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psnet.ahrq.gov/issue/strategies-reduce-risk-iatrogenic-illness-complex-older-adults
January 12, 2022 - Review
Strategies to reduce the risk of iatrogenic illness in complex older adults.
Citation Text:
Onder G, van der Cammen TJM, Petrovic M, et al. Strategies to reduce the risk of iatrogenic illness in complex older adults. Age Ageing. 2013;42(3):284-91. doi:10.1093/ageing/aft038.
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psnet.ahrq.gov/issue/opioid-prescribing-after-surgical-extraction-teeth-medicaid-patients-2000-2010
March 02, 2011 - Study
Opioid prescribing after surgical extraction of teeth in Medicaid patients, 2000–2010.
Citation Text:
Baker JA, Avorn J, Levin R, et al. Opioid Prescribing After Surgical Extraction of Teeth in Medicaid Patients, 2000-2010. JAMA. 2016;315(15):1653-4. doi:10.1001/jama.2015.19058.
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psnet.ahrq.gov/issue/oncology-patients-willingness-report-their-medication-safety-concerns-home-qualitative-study
August 21, 2024 - Study
Oncology patients' willingness to report their medication safety concerns from home: a qualitative study.
Citation Text:
Bunni D, Walters G, Hwang M, et al. Oncology patients’ willingness to report their medication safety concerns from home: a qualitative study. Support Care Cancer…
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psnet.ahrq.gov/issue/project-boost-implementation-lessons-learned
August 21, 2013 - Study
Project BOOST implementation: lessons learned.
Citation Text:
Williams M, Li J, Hansen LO, et al. Project BOOST implementation: lessons learned. South Med J. 2014;107(7):455-65. doi:10.14423/SMJ.0000000000000140.
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psnet.ahrq.gov/issue/project-boost-effectiveness-multihospital-effort-reduce-rehospitalization
September 10, 2014 - Study
Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization.
Citation Text:
Hansen LO, Greenwald JL, Budnitz T, et al. Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization. J Hosp Med. 2013;8(8):421-7. doi:10.1002/jhm.2054.
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psnet.ahrq.gov/issue/evidence-bias-and-variation-diagnostic-accuracy-studies
February 15, 2023 - Review
Evidence of bias and variation in diagnostic accuracy studies.
Citation Text:
Rutjes AWS, Reitsma JB, Di Nisio M, et al. Evidence of bias and variation in diagnostic accuracy studies. CMAJ. 2006;174(4):469-476. doi:10.1503/cmaj.050090.
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psnet.ahrq.gov/issue/scaffolding-our-systems-patients-and-families-reaching-source-healthcare-resilience
February 23, 2022 - Commentary
Scaffolding our systems? Patients and families 'reaching in' as a source of healthcare resilience.
Citation Text:
O'Hara JK, Aase K, Waring J. Scaffolding our systems? Patients and families 'reaching in' as a source of healthcare resilience. BMJ Qual Saf. 2019;28(1):3-6. doi:1…
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psnet.ahrq.gov/issue/paediatric-dosing-errors-and-after-electronic-prescribing
February 13, 2008 - Study
Paediatric dosing errors before and after electronic prescribing.
Citation Text:
Jani Y, Barber N, Wong ICK. Paediatric dosing errors before and after electronic prescribing. Qual Saf Health Care. 2010;19(4):337-40. doi:10.1136/qshc.2009.033068.
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psnet.ahrq.gov/issue/prevention-opioid-overdose
July 18, 2018 - Review
Emerging Classic
Prevention of opioid overdose.
Citation Text:
Babu KM, Brent J, Juurlink DN. Prevention of opioid overdose. N Engl J Med. 2019;380(23):2246-2255. doi:10.1056/NEJMra1807054.
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psnet.ahrq.gov/issue/electronic-health-record-use-issues-and-diagnostic-error-scoping-review-and-framework
September 14, 2011 - Review
Electronic health record use issues and diagnostic error: a scoping review and framework.
Citation Text:
Dixit RA, Boxley CL, Samuel S, et al. Electronic health record use issues and diagnostic error: a scoping review and framework. J Patient Saf. 2023;19(1):e25-e30. doi:10.1097/p…
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psnet.ahrq.gov/issue/classifying-adverse-events-dental-office
July 09, 2014 - Study
Classifying adverse events in the dental office.
Citation Text:
Kalenderian E, Obadan-Udoh E, Maramaldi P, et al. Classifying Adverse Events in the Dental Office. J Patient Saf. 2021;17(6):e540-e356. doi:10.1097/PTS.0000000000000407.
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psnet.ahrq.gov/web-mm/no-bp-during-nibp
March 01, 2011 - Critical incident reports concerning anaesthetic equipment: analysis of the UK National Reporting and
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psnet.ahrq.gov/web-mm/danger-disruption
July 29, 2020 - The child was apneic briefly but recovered without incident.
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psnet.ahrq.gov/web-mm/discontinued-medications-are-they-really-discontinued
January 05, 2017 - July 22, 2015
Exploring health care professionals' perceptions of incidents and incident
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psnet.ahrq.gov/node/49819/psn-pdf
February 01, 2018 - In the above case, a positive outcome of the incident was the decision to leverage graduate medical
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psnet.ahrq.gov/web-mm/wrong-channel
February 01, 2003 - compared the error rates seen under direct observation with those reported through the institution’s incident
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psnet.ahrq.gov/web-mm/forgotten-line
March 11, 2011 - The incident was reported and investigated, revealing several contributing factors.
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psnet.ahrq.gov/node/33881/psn-pdf
August 01, 2019 - In most cases, we're not looking at things that fail in the sense
there's an accident or an incident
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psnet.ahrq.gov/web-mm/one-dose-fifty-pills
January 13, 2021 - October 25, 2023
Self-Reported Learning (SRL), a voluntary incident reporting system
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psnet.ahrq.gov/node/33626/psn-pdf
January 01, 2006 - We also had another incident where one team member present during a surgery felt empowered to actually