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psnet.ahrq.gov/issue/rapid-response-systems-patient-safety-strategy-systematic-review
March 20, 2013 - Review
Rapid response systems as a patient safety strategy: a systematic review.
Citation Text:
Winters BD, Weaver SJ, Pfoh ER, et al. Rapid-response systems as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158(5 Pt 2):417-25. doi:10.7326/0003-4819-158-5-201303051…
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psnet.ahrq.gov/issue/lessons-covid-war-investigative-report
March 09, 2022 - Book/Report
Lessons from the Covid War: An Investigative Report.
Citation Text:
Lessons from the Covid War: An Investigative Report. Covid Crisis Group. New York: Public Affairs; 2023. ISBN: 9781541703803.
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psnet.ahrq.gov/issue/patient-safety-perioperative-medication-through-lens-digital-health-and-artificial
September 02, 2020 - Commentary
Patient safety of perioperative medication through the lens of digital health and artificial intelligence.
Citation Text:
Ye J. Patient safety of perioperative medication through the lens of digital health and artificial intelligence. JMIR Periop Med. 2023;6:e34453. doi:10.219…
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psnet.ahrq.gov/issue/barriers-self-reporting-patient-safety-incidents-paramedics-mixed-methods-study
November 16, 2022 - Study
Barriers to self-reporting patient safety incidents by paramedics: a mixed methods study.
Citation Text:
Sinclair JE, Austin MA, Bourque C, et al. Barriers to Self-Reporting Patient Safety Incidents by Paramedics: A Mixed Methods Study. Prehosp Emerg Care. 2018;22(6):762-772. doi:1…
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psnet.ahrq.gov/issue/inappropriate-surgeries-resulting-misdiagnosis-early-amyotrophic-lateral-sclerosis
October 31, 2014 - Study
Inappropriate surgeries resulting from misdiagnosis of early amyotrophic lateral sclerosis.
Citation Text:
Srinivasan J, Scala S, Jones R, et al. Inappropriate surgeries resulting from misdiagnosis of early amyotrophic lateral sclerosis. Muscle Nerve. 2006;34(3):359-60.
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psnet.ahrq.gov/issue/impact-hospital-accreditation-quality-improvement-healthcare-systematic-review
September 23, 2020 - Review
Impact of hospital accreditation on quality improvement in healthcare: a systematic review.
Citation Text:
Alhawajreh MJ, Paterson AS, Jackson WJ. Impact of hospital accreditation on quality improvement in healthcare: a systematic review. PLoS ONE. 2023;18(12):e0294180. doi:10.137…
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psnet.ahrq.gov/issue/clinician-factors-associated-delayed-diagnosis-appendicitis
October 26, 2022 - Study
Clinician factors associated with delayed diagnosis of appendicitis.
Citation Text:
Michelson KA, McGarghan FLE, Patterson EE, et al. Clinician factors associated with delayed diagnosis of appendicitis. Diagnosis (Berl). 2023;10(2):183-186. doi:10.1515/dx-2022-0119.
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psnet.ahrq.gov/issue/standardized-competencies-parenteral-nutrition-administration-aspen-model
June 12, 2018 - Organizational Policy/Guidelines
Standardized Competencies for Parenteral Nutrition Administration: the ASPEN Model.
Citation Text:
Guenter P, Worthington P, Ayers P, et al. Standardized Competencies for Parenteral Nutrition Administration: The ASPEN Model. Nutr Clin Pract. 2018;33(2):29…
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psnet.ahrq.gov/issue/costs-and-consequences-associated-misdiagnosed-lower-extremity-cellulitis
November 12, 2014 - Study
Costs and consequences associated with misdiagnosed lower extremity cellulitis.
Citation Text:
Weng QY, Raff AB, Cohen JM, et al. Costs and Consequences Associated With Misdiagnosed Lower Extremity Cellulitis. JAMA Dermatol. 2016;153(2). doi:10.1001/jamadermatol.2016.3816.
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psnet.ahrq.gov/issue/measurement-ambulatory-medication-errors-children-scoping-review
February 07, 2024 - Review
Measurement of ambulatory medication errors in children: a scoping review.
Citation Text:
Rickey L, Auger K, Britto MT, et al. Measurement of ambulatory medication errors in children: a scoping review. Pediatrics. 2023;152(6):e2023061281. doi:10.1542/peds.2023-061281.
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psnet.ahrq.gov/issue/doing-right-our-patients-when-things-go-wrong-ambulatory-setting
August 14, 2017 - Commentary
Doing right by our patients when things go wrong in the ambulatory setting.
Citation Text:
Schiff G, Griswold P, Ellis BR, et al. Doing right by our patients when things go wrong in the ambulatory setting. Jt Comm J Qual Patient Saf. 2014;40(2):91-96.
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psnet.ahrq.gov/issue/notice-intent-publish-funding-opportunity-announcement-examining-impact-artificial
July 22, 2024 - Grant Announcement
Examining the Impact of Artificial Intelligence (AI) on Healthcare Safety (R18).
Citation Text:
Examining the Impact of Artificial Intelligence (AI) on Healthcare Safety (R18). Rockville, MD: Agency for Research and Quality; July 15, 2024. PA-24-261.
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psnet.ahrq.gov/issue/laneys-story-problem-delayed-diagnosis-pediatric-stroke
April 24, 2018 - Commentary
Laney's story: the problem of delayed diagnosis of pediatric stroke.
Citation Text:
Fitzsimons BT, Fitzsimons LL, Sun LR. Laney's Story: The Problem of Delayed Diagnosis of Pediatric Stroke. Pediatrics. 2019;143(4):e20183458. doi:10.1542/peds.2018-3458.
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psnet.ahrq.gov/issue/drawing-boundaries-difficulty-defining-clinical-reasoning
June 26, 2019 - Commentary
Emerging Classic
Drawing boundaries: the difficulty in defining clinical reasoning.
Citation Text:
Young M, Thomas A, Lubarsky S, et al. Drawing Boundaries: The Difficulty in Defining Clinical Reasoning. Acad Med. 2018;93(7):990-995. doi:10.1097/ACM.0…
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psnet.ahrq.gov/issue/cognitive-errors-diagnosis-instantiation-classification-and-consequences
June 21, 2016 - Study
Classic
Cognitive errors in diagnosis: instantiation, classification, and consequences.
Citation Text:
Kassirer JP, Kopelman RI. Cognitive errors in diagnosis: instantiation, classification, and consequences. Am J Med. 1989;86(4):433-41.
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psnet.ahrq.gov/node/840256/psn-pdf
November 16, 2022 - In Conversation With... Pascale Carayon, PhD and Nicole
Werner, PhD
November 16, 2022
In Conversation With.. Pascale Carayon, PhD and Nicole Werner, PhD. PSNet [internet]. 2022.
https://psnet.ahrq.gov/perspective/conversation-pascale-carayon-phd-and-nicole-werner-phd
Editor’s note: Dr. Pascale Carayon, PhD, is a p…
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psnet.ahrq.gov/web-mm/tale-two-falls
March 27, 2024 - A Tale of Two Falls
Citation Text:
Jackson V, Satake A. A Tale of Two Falls. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2024.
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psnet.ahrq.gov/primer/maternal-safety
January 10, 2024 - Maternal Safety
Citation Text:
Shauer M, Nichols A, Lyndon A. Maternal Safety. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2024.
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psnet.ahrq.gov/node/867035/psn-pdf
October 30, 2024 - A Tale of Two Falls
October 30, 2024
Jackson V, Satake A. A Tale of Two Falls. PSNet [internet]. 2024.
https://psnet.ahrq.gov/web-mm/tale-two-falls
The Cases
Case #1: A 79-year-old woman with a history of impaired cognition at baseline was brought from a skilled
nursing facility to the emergency department (ED) f…
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psnet.ahrq.gov/issue/medication-errors-school-nurse-second-victim
October 19, 2022 - Commentary
Medication errors: the school nurse as second victim.
Citation Text:
Stillwater AR. Medication Errors: The School Nurse as Second Victim. NASN School Nurse. 2018;33(3):163-166. doi:10.1177/1942602x17747294.
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