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psnet.ahrq.gov/node/72674/psn-pdf
January 27, 2021 - The effect of blue-enriched lighting on medical error rate
in a university hospital ICU.
January 27, 2021
Chen Y, Broman AT, Priest G, et al. The Effect of Blue-Enriched Lighting on Medical Error Rate in a
University Hospital ICU. Jt Comm J Qual Saf. 2021;47(3):165-175. doi:10.1016/j.jcjq.2020.11.007.
https://psne…
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psnet.ahrq.gov/node/764411/psn-pdf
March 02, 2022 - Nowhere is safe: record number of patients contracted
Covid in the hospital in January.
March 2, 2022
Levy R, Vestal AJ. Politico. February 19, 2022.
https://psnet.ahrq.gov/issue/nowhere-safe-record-number-patients-contracted-covid-hospital-january
Transmission of COVID-19 in the health care setting continues to b…
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psnet.ahrq.gov/node/43321/psn-pdf
August 02, 2015 - Costs associated with surgical site infections in Veterans
Affairs hospitals.
August 2, 2015
Schweizer ML, Cullen JJ, Perencevich E, et al. Costs Associated With Surgical Site Infections in Veterans
Affairs Hospitals. JAMA Surg. 2014;149(6):575-81. doi:10.1001/jamasurg.2013.4663.
https://psnet.ahrq.gov/issue/costs…
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psnet.ahrq.gov/node/47095/psn-pdf
October 10, 2018 - Adverse drug events and medication problems in
"Hospital at Home" patients.
October 10, 2018
Mann E, Zepeda O, Soones T, et al. Adverse drug events and medication problems in "Hospital at Home"
patients. Home Health Care Serv Q. 2018;37(3):177-186. doi:10.1080/01621424.2018.1454372.
https://psnet.ahrq.gov/issue/ad…
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psnet.ahrq.gov/node/41336/psn-pdf
May 02, 2012 - Human factors–focused reporting system for improving
care quality and safety in hospital wards.
May 2, 2012
Morag I, Gopher D, Spillinger A, et al. Human Factors–Focused Reporting System for Improving Care
Quality and Safety in Hospital Wards. Hum Factors. 2012;54(2):195-213. doi:10.1177/0018720811434767.
https://…
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psnet.ahrq.gov/node/36224/psn-pdf
October 19, 2010 - Nonpunitive medication error reporting: 3-year findings
from one hospital's primum non nocere initiative.
October 19, 2010
Potylycki MJ, Kimmel SR, Ritter M, et al. Nonpunitive medication error reporting: 3-year findings from one
hospital's Primum Non Nocere initiative. J Nurs Adm. 2006;36(7-8):370-376.
https://ps…
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psnet.ahrq.gov/node/43440/psn-pdf
August 13, 2014 - Hospital Experiences Using Electronic Health Records to
Support Medication Reconciliation.
August 13, 2014
Grossman JM, Gourevitch R, Cross D. Washington, DC: National Institute for Health Care Reform; July
2014. NIHCR Research Brief No. 17.
https://psnet.ahrq.gov/issue/hospital-experiences-using-electronic-health…
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psnet.ahrq.gov/node/37210/psn-pdf
December 19, 2011 - Effects of an integrated clinical information system on
medication safety in a multi-hospital setting.
December 19, 2011
Mahoney CD, Berard-Collins CM, Coleman R, et al. Effects of an integrated clinical information system on
medication safety in a multi-hospital setting. Am J Health Syst Pharm. 2007;64(18):1969-77…
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psnet.ahrq.gov/node/74133/psn-pdf
January 01, 2022 - Predicting avoidable hospital events in Maryland.
December 1, 2021
Henderson M, Han F, Perman C, et al. Predicting avoidable hospital events in Maryland. Health Serv Res.
2022;57(1):192-199. doi:10.1111/1475-6773.13891.
https://psnet.ahrq.gov/issue/predicting-avoidable-hospital-events-maryland
With the goal of imp…
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psnet.ahrq.gov/node/38907/psn-pdf
January 03, 2017 - Applying Toyota Production System principles to a
psychiatric hospital: making transfers safer and more
timely.
January 3, 2017
Young JQ, Wachter R. Applying Toyota Production System principles to a psychiatric hospital: making
transfers safer and more timely. Jt Comm J Qual Patient Saf. 2009;35(9):439-448.
https…
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psnet.ahrq.gov/node/836784/psn-pdf
March 23, 2022 - Qualitative content analysis: a framework for the
substantive review of hospital incident reports.
March 23, 2022
Stephens S. Qualitative content analysis: a framework for the substantive review of hospital incident
reports. J Healthc Risk Manag. 2022;41(4):17-26. doi:10.1002/jhrm.21498.
https://psnet.ahrq.gov/iss…
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psnet.ahrq.gov/node/42540/psn-pdf
September 04, 2013 - A qualitative study comparing experiences of the surgical
safety checklist in hospitals in high-income and low-
income countries.
September 4, 2013
Aveling E-L, McCulloch P, Dixon-Woods M. A qualitative study comparing experiences of the surgical
safety checklist in hospitals in high-income and low-income countrie…
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psnet.ahrq.gov/node/34866/psn-pdf
February 03, 2011 - Error reporting and disclosure systems: views from
hospital leaders.
February 3, 2011
Weissman JS, Annas CL, Epstein AM, et al. Error reporting and disclosure systems: views from hospital
leaders. JAMA. 2005;293(11):1359-66.
https://psnet.ahrq.gov/issue/error-reporting-and-disclosure-systems-views-hospital-leaders…
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psnet.ahrq.gov/node/38326/psn-pdf
January 14, 2009 - Results of a medication reconciliation survey from the
2006 Society of Hospital Medicine national meeting.
January 14, 2009
Clay BJ, Halasyamani L, Stucky ER, et al. Results of a medication reconciliation survey from the 2006
Society of Hospital Medicine national meeting. J Hosp Med. 2008;3(6). doi:10.1002/jhm.370.…
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psnet.ahrq.gov/node/36690/psn-pdf
January 18, 2011 - The risk of adverse drug events and hospital-related
morbidity and mortality among older adults with
potentially inappropriate medication use.
January 18, 2011
Page RL, Ruscin M. The risk of adverse drug events and hospital-related morbidity and mortality among
older adults with potentially inappropriate medicatio…
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psnet.ahrq.gov/node/41381/psn-pdf
May 16, 2012 - Clinical review: the hospital of the future—building
intelligent environments to facilitate safe and effective
acute care delivery.
May 16, 2012
Pickering BW, Litell JM, Herasevich V, et al. Clinical review: the hospital of the future - building intelligent
environments to facilitate safe and effective acute care …
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psnet.ahrq.gov/node/35355/psn-pdf
July 20, 2009 - Risky procedures by nurses in hospitals: problems and
(contemplated) refusals of orders by physicians, and
views of physicians and nurses: a questionnaire survey.
July 20, 2009
de Bie J, Cuperus-Bosma JM, van der Jagt MAB, et al. Risky procedures by nurses in hospitals: problems
and (contemplated) refusals of or…
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psnet.ahrq.gov/node/34809/psn-pdf
February 18, 2011 - Iatrogenic illness on a general medical service at a
university hospital.
February 18, 2011
Steel K, Gertman PM, Crescenzi C, et al. Iatrogenic illness on a general medical service at a university
hospital. N Engl J Med. 1981;304(11):638-42.
https://psnet.ahrq.gov/issue/iatrogenic-illness-general-medical-service-u…
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psnet.ahrq.gov/node/37548/psn-pdf
February 20, 2008 - Adequacy of information transferred at resident sign-out
(in-hospital handover of care): a prospective survey.
February 20, 2008
Borowitz SM, Waggoner-Fountain LA, Bass EJ, et al. Adequacy of information transferred at resident sign-
out (in-hospital handover of care): a prospective survey. Qual Saf Health Care. 20…
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psnet.ahrq.gov/node/43473/psn-pdf
August 27, 2014 - Rapid response team implementation and in-hospital
mortality.
August 27, 2014
Salvatierra G, Bindler RC, Corbett CF, et al. Rapid response team implementation and in-hospital
mortality*. Crit Care Med. 2014;42(9):2001-6. doi:10.1097/CCM.0000000000000347.
https://psnet.ahrq.gov/issue/rapid-response-team-implementat…