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psnet.ahrq.gov/node/60054/psn-pdf
March 18, 2020 - Ensuring successful implementation of communication-
and-resolution programmes.
March 18, 2020
Mello MM, Roche S, Greenberg Y, et al. Ensuring successful implementation of communication-and-
resolution programmes. BMJ Qual Saf. 2020;29(11):895-904. doi:10.1136/bmjqs-2019-010296.
https://psnet.ahrq.gov/issue/ensuri…
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psnet.ahrq.gov/node/844548/psn-pdf
February 15, 2023 - Use of complete medication history to identify and correct
transitions-of-care medication errors at psychiatric
hospital admission.
February 15, 2023
Vargas V, Blakeslee WW, Banas CA, et al. Use of complete medication history to identify and correct
transitions-of-care medication errors at psychiatric hospital adm…
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psnet.ahrq.gov/node/45299/psn-pdf
July 20, 2016 - Reducing readmission at an academic medical center:
results of a pharmacy-facilitated discharge counseling
and medication reconciliation program.
July 20, 2016
Zemaitis CT, Morris G, Cabie M, et al. Reducing Readmission at an Academic Medical Center: Results of a
Pharmacy-Facilitated Discharge Counseling and Medic…
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psnet.ahrq.gov/node/46878/psn-pdf
June 25, 2018 - Patient perceptions of deterioration and patient and
family activated escalation systems—a qualitative study.
June 25, 2018
Guinane J, Hutchinson AM, Bucknall T. Patient perceptions of deterioration and patient and family
activated escalation systems-A qualitative study. J Clin Nurs. 2018;27(7-8):1621-1631.
doi:10…
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psnet.ahrq.gov/node/47349/psn-pdf
January 30, 2019 - Relationship of staff information sharing and advice
networks to patient safety outcomes.
January 30, 2019
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:10.1097/NNA.0000000000000646.
ht…
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psnet.ahrq.gov/node/867349/psn-pdf
December 11, 2024 - Prevalence and Burden of Healthcare-Associated
Infections (HAIs), 2016–2021. HCUP Statistical Brief #313.
December 11, 2024
Miller MA, Umscheid CA, Dowell J, et al. Prevalence And Burden Of Healthcare-Associated Infections
(Hais), 2016–2021. Hcup Statistical Brief #313. Rockville, MD: Agency for Healthcare Research…
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psnet.ahrq.gov/node/35134/psn-pdf
June 22, 2009 - Introduction of the medical emergency team (MET)
system: a cluster-randomised controlled trial.
June 22, 2009
Hillman K, Chen J, Cretikos M, et al. Introduction of the medical emergency team (MET) system: a cluster-
randomised controlled trial. Lancet. 2005;365(9477):2091-7.
https://psnet.ahrq.gov/issue/introducti…
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psnet.ahrq.gov/node/46571/psn-pdf
October 25, 2017 - Incorporating nursing complexity in reimbursement
coding systems: the potential impact on missed care.
October 25, 2017
Sasso L, Bagnasco A, Aleo G, et al. Incorporating nursing complexity in reimbursement coding systems:
the potential impact on missed care. BMJ Qual Saf. 2017;26(11):929-932. doi:10.1136/bmjqs-2017…
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psnet.ahrq.gov/node/60614/psn-pdf
June 24, 2020 - A systems approach to analyzing and preventing hospital
adverse events.
June 24, 2020
Leveson N, Samost A, Dekker SWA, et al. A systems approach to analyzing and preventing hospital
adverse events. J Patient Saf. 2020;16(2):162-167. doi:10.1097/pts.0000000000000263.
https://psnet.ahrq.gov/issue/systems-approach-an…
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psnet.ahrq.gov/node/50746/psn-pdf
December 18, 2019 - The influence of organizational culture, climate and
commitment on speaking up about medical errors.
December 18, 2019
Levine KJ, Carmody M, Silk KJ. The influence of organizational culture, climate and commitment on
speaking up about medical errors. J Nurs Manag. 2019;28(1):130-138. doi:10.1111/jonm.12906.
https:…
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psnet.ahrq.gov/node/33634/psn-pdf
May 04, 2006 - The Wild West: Patient Safety in Office-Based Anesthesia
May 1, 2006
Kaushal R, Upadhyayula S, Gaba DM, et al. The Wild West: Patient Safety in Office-Based Anesthesia.
PSNet [internet]. 2006.
https://psnet.ahrq.gov/perspective/wild-west-patient-safety-office-based-anesthesia
Perspective
Over the last decade, sur…
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psnet.ahrq.gov/web-mm/mobility-lost-icu
August 01, 2018 - SPOTLIGHT CASE
Mobility Lost in the ICU
Citation Text:
Smith J. Mobility Lost in the ICU. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011.
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psnet.ahrq.gov/issue/errors-otolaryngology-revisited
August 11, 2010 - Study
Errors in otolaryngology revisited.
Citation Text:
Shah RK, Boss EF, Brereton J, et al. Errors in otolaryngology revisited. Otolaryngol Head Neck Surg. 2014;150(5):779-784. doi:10.1177/0194599814521985.
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psnet.ahrq.gov/issue/environmental-cleaning-prevention-healthcare-associated-infections-hais
October 02, 2013 - Government Resource
Environmental Cleaning for the Prevention of Healthcare-Associated Infections (HAIs).
Citation Text:
Environmental Cleaning for the Prevention of Healthcare-Associated Infections (HAIs). Leas BF, Sullivan N, Han JH, Pegues DA, Kaczmarek JL, Umscheid CA. Rockville, MD:…
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psnet.ahrq.gov/issue/rx-medication-errors
July 19, 2023 - Newspaper/Magazine Article
Rx for medication errors.
Citation Text:
Friedley NJC. Rx for medication errors. A patient medication safety plan can help prevent the cascade of devastating and preventable complications from adverse drug events. Medical economics. 2008;85(20):34-8.
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psnet.ahrq.gov/issue/prevent-errors-during-emergency-use-hypertonic-sodium-chloride-solutions
March 10, 2021 - Newspaper/Magazine Article
Prevent errors during emergency use of hypertonic sodium chloride solutions.
Citation Text:
Prevent errors during emergency use of hypertonic sodium chloride solutions. ISMP Medication Safety Alert! Acute care edition. November 4, 2021;26(22); 1-4.
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psnet.ahrq.gov/issue/pharmacist-medication-assessments-surgical-preadmission-clinic
October 15, 2008 - Study
Pharmacist medication assessments in a surgical preadmission clinic.
Citation Text:
Kwan Y, Fernandes O, Nagge JJ, et al. Pharmacist medication assessments in a surgical preadmission clinic. Arch Intern Med. 2007;167(10):1034-40.
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psnet.ahrq.gov/issue/mirror-mirror-wall-update-quality-american-health-care-through-patients-lens
August 15, 2007 - Book/Report
Mirror, Mirror on the Wall: An Update on the Quality of American Health Care Through the Patient's Lens.
Citation Text:
Mirror, Mirror on the Wall: An Update on the Quality of American Health Care Through the Patient's Lens. Davis K, Schoen S, Schoenbaum SC, et al. New Yo…
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psnet.ahrq.gov/issue/interruptions-and-multi-tasking-moving-research-agenda-new-directions
March 23, 2011 - Commentary
Interruptions and multi-tasking: moving the research agenda in new directions.
Citation Text:
Westbrook JI. Interruptions and multi-tasking: moving the research agenda in new directions. BMJ Qual Saf. 2014;23(11):877-9. doi:10.1136/bmjqs-2014-003372.
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psnet.ahrq.gov/issue/leadership-and-patient-safety-review-literature
March 29, 2023 - Review
Leadership and patient safety: a review of the literature.
Citation Text:
Ring L, Fairchild RM. Leadership and Patient Safety: A Review of the Literature. J Nurs Reg. 2015;4(1):52-56. doi:10.1016/s2155-8256(15)30164-2.
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