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Do Not Miss Sepsis Needles in Viral Haystacks! | PSNet

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March 27, 2024 - SPOTLIGHT CASE Do Not Miss Sepsis Needles in Viral Haystacks! Citation Text: Hamline M, Shaikh U. Do Not Miss Sepsis Needles in Viral Haystacks!. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2024. Copy Citation For…

Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression | PSNet

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May 26, 2021 - SPOTLIGHT CASE Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression Citation Text: Fazio S, Firestone R. Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Depar…

Strengthening open disclosure after incidents in maternity care: a realist synthesis of international research evidence. | PSNet

psnet.ahrq.gov/issue/strengthening-open-disclosure-after-incidents-maternity-care-realist-synthesis-international

September 18, 2024 - Review Strengthening open disclosure after incidents in maternity care: a realist synthesis of international research evidence. Citation Text: Adams M, Hartley J, Sanford N, et al. Strengthening open disclosure after incidents in maternity care: a realist synthesis of international resea…

Development and validation of a brief culture-of-safety survey. | PSNet

psnet.ahrq.gov/issue/development-and-validation-brief-culture-safety-survey

May 26, 2021 - Study Development and validation of a brief culture-of-safety survey. Citation Text: Barnard C, Chung JW, Flaherty V, et al. Development and validation of a brief culture-of-safety survey. Jt Comm J Qual Patient Saf. 2022;48(9):430-438. doi:10.1016/j.jcjq.2022.04.006. Copy Citation …

Direct oral anticoagulant-related medication incidents and pharmacists' interventions in hospital in-patients: evaluation using Reason's accident causation theory. | PSNet

psnet.ahrq.gov/issue/direct-oral-anticoagulant-related-medication-incidents-and-pharmacists-interventions-hospital

January 12, 2022 - Study Direct oral anticoagulant-related medication incidents and pharmacists' interventions in hospital in-patients: evaluation using Reason's accident causation theory. Citation Text: Haque H, Alrowily A, Jalal Z, et al. Direct oral anticoagulant-related medication incidents and pharmac…

Review of medication errors that are new or likely to occur more frequently with electronic medication management systems. | PSNet

psnet.ahrq.gov/issue/review-medication-errors-are-new-or-likely-occur-more-frequently-electronic-medication

August 18, 2021 - Study Review of medication errors that are new or likely to occur more frequently with electronic medication management systems. Citation Text: Van de Vreede M, McGrath A, de Clifford J. Review of medication errors that are new or likely to occur more frequently with electronic medicatio…

Is oral chemotherapy prescription safe for patients? A cross-sectional survey. | PSNet

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May 18, 2022 - Study Is oral chemotherapy prescription safe for patients? A cross-sectional survey. Citation Text: Bourmaud A, Pacaut C, Melis A, et al. Is oral chemotherapy prescription safe for patients? A cross-sectional survey. Ann Oncol. 2014;25(2):500-504. doi:10.1093/annonc/mdt553. Copy Citati…

Association of anesthesiologist staffing ratio with surgical patient morbidity and mortality. | PSNet

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July 06, 2022 - Study Association of anesthesiologist staffing ratio with surgical patient morbidity and mortality. Citation Text: Burns ML, Saager L, Cassidy RB, et al. Association of anesthesiologist staffing ratio with surgical patient morbidity and mortality. JAMA Surg. 2022;157(9):807-815. doi:10.1…

The impact of electronic health record interoperability on safety and quality of care in high-income countries: systematic review. | PSNet

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July 27, 2022 - Review The impact of electronic health record interoperability on safety and quality of care in high-income countries: systematic review. Citation Text: Li E, Clarke J, Ashrafian H, et al. The impact of electronic health record interoperability on safety and quality of care in high-incom…

Adverse event and error of unexpected life-threatening events within 24h of emergency department admission. | PSNet

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October 27, 2016 - Study Adverse event and error of unexpected life-threatening events within 24h of emergency department admission. Citation Text: Zhang E, Hung S-C, Wu C-H, et al. Adverse event and error of unexpected life-threatening events within 24hours of ED admission. Am J Emerg Med. 2017;35(3):479-…

Device use errors among patients with asthma and COPD and the role of training: a real-life study. | PSNet

psnet.ahrq.gov/issue/device-use-errors-among-patients-asthma-and-copd-and-role-training-real-life-study

June 22, 2022 - Study Device use errors among patients with asthma and COPD and the role of training: a real-life study. Citation Text: Papaioannou AI, Bartziokas K, Hillas G, et al. Device use errors among patients with asthma and COPD and the role of training: a real-life study. Postgrad Med. 2021;133…

The role of organizational and professional cultures in medication safety: a scoping review of the literature. | PSNet

psnet.ahrq.gov/issue/role-organizational-and-professional-cultures-medication-safety-scoping-review-literature

February 12, 2020 - Review The role of organizational and professional cultures in medication safety: a scoping review of the literature. Citation Text: Machen S, Jani Y, Turner S, et al. The role of organizational and professional cultures in medication safety: a scoping review of the literature. Int J Hea…

Patient, carer and family experiences of seeking redress and reconciliation following a life-changing event: systematic review of qualitative evidence. | PSNet

psnet.ahrq.gov/issue/patient-carer-and-family-experiences-seeking-redress-and-reconciliation-following-life

April 24, 2018 - Review Patient, carer and family experiences of seeking redress and reconciliation following a life-changing event: systematic review of qualitative evidence. Citation Text: Shaw L, Lawal HM, Briscoe S, et al. Patient, carer and family experiences of seeking redress and reconciliation fo…

Interprofessional training and communication practices among clinicians in the postoperative ICU handoff. | PSNet

psnet.ahrq.gov/issue/interprofessional-training-and-communication-practices-among-clinicians-postoperative-icu

February 06, 2019 - Study Interprofessional training and communication practices among clinicians in the postoperative ICU handoff. Citation Text: Massa S, Wu J, Wang C, et al. Interprofessional training and communication practices among clinicians in the postoperative ICU handoff. Jt Comm J Qual Patient Sa…

The use of patient feedback by hospital boards of directors: a qualitative study of two NHS hospitals in England. | PSNet

psnet.ahrq.gov/issue/use-patient-feedback-hospital-boards-directors-qualitative-study-two-nhs-hospitals-england

June 12, 2019 - Study The use of patient feedback by hospital boards of directors: a qualitative study of two NHS hospitals in England. Citation Text: Lee R, Baeza JI, Fulop NJ. The use of patient feedback by hospital boards of directors: a qualitative study of two NHS hospitals in England. BMJ Qual Saf…

Preferences and perceptions of medical error disclosure among marginalized populations: a narrative review. | PSNet

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June 15, 2022 - Review Preferences and perceptions of medical error disclosure among marginalized populations: a narrative review. Citation Text: Olazo K, Wang K, Sierra M, et al. Preferences and perceptions of medical error disclosure among marginalized populations: a narrative review. Jt Comm J Qual P…

Adopting real-time surveillance dashboards as a component of an enterprisewide medication safety strategy. | PSNet

psnet.ahrq.gov/issue/adopting-real-time-surveillance-dashboards-component-enterprisewide-medication-safety

June 27, 2018 - Study Adopting real-time surveillance dashboards as a component of an enterprisewide medication safety strategy. Citation Text: Waitman LR, Phillips IE, McCoy AB, et al. Adopting real-time surveillance dashboards as a component of an enterprisewide medication safety strategy. Jt Comm J Q…

Final Report on Prioritization of Patient Safety Practices for a New Rapid Review or Rapid Response. Making Healthcare Safer IV Series. | PSNet

psnet.ahrq.gov/issue/final-report-prioritization-patient-safety-practices-new-rapid-review-or-rapid-response

December 21, 2022 - Book/Report Final Report on Prioritization of Patient Safety Practices for a New Rapid Review or Rapid Response. Making Healthcare Safer IV Series. Citation Text: Final Report on Prioritization of Patient Safety Practices for a New Rapid Review or Rapid Response. Making Healthcare Safer …

More than algorithms: an analysis of safety events involving ML-enabled medical devices reported to the FDA. | PSNet

psnet.ahrq.gov/issue/more-algorithms-analysis-safety-events-involving-ml-enabled-medical-devices-reported-fda

May 01, 2019 - Study More than algorithms: an analysis of safety events involving ML-enabled medical devices reported to the FDA. Citation Text: Lyell D, Wang Y, Coiera E, et al. More than algorithms: an analysis of safety events involving ML-enabled medical devices reported to the FDA. J Am Med Inform…

Emergency physician perceptions of electronic health record usability and safety. | PSNet

psnet.ahrq.gov/issue/emergency-physician-perceptions-electronic-health-record-usability-and-safety

August 24, 2022 - Study Emergency physician perceptions of electronic health record usability and safety. Citation Text: Pruitt ZM, Howe JL, Hettinger AZ, et al. Emergency physician perceptions of electronic health record usability and safety. J Patient Saf. 2021;17(8):e983-e987. doi:10.1097/pts.000000000…

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