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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42810/psn-pdf
    June 10, 2018 - First annual review of data submitted to the ISMP National Vaccine Errors Reporting Program (VERP). June 10, 2018 ISMP Medication Safety Alert! Acute Care Edition. November 28, 2013;18:1-5. https://psnet.ahrq.gov/issue/first-annual-review-data-submitted-ismp-national-vaccine-errors-reporting- program-verp This re…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42043/psn-pdf
    February 13, 2013 - Reason's accident causation model: application to adverse events in acute care. February 13, 2013 Elliott M, Page K, Worrall-Carter L. Reason's accident causation model: application to adverse events in acute care. Contemp Nurse. 2012;43(1):22-8. doi:10.5172/conu.2012.43.1.22. https://psnet.ahrq.gov/issue/reasons-…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39585/psn-pdf
    June 09, 2010 - Bar code technology and medication administration error. June 9, 2010 Young J, Slebodnik M, Sands L. Bar Code Technology and Medication Administration Error. J Patient Saf. 2010;6(2):115-120. doi:10.1097/pts.0b013e3181de35f7. https://psnet.ahrq.gov/issue/bar-code-technology-and-medication-administration-error This…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35888/psn-pdf
    July 23, 2010 - Medication errors and patient complications with continuous renal replacement therapy. July 23, 2010 Barletta JF, Barletta G-M, Brophy PD, et al. Medication errors and patient complications with continuous renal replacement therapy. Pediatr Nephrol. 2006;21(6):842-5. https://psnet.ahrq.gov/issue/medication-errors-…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50763/psn-pdf
    December 18, 2019 - Their kids died on the psych ward. They were far from alone, a Times investigation found. December 18, 2019 Karlamangla S. Los Angeles Times. December 1, 2019. https://psnet.ahrq.gov/issue/their-kids-died-psych-ward-they-were-far-alone-times-investigation-found Patient suicide is considered a sentinel event. This …

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44226/psn-pdf
    November 03, 2015 - The Patient Survival Handbook. November 3, 2015 Powell SM, Stone RD. Peachtree City, GA: Synensis; 2015. https://psnet.ahrq.gov/issue/patient-survival-handbook Engaging patients in their care is increasingly advocated as a way to improve safety. This book recommends actions for patients and families to reduce risk…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36284/psn-pdf
    March 10, 2011 - E-prescribing, efficiency, quality: lessons from the computerization of UK family practice. March 10, 2011 Schade CP, Sullivan FM, de Lusignan S, et al. e-Prescribing, efficiency, quality: lessons from the computerization of UK family practice. J Am Med Inform Assoc. 2006;13(5):470-5. https://psnet.ahrq.gov/issue/…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40066/psn-pdf
    January 01, 2011 - Communication errors in dispatch of air medical transport. December 8, 2010 Vilensky D, MacDonald RD. Communication errors in dispatch of air medical transport. Prehosp Emerg Care. 2011;15(1):39-43. doi:10.3109/10903127.2011.519817. https://psnet.ahrq.gov/issue/communication-errors-dispatch-air-medical-transport …

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44115/psn-pdf
    June 03, 2015 - An approach to assessing patient safety in hospitals in low-income countries. June 3, 2015 Lindfield R, Knight A, Bwonya D. An approach to assessing patient safety in hospitals in low-income countries. PLoS One. 2015;10(3):e0121628. doi:10.1371/journal.pone.0121628. https://psnet.ahrq.gov/issue/approach-assessing-…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37815/psn-pdf
    June 18, 2008 - A 2-year study of patient safety competency assessment in 29 clinical laboratories. June 18, 2008 Reed RC, Kim S, Farquharson K, et al. A 2-Year Study of Patient Safety Competency Assessment in 29 Clinical Laboratories. Am J Clin Pathol. 2008;129(6). doi:10.1309/bm8jje1auca408tq. https://psnet.ahrq.gov/issue/2-yea…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42343/psn-pdf
    June 19, 2013 - Top 10 patient safety issues: what more can we do? June 19, 2013 Steelman VM, Graling PR. Top 10 patient safety issues: what more can we do? AORN J. 2013;97(6):679- 98, quiz 699-701. doi:10.1016/j.aorn.2013.04.012. https://psnet.ahrq.gov/issue/top-10-patient-safety-issues-what-more-can-we-do This commentary reveal…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44613/psn-pdf
    October 28, 2015 - Getting rid of "never events" in hospitals. October 28, 2015 Morgenthaler T; Harper CM. https://psnet.ahrq.gov/issue/getting-rid-never-events-hospitals Never events are devastating and preventable, and health care organizations are under increasing pressure to eliminate them. This commentary discusses how the Mayo…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39784/psn-pdf
    August 25, 2010 - Perceptions of effective and ineffective nurse–physician communication in hospitals. August 25, 2010 Robinson P, Gorman G, Slimmer LW, et al. Perceptions of effective and ineffective nurse-physician communication in hospitals. Nurs Forum. 2010;45(3):206-16. doi:10.1111/j.1744-6198.2010.00182.x. https://psnet.ahrq.…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35845/psn-pdf
    June 13, 2011 - Reconcilable differences: correcting medication errors at hospital admission and discharge. June 13, 2011 Vira T, Colquhoun M, Etchells E. Reconcilable differences: correcting medication errors at hospital admission and discharge. Qual Saf Health Care. 2006;15(2):122-6. https://psnet.ahrq.gov/issue/reconcilable-di…

  15. Making Just Culture a Reality: One Organization's Approach | PSNet

    psnet.ahrq.gov/perspective/making-just-culture-reality-one-organizations-approach
    October 01, 2007 - Making Just Culture a Reality: One Organization's Approach Alison H. Page, MS, MHA | October 1, 2007  Also Read a Conversation View more articles from the same authors. Citation Text: Page AH. Making Just Culture a Reality: One Organization's Approach. PSNet [in…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/852795/psn-pdf
    August 23, 2023 - Perceptions of radiation safety culture in medical imaging by role. August 23, 2023 Moore QT, Haynes KW. Radiol Technol. 2023;94(5):337-347. https://psnet.ahrq.gov/issue/perceptions-radiation-safety-culture-medical-imaging-role Fostering a culture of safety is a core patient safety objective. This survey of 425 ra…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42032/psn-pdf
    April 10, 2013 - Evaluation of a nurse-led safety program in a critical care unit. April 10, 2013 Saladino L, Pickett LC, Frush K, et al. Evaluation of a nurse-led safety program in a critical care unit. J Nurs Care Qual. 2013;28(2):139-46. doi:10.1097/NCQ.0b013e31827464c3. https://psnet.ahrq.gov/issue/evaluation-nurse-led-safety-…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41631/psn-pdf
    September 24, 2016 - Interruption handling strategies during paediatric medication administration. September 24, 2016 Colligan L, Bass EJ. Interruption handling strategies during paediatric medication administration. BMJ Qual Saf. 2012;21(11):912-7. doi:10.1136/bmjqs-2011-000292. https://psnet.ahrq.gov/issue/interruption-handling-stra…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35912/psn-pdf
    July 23, 2010 - Portable advanced medical simulation for new emergency department testing and orientation. July 23, 2010 Kobayashi L, Shapiro MJ, Sucov A, et al. Portable advanced medical simulation for new emergency department testing and orientation. Acad Emerg Med. 2006;13(6):691-5. https://psnet.ahrq.gov/issue/portable-advanc…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39262/psn-pdf
    March 04, 2011 - Unintended errors with EHR-based result management: a case series. March 4, 2011 Yackel TR, Embi P. Unintended errors with EHR-based result management: a case series. J Am Med Inform Assoc. 2010;17(1):104-7. doi:10.1197/jamia.M3294. https://psnet.ahrq.gov/issue/unintended-errors-ehr-based-result-management-case-se…
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