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Wrong-site and wrong-patient procedures in the Universal Protocol era: analysis of a prospective database of physician self-reported occurrences. | PSNet

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October 13, 2010 - Study Wrong-site and wrong-patient procedures in the Universal Protocol era: analysis of a prospective database of physician self-reported occurrences. Citation Text: Stahel PF, Sabel A, Victoroff MS, et al. Wrong-site and wrong-patient procedures in the universal protocol era: analysis …

Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data. | PSNet

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December 21, 2014 - Study Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data. Citation Text: Meeks DW, Meyer AND, Rose B, et al. Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer revi…

Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation. | PSNet

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September 29, 2021 - Study Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation. Citation Text: Qureshi N, Kroger J, Zangwill KM, et al. Changes in perceptions of antibioti…

Delayed time to defibrillation after in-hospital cardiac arrest. | PSNet

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June 08, 2010 - Study Classic Delayed time to defibrillation after in-hospital cardiac arrest. Citation Text: Chan PS, Krumholz HM, Nichol G, et al. Delayed time to defibrillation after in-hospital cardiac arrest. N Engl J Med. 2008;358(1):9-17. doi:10.1056/NEJMoa0706467. C…

High-profile investigations into hospital safety problems in England did not prompt patients to switch providers. | PSNet

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July 11, 2012 - Study High-profile investigations into hospital safety problems in England did not prompt patients to switch providers. Citation Text: Laverty AA, Smith PC, Pape UJ, et al. High-profile investigations into hospital safety problems in England did not prompt patients to switch providers.…

Potentially inappropriate medication use among elderly home care patients in Europe. | PSNet

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September 19, 2016 - Study Potentially inappropriate medication use among elderly home care patients in Europe. Citation Text: Fialová D, Topinková E, Gambassi G, et al. Potentially inappropriate medication use among elderly home care patients in Europe. JAMA. 2005;293(11):1348-58. Copy Citation Form…

A look into the nature and causes of human errors in the intensive care unit. | PSNet

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June 29, 2009 - Study Classic A look into the nature and causes of human errors in the intensive care unit. Citation Text: Donchin Y, Gopher D, Olin M, et al. A look into the nature and causes of human errors in the intensive care unit. Crit Care Med. 1995;23(2):294-300. Co…

Ticket to ride: reducing handoff risk during hospital patient transport. | PSNet

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May 30, 2018 - Commentary Ticket to ride: reducing handoff risk during hospital patient transport. Citation Text: Pesanka DA, Greenhouse PK, Rack LL, et al. Ticket to ride: reducing handoff risk during hospital patient transport. J Nurs Care Qual. 2009;24(2):109-15. doi:10.1097/01.NCQ.0000347446.982…

Patients as partners in learning from unexpected events. | PSNet

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December 15, 2021 - Study Patients as partners in learning from unexpected events. Citation Text: Etchegaray J, Ottosen M, Aigbe A, et al. Patients as Partners in Learning from Unexpected Events. Health Serv Res. 2016;51 Suppl 3:2600-2614. doi:10.1111/1475-6773.12593. Copy Citation Format: DOI…

Impact of weekend effect on postoperative mortality in patients undergoing emergency General surgery procedures: meta-analysis of prospectively maintained national databases across the world. | PSNet

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December 04, 2016 - Review Impact of weekend effect on postoperative mortality in patients undergoing emergency General surgery procedures: meta-analysis of prospectively maintained national databases across the world. Citation Text: Hajibandeh S, Hajibandeh S, Satyadas T. Impact of weekend effect on postop…

Computerized provider order entry implementation: no association with increased mortality rates in an intensive care unit. | PSNet

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November 16, 2022 - Study Computerized provider order entry implementation: no association with increased mortality rates in an intensive care unit. Citation Text: Del Beccaro MA, Jeffries HE, Eisenberg MA, et al. Computerized provider order entry implementation: no association with increased mortality ra…

Prevalence of undiagnosed diabetes identified by a novel electronic medical record diabetes screening program in an urban emergency department in the US. | PSNet

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January 04, 2021 - Study Prevalence of undiagnosed diabetes identified by a novel electronic medical record diabetes screening program in an urban emergency department in the US. Citation Text: Danielson KK, Rydzon B, Nicosia M, et al. Prevalence of undiagnosed diabetes identified by a novel electronic med…

Association of hospital participation in a quality reporting program with surgical outcomes and expenditures for Medicare beneficiaries. | PSNet

psnet.ahrq.gov/issue/association-hospital-participation-quality-reporting-program-surgical-outcomes-and

January 13, 2016 - Study Classic Association of hospital participation in a quality reporting program with surgical outcomes and expenditures for Medicare beneficiaries. Citation Text: Osborne NH, Nicholas LH, Ryan AM, et al. Association of hospital participation in a quality repo…

Implementation of the trigger review method in Scottish general practices: patient safety outcomes and potential for quality improvement. | PSNet

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November 07, 2011 - Study Implementation of the trigger review method in Scottish general practices: patient safety outcomes and potential for quality improvement. Citation Text: de Wet C, Black C, Luty S, et al. Implementation of the trigger review method in Scottish general practices: patient safety outco…

Quality and reporting of large-scale improvement programmes: a review of maternity initiatives in the English NHS, 2010–2023. | PSNet

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February 07, 2024 - Review Quality and reporting of large-scale improvement programmes: a review of maternity initiatives in the English NHS, 2010–2023. Citation Text: McGowan JE, Attal B, Kuhn I, et al. Quality and reporting of large-scale improvement programmes: a review of maternity initiatives in the En…

Improving the discharge process by embedding a discharge facilitator in a resident team. | PSNet

psnet.ahrq.gov/issue/improving-discharge-process-embedding-discharge-facilitator-resident-team

January 23, 2019 - Study Improving the discharge process by embedding a discharge facilitator in a resident team. Citation Text: Finn KM, Heffner R, Chang Y, et al. Improving the discharge process by embedding a discharge facilitator in a resident team. J Hosp Med. 2011;6(9):494-500. doi:10.1002/jhm.924.…

Failure to rescue and 30-day in-hospital mortality in hospitals with and without crew-resource-management safety training. | PSNet

psnet.ahrq.gov/issue/failure-rescue-and-30-day-hospital-mortality-hospitals-and-without-crew-resource-management

January 26, 2022 - Study Failure to rescue and 30-day in-hospital mortality in hospitals with and without crew-resource-management safety training. Citation Text: Bacon CT, McCoy TP, Henshaw DS. Failure to rescue and 30‐day in‐hospital mortality in hospitals with and without crew‐resource‐management safety…

Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era. | PSNet

psnet.ahrq.gov/issue/quality-improvements-decreasing-medication-administration-errors-made-nursing-staff-academic

March 24, 2019 - Study Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era. Citation Text: Wang H-F, Jin J-F,…

System hazards in managing laboratory test requests and results in primary care: medical protection database analysis and conceptual model. | PSNet

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November 08, 2017 - Study System hazards in managing laboratory test requests and results in primary care: medical protection database analysis and conceptual model. Citation Text: Bowie P, Price J, Hepworth N, et al. System hazards in managing laboratory test requests and results in primary care: medical p…

Do clinicians know which of their patients have central venous catheters?: A multicenter observational study. | PSNet

psnet.ahrq.gov/issue/do-clinicians-know-which-their-patients-have-central-venous-catheters-multicenter

June 08, 2016 - Study Do clinicians know which of their patients have central venous catheters?: A multicenter observational study. Citation Text: Chopra V, Govindan S, Kuhn L, et al. Do clinicians know which of their patients have central venous catheters?: a multicenter observational study. Ann Intern…

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