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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39213/psn-pdf
    October 03, 2017 - Using patient safety morbidity and mortality conferences to promote transparency and a culture of safety. October 3, 2017 Szekendi MK, Barnard C, Creamer J, et al. Using patient safety morbidity and mortality conferences to promote transparency and a culture of safety. Jt Comm J Qual Patient Saf. 2010;36(1):3-9. h…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/48095/psn-pdf
    June 26, 2019 - Exposure to incivility hinders clinical performance in a simulated operative crisis. June 26, 2019 Katz D, Blasius K, Isaak R, et al. Exposure to incivility hinders clinical performance in a simulated operative crisis. BMJ Qual Saf. 2019;28(9):750-757. doi:10.1136/bmjqs-2019-009598. https://psnet.ahrq.gov/issue/ex…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34053/psn-pdf
    March 02, 2011 - Prevention of ventilator-associated pneumonia: an evidence-based systematic review. March 2, 2011 Collard HR, Saint S, Matthay MA. Prevention of ventilator-associated pneumonia: an evidence-based systematic review. Ann Intern Med. 2003;138(6):494-501. https://psnet.ahrq.gov/issue/prevention-ventilator-associated-p…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37622/psn-pdf
    May 26, 2011 - Effect of computer order entry on prevention of serious medication errors in hospitalized children. May 26, 2011 Walsh KE, Landrigan CP, Adams WG, et al. Effect of computer order entry on prevention of serious medication errors in hospitalized children. Pediatrics. 2008;121(3):e421-e427. doi:10.1542/peds.2007- 022…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46404/psn-pdf
    December 07, 2017 - Preventable and mitigable adverse events in cancer care: measuring risk and harm across the continuum. December 7, 2017 Lipitz-Snyderman A, Pfister D, Classen D, et al. Preventable and mitigable adverse events in cancer care: measuring risk and harm across the continuum. Cancer. 2017;123(23):4728-4736. doi:10.1002/…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42606/psn-pdf
    September 25, 2013 - Health economic evaluation of an infection prevention and control program: are quality and patient safety programs worth the investment? September 25, 2013 Raschka S, Dempster L, Bryce E. Health economic evaluation of an infection prevention and control program: are quality and patient safety programs worth the in…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40726/psn-pdf
    July 03, 2014 - Automated identification of postoperative complications within an electronic medical record using natural language processing. July 3, 2014 Murff HJ, FitzHenry F, Matheny ME, et al. Automated identification of postoperative complications within an electronic medical record using natural language processing. JAMA. …

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45356/psn-pdf
    May 09, 2017 - Screening for medication errors using an outlier detection system. May 9, 2017 Schiff G, Volk LA, Volodarskaya M, et al. Screening for medication errors using an outlier detection system. J Am Med Inform Assoc. 2017;24(2):281-287. doi:10.1093/jamia/ocw171. https://psnet.ahrq.gov/issue/screening-medication-errors-u…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44711/psn-pdf
    September 21, 2016 - The well-defined pediatric ICU: active surveillance using nonmedical personnel to capture less serious safety events. September 21, 2016 White WA, Kennedy K, Belgum HS, et al. The Well-Defined Pediatric ICU: Active Surveillance Using Nonmedical Personnel to Capture Less Serious Safety Events. Jt Comm J Qual Patien…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47603/psn-pdf
    March 20, 2019 - Electronic patient identification for sample labeling reduces wrong blood in tube errors. March 20, 2019 Kaufman RM, Dinh A, Cohn CS, et al. Electronic patient identification for sample labeling reduces wrong blood in tube errors. Transfusion (Paris). 2019;59(3):972-980. doi:10.1111/trf.15102. https://psnet.ahrq.g…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39069/psn-pdf
    February 18, 2011 - Did duty hour reform lead to better outcomes among the highest risk patients? February 18, 2011 Volpp KG, Rosen AK, Rosenbaum PR, et al. Did duty hour reform lead to better outcomes among the highest risk patients? J Gen Intern Med. 2009;24(10):1149-55. doi:10.1007/s11606-009-1011-z. https://psnet.ahrq.gov/issue/d…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38076/psn-pdf
    February 15, 2011 - Consequences of inadequate sign-out for patient care. February 15, 2011 Horwitz LI, Moin T, Krumholz HM, et al. Consequences of inadequate sign-out for patient care. Arch Intern Med. 2008;168(16):1755-60. doi:10.1001/archinte.168.16.1755. https://psnet.ahrq.gov/issue/consequences-inadequate-sign-out-patient-care W…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45804/psn-pdf
    August 03, 2017 - Meaningful use of health information technology and declines in in-hospital adverse drug events. August 3, 2017 Furukawa MF, Spector WD, Limcangco R, et al. Meaningful use of health information technology and declines in in-hospital adverse drug events. J Am Med Inform Assoc. 2017;24(4):729-736. doi:10.1093/jamia/…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43617/psn-pdf
    September 24, 2016 - Do telephone call interruptions have an impact on radiology resident diagnostic accuracy? September 24, 2016 Balint BJ, Steenburg SD, Lin H, et al. Do telephone call interruptions have an impact on radiology resident diagnostic accuracy? Acad Radiol. 2014;21(12):1623-8. doi:10.1016/j.acra.2014.08.001. https://psne…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44064/psn-pdf
    November 03, 2015 - The July effect: an analysis of never events in the nationwide inpatient sample. November 3, 2015 Wen T, Attenello FJ, Wu B, et al. The July effect: an analysis of never events in the nationwide inpatient sample. J Hosp Med. 2015;10(7):432-438. doi:10.1002/jhm.2352. https://psnet.ahrq.gov/issue/july-effect-analysi…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/844790/psn-pdf
    January 01, 2020 - Effectiveness of double checking to reduce medication administration errors: a systematic review. September 18, 2019 Koyama AK, Maddox C-SS, Li L, et al. Effectiveness of double checking to reduce medication administration errors: a systematic review. BMJ Qual Saf. 2020;29(7):595-603. doi:10.1136/bmjqs-2019- 00955…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45719/psn-pdf
    June 29, 2017 - Systematic review of the prevalence of medication errors resulting in hospitalization and death of nursing home residents. June 29, 2017 Ferrah N, Lovell JJ, Ibrahim JE. Systematic Review of the Prevalence of Medication Errors Resulting in Hospitalization and Death of Nursing Home Residents. J Am Geriatr Soc. 2017…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39730/psn-pdf
    December 21, 2014 - Surgical case listing accuracy: failure analysis at a high- volume academic medical center. December 21, 2014 Cima RR, Hale C, Kollengode A, et al. Surgical case listing accuracy: failure analysis at a high-volume academic medical center. Arch Surg. 2010;145(7):641-6. doi:10.1001/archsurg.2010.112. https://psnet.a…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45882/psn-pdf
    June 28, 2017 - Early death after discharge from emergency departments: analysis of national US insurance claims data. June 28, 2017 Obermeyer Z, Cohn B, Wilson M, et al. Early death after discharge from emergency departments: analysis of national US insurance claims data. BMJ. 2017;356:j239. doi:10.1136/bmj.j239. https://psnet.a…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45395/psn-pdf
    August 10, 2016 - Adverse inpatient outcomes during the transition to a new electronic health record system: observational study. August 10, 2016 Barnett ML, Mehrotra A, Jena AB. Adverse inpatient outcomes during the transition to a new electronic health record system: observational study. BMJ. 2016;354:i3835. doi:10.1136/bmj.i3835.…
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