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psnet.ahrq.gov/node/38995/psn-pdf
March 04, 2011 - Does computerized provider order entry reduce
prescribing errors for hospital inpatients? A systematic
review.
March 4, 2011
Reckmann MH, Westbrook JI, Koh Y, et al. Does computerized provider order entry reduce prescribing
errors for hospital inpatients? A systematic review. J Am Med Inform Assoc. 2009;16(5):613-…
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psnet.ahrq.gov/node/866563/psn-pdf
August 21, 2024 - Leadership and the high reliability transformation: a
qualitative study at Truman VA medical center.
August 21, 2024
Leonard C, Gilmartin HM, Starr LM, et al. Leadership and the high reliability transformation: a qualitative
study at Truman VA medical center. J Healthc Risk Manag. 2024;44(1):17-23. doi:10.1002/jhrm…
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psnet.ahrq.gov/node/42400/psn-pdf
July 10, 2013 - Development and reliability of the explicit professional
oral communication observation tool to quantify the use
of non-technical skills in healthcare.
July 10, 2013
Kemper PF, van Noord I, de Bruijne M, et al. Development and reliability of the explicit professional oral
communication observation tool to quantify…
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psnet.ahrq.gov/node/74141/psn-pdf
December 01, 2021 - Incident reporting systems: what will it take to make them
less frustrating and achieve anything useful?
December 1, 2021
Shojania KG. Incident reporting systems: what will it take to make them less frustrating and achieve
anything useful? Jt Comm J Qual Patient Saf. 2021;47(12):755-758. doi:10.1016/j.jcjq.2021.10.…
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psnet.ahrq.gov/node/41132/psn-pdf
March 13, 2012 - Spreading a medication administration intervention
organizationwide in six hospitals.
March 13, 2012
Kliger J, Singer SJ, Hoffman F, et al. Spreading a medication administration intervention organizationwide
in six hospitals. Jt Comm J Qual Patient Saf. 2012;38(2):51-60.
https://psnet.ahrq.gov/issue/spreading-medi…
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psnet.ahrq.gov/node/40172/psn-pdf
January 26, 2011 - Risk of adverse drug events in neonates treated with
opioids and the effect of a bar-code–assisted medication
administration system.
January 26, 2011
Morriss FH, Abramowitz PW, Nelson S, et al. Risk of adverse drug events in neonates treated with opioids
and the effect of a bar-code-assisted medication administrat…
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psnet.ahrq.gov/node/34889/psn-pdf
March 04, 2011 - Effect of electronic health records in ambulatory care:
retrospective, serial, cross sectional study.
March 4, 2011
Garrido T, Jamieson L, Zhou Y, et al. Effect of electronic health records in ambulatory care: retrospective,
serial, cross sectional study. BMJ. 2005;330(7491):581.
https://psnet.ahrq.gov/issue/effec…
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psnet.ahrq.gov/node/43169/psn-pdf
May 07, 2014 - Copy, paste, and cloned notes in electronic health
records: prevalence, benefits, risks, and best practice
recommendations.
May 7, 2014
Weis JM, Levy PC. Copy, paste, and cloned notes in electronic health records: prevalence, benefits, risks,
and best practice recommendations. Chest. 2014;145(3):632-8. doi:10.1378…
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psnet.ahrq.gov/node/74264/psn-pdf
January 19, 2022 - Characteristics of critical incident reporting systems in
primary care: an international survey.
January 19, 2022
Höcherl A, Lüttel D, Schütze D, et al. Characteristics of critical incident reporting systems in primary care:
an international survey. J Patient Saf. 2022;18(1):e85-e91. doi:10.1097/pts.000000000000070…
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psnet.ahrq.gov/node/865677/psn-pdf
April 24, 2024 - The impact of adding a 2-way video monitoring system on
falls and costs for high-risk inpatients.
April 24, 2024
Sosa MA, Soares M, Patel S, et al. The impact of adding a 2-way video monitoring system on falls and
costs for high-risk inpatients. J Patient Saf. 2024;20(3):186-191. doi:10.1097/pts.0000000000001197.
…
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psnet.ahrq.gov/node/44884/psn-pdf
February 17, 2016 - Changes in default alarm settings and standard in-service
are insufficient to improve alarm fatigue in an intensive
care unit: a pilot project.
February 17, 2016
Sowan AK, Gomez TM, Tarriela AF, et al. Changes in Default Alarm Settings and Standard In-Service are
Insufficient to Improve Alarm Fatigue in an Intensi…
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psnet.ahrq.gov/node/42909/psn-pdf
December 12, 2014 - Does applying technology throughout the medication use
process improve patient safety with antineoplastics?
December 12, 2014
Bubalo J, Warden BA, Wiegel JJ, et al. Does applying technology throughout the medication use process
improve patient safety with antineoplastics? J Oncol Pharm Pract. 2014;20(6):445-60.
do…
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psnet.ahrq.gov/node/838917/psn-pdf
October 26, 2022 - The e-Autopsy/e-Biopsy: a systematic chart review to
increase safety and diagnostic accuracy.
October 26, 2022
Kanter MH, Ghobadi A, Lurvey LD, et al. The e-Autopsy/e-Biopsy: a systematic chart review to increase
safety and diagnostic accuracy. Diagnosis (Berl). 2022;9(4):430-436. doi:10.1515/dx-2022-0083.
https:/…
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psnet.ahrq.gov/node/41245/psn-pdf
March 29, 2012 - The occurrence of wrong-site surgery self-reported by
candidates for certification by the American Board of
Orthopaedic Surgery.
March 29, 2012
James MA, Seiler JG, Harrast JJ, et al. The occurrence of wrong-site surgery self-reported by candidates
for certification by the American Board of Orthopaedic Surgery. J …
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psnet.ahrq.gov/node/863222/psn-pdf
February 28, 2024 - Systematic review of morbidity and mortality meeting
standardization: does it lead to improved professional
development, system improvements, clinician
engagement, and enhanced patient safety culture?
February 28, 2024
Steel EJ, Janda M, Jamali S, et al. Systematic review of morbidity and mortality meeting standar…
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psnet.ahrq.gov/node/42918/psn-pdf
February 05, 2014 - Ascension Health's demonstration of full disclosure
protocol for unexpected events during labor and delivery
shows promise.
February 5, 2014
Hendrich A, McCoy CK, Gale J, et al. Ascension health's demonstration of full disclosure protocol for
unexpected events during labor and delivery shows promise. Health Aff (M…
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psnet.ahrq.gov/node/865873/psn-pdf
May 15, 2024 - A review of medication errors and the second victim in
pediatric pharmacy.
May 15, 2024
Bredenkamp K, Raschka MJ, Holmes A. A review of medication errors and the second victim in pediatric
pharmacy. J Pediatr Pharmacol Ther. 2024;29(2):100-106. doi:10.5863/1551-6776-29.2.100.
https://psnet.ahrq.gov/issue/review-me…
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psnet.ahrq.gov/node/857452/psn-pdf
December 06, 2023 - Improving patient safety governance and systems
through learning from successes and failures: qualitative
surveys and interviews with international experts.
December 6, 2023
Hibbert PD, Stewart S, Wiles LK, et al. Improving patient safety governance and systems through learning
from successes and failures: qualita…
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psnet.ahrq.gov/node/836831/psn-pdf
March 30, 2022 - A qualitative analysis of the impact of electronic health
records (EHR) on healthcare quality and safety: clinicians'
lived experiences.
March 30, 2022
Upadhyay S, Hu H-fen. . A Qualitative analysis of the impact of electronic health records (EHR) on
healthcare quality and safety: clinicians' lived experiences. He…
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psnet.ahrq.gov/node/45760/psn-pdf
February 08, 2017 - Safe practices for copy and paste in the EHR. Systematic
review, recommendations, and novel model for health IT
collaboration.
February 8, 2017
Tsou AY, Lehmann CU, Michel J, et al. Safe Practices for Copy and Paste in the EHR. Systematic Review,
Recommendations, and Novel Model for Health IT Collaboration. Appl C…