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psnet.ahrq.gov/issue/impact-regionalized-care-concordance-plan-and-preventable-adverse-events-general-medicine
November 16, 2022 - Study
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
Citation Text:
Mueller SK, Schnipper JL, Giannelli K, et al. Impact of regionalized care on concordance of plan and preventable adverse events on general medicine service…
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psnet.ahrq.gov/issue/more-holes-cheese-what-prevents-delivery-effective-high-quality-and-safe-healthcare-england
December 18, 2017 - Study
More holes than cheese. What prevents the delivery of effective, high quality, and safe healthcare in England?
Citation Text:
Hignett S, Lang A, Pickup L, et al. More holes than cheese. What prevents the delivery of effective, high quality and safe health care in England? Ergonomic…
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psnet.ahrq.gov/issue/emotional-impact-errors-or-adverse-events-healthcare-providers-nicu-protective-role-coworker
January 23, 2019 - Study
The emotional impact of errors or adverse events on healthcare providers in the NICU: the protective role of coworker support.
Citation Text:
Winning AM, Merandi JM, Lewe D, et al. The emotional impact of errors or adverse events on healthcare providers in the NICU: The protective …
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psnet.ahrq.gov/issue/verifying-patient-identity-and-site-surgery-improving-compliance-protocol-audit-and-feedback
October 26, 2010 - Study
Verifying patient identity and site of surgery: improving compliance with protocol by audit and feedback.
Citation Text:
Garnerin P, Arès M, Huchet A, et al. Verifying patient identity and site of surgery: improving compliance with protocol by audit and feedback. Qual Saf Health …
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psnet.ahrq.gov/issue/systematic-narrative-review-coroners-prevention-future-deaths-reports-pfds-tool-patient
October 19, 2022 - Review
A systematic narrative review of coroners’ Prevention of Future Deaths reports (PFDs): a tool for patient safety in hospitals.
Citation Text:
Bremner BT, Heneghan CJ, Aronson JK, et al. A systematic narrative review of coroners’ Prevention of Future Deaths reports (PFDs): a tool f…
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psnet.ahrq.gov/issue/nurses-perceptions-electronic-patient-record-patient-safety-perspective-qualitative-study
October 09, 2013 - Study
Nurses' perceptions of an electronic patient record from a patient safety perspective: a qualitative study.
Citation Text:
Stevenson JE, Nilsson G. Nurses' perceptions of an electronic patient record from a patient safety perspective: a qualitative study. J Adv Nurs. 2012;68(3):6…
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psnet.ahrq.gov/issue/clinical-alerts-decrease-high-risk-medication-use-older-adults
September 02, 2015 - Commentary
Clinical alerts to decrease high-risk medication use in older adults.
Citation Text:
Lord-Adem W, Brandt NJ. Clinical Alerts to Decrease High-Risk Medication Use in Older Adults. J Gerontol Nurs. 2017;43(7):7-12. doi:10.3928/00989134-20170614-04.
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psnet.ahrq.gov/issue/seen-through-patients-eyes-surgical-safety-and-checklists
May 16, 2018 - Study
Seen through the patients' eyes: surgical safety and checklists.
Citation Text:
Bergs J, Lambrechts F, Desmedt M, et al. Seen through the patients' eyes: surgical safety and checklists. Int J Qual Health Care. 2018;30(2):118-123. doi:10.1093/intqhc/mzx180.
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psnet.ahrq.gov/issue/trends-central-line-associated-bloodstream-infections-trauma-surgical-intensive-care-unit
September 13, 2023 - Study
Trends in central line–associated bloodstream infections in a trauma-surgical intensive care unit.
Citation Text:
Ong A, Dysert K, Herbert C, et al. Trends in central line-associated bloodstream infections in a trauma-surgical intensive care unit. Arch Surg. 2011;146(3):302-7. doi:…
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psnet.ahrq.gov/issue/systematic-review-simulation-multidisciplinary-team-training-operating-rooms
November 17, 2014 - Review
A systematic review of simulation for multidisciplinary team training in operating rooms.
Citation Text:
Cumin D, Boyd MJ, Webster CS, et al. A systematic review of simulation for multidisciplinary team training in operating rooms. Simul Healthc. 2013;8(3):171-179. doi:10.1097/S…
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psnet.ahrq.gov/issue/understanding-clinical-implications-resident-involvement-uncommon-operations
October 26, 2022 - Study
Understanding the clinical implications of resident involvement in uncommon operations.
Citation Text:
Dasani SS, Simmons KD, Wirtalla CJ, et al. Understanding the Clinical Implications of Resident Involvement in Uncommon Operations. J Surg Educ. 2019;76(5):1319-1328. doi:10.1016/j…
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psnet.ahrq.gov/issue/effect-emergency-department-boarding-order-completion
January 29, 2018 - Study
The effect of emergency department boarding on order completion.
Citation Text:
Coil CJ, Flood JD, Belyeu BM, et al. The Effect of Emergency Department Boarding on Order Completion. Ann Emerg Med. 2016;67(6):730-736.e2. doi:10.1016/j.annemergmed.2015.09.018.
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psnet.ahrq.gov/issue/effect-clinical-experience-error-rate-emergency-physicians
November 16, 2022 - Study
The effect of clinical experience on the error rate of emergency physicians.
Citation Text:
Berk WA, Welch RD, Levy PD, et al. The effect of clinical experience on the error rate of emergency physicians. Ann Emerg Med. 2008;52(5):497-501. doi:10.1016/j.annemergmed.2008.01.329.
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psnet.ahrq.gov/issue/enhancing-resident-education-embedding-improvement-specialists-quality-and-safety-curriculum
April 24, 2018 - Study
Enhancing resident education by embedding improvement specialists into a quality and safety curriculum.
Citation Text:
Levy KL, Grzyb K, Heidemann LA, et al. Enhancing resident education by embedding improvement specialists into a quality and safety curriculum. J Grad Med Educ. 202…
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psnet.ahrq.gov/issue/impact-post-fall-huddles-repeat-fall-rates-and-perceptions-safety-culture-quasi-experimental
December 30, 2014 - Journal Article
The impact of post-fall huddles on repeat fall rates and perceptions of safety culture: a quasi-experimental evaluation of a patient safety demonstration project
Citation Text:
Jones KJ, Crowe J, Allen JA, et al. The impact of post-fall huddles on repeat fall rates and pe…
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psnet.ahrq.gov/issue/introduction-mobile-adverse-event-reporting-system-associated-participation-adverse-event
July 03, 2016 - Study
Introduction of a mobile adverse event reporting system is associated with participation in adverse event reporting.
Citation Text:
Rubin DS, Pesyna C, Jakubczyk S, et al. Introduction of a Mobile Adverse Event Reporting System Is Associated With Participation in Adverse Event Repo…
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psnet.ahrq.gov/issue/assessing-effectiveness-engaging-patients-and-their-families-three-step-fall-prevention
February 19, 2020 - Study
Assessing the effectiveness of engaging patients and their families in the three-step fall prevention process across modalities of an evidence-based fall prevention toolkit: an implementation science study.
Citation Text:
Duckworth M, Adelman JS, Belategui K, et al. Assessing the E…
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psnet.ahrq.gov/issue/adverse-drug-events-pediatric-outpatients
February 06, 2008 - Study
Adverse drug events in pediatric outpatients.
Citation Text:
Kaushal R, Goldmann DA, Keohane C, et al. Adverse drug events in pediatric outpatients. Ambul Pediatr. 2007;7(5):383-9.
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psnet.ahrq.gov/issue/relationship-staff-information-sharing-and-advice-networks-patient-safety-outcomes
June 22, 2011 - Study
Relationship of staff information sharing and advice networks to patient safety outcomes.
Citation Text:
Brewer BB, Carley KM, Benham-Hutchins MM, et al. Relationship of Staff Information Sharing and Advice Networks to Patient Safety Outcomes. J Nurs Adm. 2018;48(9):437-444. doi:10…
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psnet.ahrq.gov/node/42983/psn-pdf
June 27, 2018 - Medication reconciliation: getting started with IT.
June 27, 2018
Lefeber J
https://psnet.ahrq.gov/issue/medication-reconciliation-getting-started-it
This article reveals the experience of a critical access hospital that used medication reconciliation to
expand electronic health record adoption efforts. The author…