable. Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL September 8, 2010 This newspaper article describes steps p…

8462. Focus Group Guide | Digital Healthcare Research
      digital.ahrq.gov/document-type/focus-group-guide
      January 01, 2023 - Focus Group Guide Improving Sickle Cell Transitions, Focus Group Moderator Guide: IT Developers Description This is a focus group guide designed to be conducted with developers across a health care system. The tool includes questions to assess assess user's needs of electronic…

8463. Informed Consent Document | Digital Healthcare Research
      digital.ahrq.gov/document-type/informed-consent-document
      January 01, 2023 - Informed Consent Document Focus Group Consent Form (Spanish) Description Example consent form used in an AHRQ-funded project involving older adults. The study involves a focus group on medication management practices. The form is in Spanish. Document Source …

8464. Map of PSOs | PSO
      pso.ahrq.gov/pso/listed/geographic
      October 01, 2022 - SHARE: Map of PSOs There are 116 PSOs  in 37 States and the District of Columbia. This map shows the physical location of each PSO. All PSOs can operate nationally regardless of their home state. Note: AHRQ updates…

8465. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/74152/psn-pdf
      December 08, 2021 - Adverse events and their contributors among older adults during skilled nursing stays for rehabilitation: a scoping review. December 8, 2021 Okpalauwaekwe U, Tzeng H-M. Adverse events and their contributors among older adults during skilled nursing stays for rehabilitation: a scoping review. Patient Relat Outcome …

8466. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/43141/psn-pdf
      April 30, 2014 - Engaging residents and fellows to improve institution- wide quality: the first six years of a novel financial incentive program. April 30, 2014 Vidyarthi A, Green AL, Rosenbluth G, et al. Engaging residents and fellows to improve institution-wide quality: the first six years of a novel financial incentive program.…

8467. Battle Buddies Tip Sheet (1) (pdf file)
      psnet.ahrq.gov/sites/default/files/2021-09/Battle%20buddies%20tip%20sheet%20(1).pdf
      January 01, 2021 - I have a Battle Buddy – Now What? Battle Buddies are not just for battle.  It’s critical to start connecting with your Battle Buddy now - before things get really stressful.  It’s like training prior to a marathon.  Brief conversations now will strengthen your individual and team resilience and ensure o…

8468. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/72851/psn-pdf
      March 17, 2021 - Effect of a multifaceted clinical pharmacist intervention on medication safety after hospitalization in persons prescribed high-risk medications: a randomized clinical trial. March 17, 2021 Gurwitz JH, Kapoor A, Garber L, et al. Effect of a multifaceted clinical pharmacist intervention on medication safety after …

8469. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/45105/psn-pdf
      May 11, 2016 - Medicines management, medication errors and adverse medication events in older people referred to a community nursing service: a retrospective observational study. May 11, 2016 Elliott RA, Lee CY, Beanland C, et al. Medicines Management, Medication Errors and Adverse Medication Events in Older People Referred to …

8470. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/866695/psn-pdf
      September 11, 2024 - Reducing ambulatory central line-associated bloodstream infections: a family-centered approach. September 11, 2024 Wong CI, Ilowite M, Yan A, et al. Reducing ambulatory central line?associated bloodstream infections: a family?centered approach. Pediatr Blood Cancer. 2024;71(8):e31064. doi:10.1002/pbc.31064. https:…

8471. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/40376/psn-pdf
      July 06, 2012 - Electronic prescribing in an ambulatory care setting: a cluster randomized trial. July 6, 2012 Dainty KN, Adhikari NKJ, Kiss A, et al. Electronic prescribing in an ambulatory care setting: a cluster randomized trial. J Eval Clin Pract. 2012;18(4):761-7. doi:10.1111/j.1365-2753.2011.01657.x. https://psnet.ahrq.gov/…

8472. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/839827/psn-pdf
      December 20, 2020 - Racial bias in pulse oximetry measurement. December 20, 2020 Sjoding MW, Dickson RP, Iwashyna TJ, et al. Racial bias in pulse oximetry measurement. N Engl J Med. 2020;383(25):2477-2478. doi:10.1056/nejmc2029240. https://psnet.ahrq.gov/issue/racial-bias-pulse-oximetry-measurement Pulse oximetry is used to triage pa…

8473. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/851355/psn-pdf
      July 12, 2023 - Assessing the impact of a new pediatric healthcare facility on medication administration: a human factors approach. July 12, 2023 Godin MR, Nasr AS. Assessing the impact of a new pediatric healthcare facility on medication administration: a human factors approach. J Nurs Adm. 2023;53(6):331-336. doi:10.1097/nna.0…

8474. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/866279/psn-pdf
      July 10, 2024 - Need to systematically identify and mitigate risks upon hospitalisation for patients with chronic health conditions. July 10, 2024 Pronovost PJ, Carrington EM. Need to systematically identify and mitigate risks upon hospitalisation for patients with chronic health conditions. BMJ Qual Saf. 2024;33(11):755-758. doi…

8475. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/73506/psn-pdf
      July 21, 2021 - Patient-safety incidents during COVID-19 health crisis in France: An exploratory sequential multi-method study in primary care. July 21, 2021 Fournier JP, Amélineau JB, Hild S, et al. Eur J Gen Pract. 2021;27(1):142-151. https://psnet.ahrq.gov/issue/patient-safety-incidents-during-covid-19-health-crisis-france-exp…

8476. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/837672/psn-pdf
      July 13, 2022 - Optimizing post-acute care patient safety: a scoping review of multifactorial fall prevention interventions for older adults. July 13, 2022 Leland NE, Lekovitch C, Martínez J, et al. Optimizing post-acute care patient safety: a scoping review of multifactorial fall prevention interventions for older adults. J Appl…

8477. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44063/psn-pdf
      June 01, 2016 - Post-discharge adverse events among urban and rural patients of an urban community hospital: a prospective cohort study. June 1, 2016 Tsilimingras D, Schnipper JL, Duke A, et al. Post-Discharge Adverse Events Among Urban and Rural Patients of an Urban Community Hospital: A Prospective Cohort Study. J Gen Intern Me…

8478. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47255/psn-pdf
      August 29, 2018 - Influence of shift duration on cognitive performance of emergency physicians: a prospective cross-sectional study. August 29, 2018 Persico N, Maltese F, Ferrigno C, et al. Influence of Shift Duration on Cognitive Performance of Emergency Physicians: A Prospective Cross-Sectional Study. Ann Emerg Med. 2018;72(2):17…

8479. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/836956/psn-pdf
      April 20, 2022 - Effectiveness and safety of pulse oximetry in remote patient monitoring of patients with COVID-19: a systematic review. April 20, 2022 Alboksmaty A, Beaney T, Elkin S, et al. Effectiveness and safety of pulse oximetry in remote patient monitoring of patients with COVID-19: a systematic review. Lancet Digit Health.…

8480. Teach-Back Quick Guide (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/TeachBack-QuickGuide-card.pdf
      June 02, 2025 - Teach-Back Quick Guide Teach-Back Quick Guide • Use teach-back for ALL patients. • Start with most important message. • Limit to 2-4 key points. • Use plain language. • Rephrase message until patient demonstrates clear understanding. Examples of Teach-Back Starters • “Just t…