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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39177/psn-pdf
    May 04, 2010 - The impact of organisational and individual factors on team communication in surgery: a qualitative study. May 4, 2010 Gillespie BM, Chaboyer W, Longbottom P, et al. The impact of organisational and individual factors on team communication in surgery: a qualitative study. Int J Nurs Stud. 2010;47(6):732-41. doi:10…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41799/psn-pdf
    December 29, 2014 - Types and patterns of safety concerns in home care: staff perspectives. December 29, 2014 Craven CK, Byrne K, Sims-Gould J, et al. Types and patterns of safety concerns in home care: staff perspectives. Int J Qual Health Care. 2012;24(5):525-31. doi:10.1093/intqhc/mzs047. https://psnet.ahrq.gov/issue/types-and-pat…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36381/psn-pdf
    April 22, 2011 - Accountability sought by patients following adverse events from medical care: the New Zealand experience. April 22, 2011 Bismark M, Dauer E, Paterson R, et al. Accountability sought by patients following adverse events from medical care: the New Zealand experience. CMAJ. 2006;175(8):889-94. https://psnet.ahrq.gov/…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/865588/psn-pdf
    April 17, 2024 - Inattentional blindness in medicine. April 17, 2024 Hults CM, Ding Y, Xie GG, et al. Inattentional blindness in medicine. Cogn Res Princ Implic. 2024;9(1):18. doi:10.1186/s41235-024-00537-x. https://psnet.ahrq.gov/issue/inattentional-blindness-medicine Inattentional blindness occurs when a person is focused so int…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42767/psn-pdf
    November 27, 2013 - Barcode medication administration work-arounds: a systematic review and implications for nurse executives. November 27, 2013 Voshall B, Piscotty R, Lawrence J, et al. Barcode medication administration work-arounds: a systematic review and implications for nurse executives. J Nurs Adm. 2013;43(10):530-535. doi:10.1…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/838139/psn-pdf
    September 21, 2022 - Error traps in acute pain management in children. September 21, 2022 Vecchione TM, Agarwal R, Monitto CL. Error traps in acute pain management in children. Paediatr Anaesth. 2022;32(9):982-992. doi:10.1111/pan.14514. https://psnet.ahrq.gov/issue/error-traps-acute-pain-management-children Appropriate pediatric pain…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73989/psn-pdf
    October 20, 2021 - How is safety climate measured? A review and evaluation. October 20, 2021 Shea T, De Cieri H, Vu T, et al. How is safety climate measured? A review and evaluation. Safety Sci. 2021;143:105413. doi:10.1016/j.ssci.2021.105413. https://psnet.ahrq.gov/issue/how-safety-climate-measured-review-and-evaluation Assessing s…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40274/psn-pdf
    December 29, 2014 - Predictors of the perceived impact of a patient safety collaborative: an exploratory study. December 29, 2014 Pinto A, Benn J, Burnett S, et al. Predictors of the perceived impact of a patient safety collaborative: an exploratory study. Int J Qual Health Care. 2011;23(2):173-81. doi:10.1093/intqhc/mzq089. https://…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36536/psn-pdf
    January 10, 2011 - What do family physicians consider an error? A comparison of definitions and physician perception. January 10, 2011 Elder NC, Pallerla H, Regan S. What do family physicians consider an error? A comparison of definitions and physician perception. BMC Fam Pract. 2006;7:73. https://psnet.ahrq.gov/issue/what-do-family…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38926/psn-pdf
    November 13, 2009 - "Canary measures" among the AHRQ Patient Safety Indicators. November 13, 2009 Yu H, Greenberg MD, Haviland AM, et al. "Canary measures" among the AHRQ patient safety indicators. Am J Med Qual. 2009;24(6):465-73. doi:10.1177/1062860609341585. https://psnet.ahrq.gov/issue/canary-measures-among-ahrq-patient-safety-in…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36905/psn-pdf
    September 01, 2011 - Engineering a safe landing: engaging medical practitioners in a systems approach to patient safety. September 1, 2011 Brand C, Ibrahim JE, Bain C, et al. Engineering a safe landing: engaging medical practitioners in a systems approach to patient safety. Intern Med J. 2007;37(5):295-302. https://psnet.ahrq.gov/issu…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45320/psn-pdf
    January 01, 2017 - The problem with the '5 whys.' September 14, 2016 Card AJ. The problem with '5 whys'. BMJ Qual Saf. 2017;26(8):671-677. doi:10.1136/bmjqs-2016-005849. https://psnet.ahrq.gov/issue/problem-5-whys Investigation of incidents in complex systems can be hindered by time limitations, lack of follow-up, and incomplete res…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42631/psn-pdf
    November 08, 2013 - "That was a close call": endorsing a broad definition of near misses in health care. November 8, 2013 Marks CM, Kasda E, Paine LA, et al. "That was a close call": endorsing a broad definition of near misses in health care. Jt Comm J Qual Patient Saf. 2013;39(10):475-479. https://psnet.ahrq.gov/issue/was-close-call…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35196/psn-pdf
    March 01, 2011 - A method for measuring system safety and latent errors associated with pediatric procedural sedation. March 1, 2011 Blike G, Christoffersen K, Cravero JP, et al. A method for measuring system safety and latent errors associated with pediatric procedural sedation. Anesth Analg. 2005;101(1):48-58, table of contents. …
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38305/psn-pdf
    January 15, 2009 - High-alert medications in the pediatric intensive care unit. January 15, 2009 Franke HA, Woods D, Holl JL. High-alert medications in the pediatric intensive care unit. Pediatr Crit Care Med. 2009;10(1):85-90. doi:10.1097/PCC.0b013e3181936ff8. https://psnet.ahrq.gov/issue/high-alert-medications-pediatric-intensive-c…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42487/psn-pdf
    September 27, 2017 - 'Safe enough in here?': Patients' expectations and experiences of feeling safe in an acute psychiatric inpatient ward. September 27, 2017 Stenhouse RC. 'Safe enough in here?': patients' expectations and experiences of feeling safe in an acute psychiatric inpatient ward. J Clin Nurs. 2013;22(21-22):3109-19. doi:10.…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38846/psn-pdf
    August 05, 2009 - Seeking a safer surgery: some states crack down on doctors who perform unregulated outpatient procedures. August 5, 2009 Landro L. https://psnet.ahrq.gov/issue/seeking-safer-surgery-some-states-crack-down-doctors-who-perform- unregulated-outpatient This article discusses growing legal oversight on outpatient surg…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43934/psn-pdf
    September 27, 2017 - Communication elements supporting patient safety in psychiatric inpatient care. September 27, 2017 Kanerva A, Kivinen T, Lammintakanen J. Communication elements supporting patient safety in psychiatric inpatient care. J Psychiatr Ment Health Nurs. 2015;22(5):298-305. doi:10.1111/jpm.12187. https://psnet.ahrq.gov/i…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42209/psn-pdf
    April 24, 2013 - Analysis of staff safety concerns. April 24, 2013 Davidson J, Lamontagne G, Burnell L, et al. Analysis of Staff Safety Concerns. J Nurs Care Qual. 2012;28(2). doi:10.1097/ncq.0b013e318277e874. https://psnet.ahrq.gov/issue/analysis-staff-safety-concerns This case study demonstrates how an organization used a safety…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39954/psn-pdf
    November 26, 2014 - Incidence of adverse drug events and medication errors in Japan: the JADE Study. November 26, 2014 Sakuma M, Bates DW, Morimoto T. Clinical prediction rule to identify high-risk inpatients for adverse drug events: the JADE Study. Pharmacoepidemiol Drug Saf. 2012;21(11). doi:10.1002/pds.3331. https://psnet.ahrq.gov…

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