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psnet.ahrq.gov/node/837517/psn-pdf
June 22, 2022 - Zero: Eliminating Unnecessary Deaths in a Post-
pandemic NHS.
June 22, 2022
Hunt J. London, UK: Swift Press; 2022. ISBN: ? 9781800751224.
https://psnet.ahrq.gov/issue/zero-eliminating-unnecessary-deaths-post-pandemic-nhs
The National Health Service (NHS) has been a leader in patient safety for over 20 years, and y…
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psnet.ahrq.gov/node/43129/psn-pdf
July 23, 2014 - Use of a daily goals checklist for morning ICU rounds: a
mixed-methods study.
July 23, 2014
Centofanti JE, Duan EH, Hoad NC, et al. Use of a daily goals checklist for morning ICU rounds: a mixed-
methods study. Crit Care Med. 2014;42(8):1797-803. doi:10.1097/CCM.0000000000000331.
https://psnet.ahrq.gov/issue/use-d…
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psnet.ahrq.gov/node/50782/psn-pdf
January 08, 2020 - What can patient safety teach us about clinician burnout?
January 8, 2020
Wu AW, Dzau VJ. What Can Patient Safety Teach Us About Clinician Burnout? Ann Intern Med.
2019;171(12):933-934. doi:10.7326/m19-2397.
https://psnet.ahrq.gov/issue/what-can-patient-safety-teach-us-about-clinician-burnout
This commentary discu…
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psnet.ahrq.gov/node/73392/psn-pdf
June 16, 2021 - AI for radiographic COVID-19 detection selects shortcuts
over signal.
June 16, 2021
DeGrave AJ, Janizek JD, Lee S-I. AI for radiographic COVID-19 detection selects shortcuts over signal.
Nat Mach Intell. 2021;3:610–619. doi:10.1038/s42256-021-00338-7.
https://psnet.ahrq.gov/issue/ai-radiographic-covid-19-detection…
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psnet.ahrq.gov/node/43390/psn-pdf
July 30, 2014 - Hazards tied to medical records rush.
July 30, 2014
Rowland C.
https://psnet.ahrq.gov/issue/hazards-tied-medical-records-rush
Government incentives have led to rapid development and adoption of electronic health records (EHRs).
This newspaper article examines some of the unintended consequences of implementing ele…
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psnet.ahrq.gov/node/849613/psn-pdf
May 31, 2023 - Smart infusion pump investigations after an unexplained
over-infusion.
May 31, 2023
ISMP Patient Safety Alert! Acute care edition. May 18, 2023;28(10);1-3.
https://psnet.ahrq.gov/issue/smart-infusion-pump-investigations-after-unexplained-over-infusion
Dose error-reduction systems (DERS) and drug libraries are tool…
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psnet.ahrq.gov/node/48133/psn-pdf
November 01, 2024 - The NHS Patient Safety Strategy.
November 1, 2024
NHS England
https://psnet.ahrq.gov/issue/nhs-patient-safety-strategy
The United Kingdom National Health Service (NHS) has been at the forefront of patient safety innovation.
This strategy seeks to further implement approaches that explore and optimize the intersect…
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psnet.ahrq.gov/node/46895/psn-pdf
March 14, 2018 - Rapid response teams: what's the latest?
March 14, 2018
Jackson SA. Rapid response teams: What's the latest? Nursing (Brux). 2017;47(12):34-41.
doi:10.1097/01.NURSE.0000526885.10306.21.
https://psnet.ahrq.gov/issue/rapid-response-teams-whats-latest
Rapid response systems are an established strategy to prevent in-h…
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psnet.ahrq.gov/node/40547/psn-pdf
June 29, 2011 - What context features might be important determinants of
the effectiveness of patient safety practice interventions?
June 29, 2011
Taylor SL, Dy SM, Foy R, et al. What context features might be important determinants of the effectiveness
of patient safety practice interventions? BMJ Qual Saf. 2011;20(7):611-7. doi:…
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psnet.ahrq.gov/node/38099/psn-pdf
October 01, 2008 - Decreased bile duct injury rate during laparoscopic
cholecystectomy in the era of the 80-hour resident
workweek.
October 1, 2008
Yaghoubian A, Saltmarsh G, Rosing DK, et al. Decreased bile duct injury rate during laparoscopic
cholecystectomy in the era of the 80-hour resident workweek. Arch Surg. 2008;143(9):847-5…
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psnet.ahrq.gov/node/47129/psn-pdf
September 05, 2018 - Impact of medication reconciliation for improving
transitions of care.
September 5, 2018
Redmond P, Grimes TC, McDonnell R, et al. Impact of medication reconciliation for improving transitions of
care. Cochrane Database Syst Rev. 2018;8(8):CD010791. doi:10.1002/14651858.CD010791.pub2.
https://psnet.ahrq.gov/issue/…
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psnet.ahrq.gov/node/36505/psn-pdf
February 16, 2011 - Complying with ACGME resident duty hours restrictions:
restructuring the 80-hour workweek to enhance education
and patient safety at Texas A&M/Scott & White Memorial
Hospital.
February 16, 2011
Ogden PE, Sibbitt S, Howell M, et al. Complying with ACGME resident duty hours restrictions: restructuring
the 80-hour w…
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psnet.ahrq.gov/node/73507/psn-pdf
July 21, 2021 - Systematic review of intraoperative anesthesia handoffs
and handoff tools.
July 21, 2021
Abraham J, Pfeifer E, Doering M, et al. Systematic review of intraoperative anesthesia handoffs and
handoff tools. Anesth Analg. 2021;132(6):1563-1575. doi:10.1213/ane.0000000000005367.
https://psnet.ahrq.gov/issue/systematic-…
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psnet.ahrq.gov/node/838014/psn-pdf
September 07, 2022 - Effect of a rapid response team on the incidence of in-
hospital mortality.
September 7, 2022
Factora F, Maheshwari K, Khanna S, et al. Effect of a rapid response team on the incidence of in-hospital
mortality. Anesth Analg. 2022;135(3):595-604. doi:10.1213/ane.0000000000006005.
https://psnet.ahrq.gov/issue/effect…
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psnet.ahrq.gov/node/42579/psn-pdf
November 18, 2013 - Surgical safety checklist compliance: a job done poorly!
November 18, 2013
Sparks EA, Wehbe-Janek H, Johnson RL, et al. Surgical Safety Checklist compliance: a job done poorly!. J
Am Coll Surg. 2013;217(5):867-73.e1-3. doi:10.1016/j.jamcollsurg.2013.07.393.
https://psnet.ahrq.gov/issue/surgical-safety-checklist-com…
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psnet.ahrq.gov/node/38274/psn-pdf
March 31, 2009 - Time motion study in a pediatric emergency department
before and after computer physician order entry.
March 31, 2009
Yen K, Shane EL, Pawar SS, et al. Time motion study in a pediatric emergency department before and
after computer physician order entry. Ann Emerg Med. 2009;53(4):462-468.e1.
doi:10.1016/j.annemerg…
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psnet.ahrq.gov/node/60878/psn-pdf
January 01, 2021 - Intervention study for the reduction of medication errors
in elderly trauma patients.
September 2, 2020
Parro Martín M de los Á, Muñoz García M, Delgado Silveira E, et al. Intervention study for the reduction of
medication errors in elderly trauma patients. J Eval Clin Pract. 2021;27(1):160-166. doi:10.1111/jep.134…
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psnet.ahrq.gov/node/36769/psn-pdf
June 15, 2011 - Using incident reporting to improve patient safety: a
conceptual model.
June 15, 2011
Pronovost PJ, Holzmueller CG, Young J, et al. Using Incident Reporting to Improve Patient Safety. J
Patient Saf. 2008;3(1). doi:10.1097/pts.0b013e318030ca05.
https://psnet.ahrq.gov/issue/using-incident-reporting-improve-patient-s…
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psnet.ahrq.gov/node/47656/psn-pdf
March 13, 2019 - Sleep and alertness in a duty-hour flexibility trial in
internal medicine.
March 13, 2019
Basner M, Asch DA, Shea JA, et al; iCOMPARE Research Group. N Engl J Med. 2019;380:915-923.
https://psnet.ahrq.gov/issue/sleep-and-alertness-duty-hour-flexibility-trial-internal-medicine
This cluster-randomized trial compared…
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psnet.ahrq.gov/node/43465/psn-pdf
February 18, 2015 - Hospital Readmissions Reduction Program: implications
for pharmacy.
February 18, 2015
Boesen KAG, Leal S, Sheehan VC, et al. Hospital Readmissions Reduction Program: implications for
pharmacy. Am J Health Syst Pharm. 2015;72(3):237-44. doi:10.2146/ajhp140177.
https://psnet.ahrq.gov/issue/hospital-readmissions-redu…