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psnet.ahrq.gov/node/43687/psn-pdf
November 12, 2014 - Changes in medical errors after implementation of a
handoff program.
November 12, 2014
Starmer AJ, Spector ND, Srivastava R, et al. Changes in medical errors after implementation of a handoff
program. New Engl J Med. 2014;371(19):1803-1812. doi:10.1056/NEJMsa1405556.
https://psnet.ahrq.gov/issue/changes-medical-er…
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psnet.ahrq.gov/node/42968/psn-pdf
February 26, 2014 - From physician intent to the pharmacy label: prevalence
and description of discrepancies from a cross-sectional
evaluation of electronic prescriptions.
February 26, 2014
Cochran GL, Klepser DG, Morien M, et al. From physician intent to the pharmacy label: prevalence and
description of discrepancies from a cross-se…
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psnet.ahrq.gov/node/43987/psn-pdf
March 25, 2015 - Emergency physicians' views of direct notification of
laboratory and radiology results to patients using the
internet: a multisite survey.
March 25, 2015
Callen J, Giardina TD, Singh H, et al. Emergency physicians' views of direct notification of laboratory and
radiology results to patients using the Internet: a m…
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psnet.ahrq.gov/node/47991/psn-pdf
July 12, 2019 - What quality and safety of care for patients admitted to
clinically inappropriate wards: a systematic review.
July 12, 2019
La Regina M, Guarneri F, Romano E, et al. What Quality and Safety of Care for Patients Admitted to
Clinically Inappropriate Wards: a Systematic Review. J Gen Intern Med. 2019;34(7):1314-1321.
…
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psnet.ahrq.gov/node/45057/psn-pdf
June 22, 2017 - Safety risks associated with the lack of integration and
interfacing of hospital health information technologies: a
qualitative study of hospital electronic prescribing
systems in England.
June 22, 2017
Cresswell K, Mozaffar H, Lee L, et al. Safety risks associated with the lack of integration and interfacing of
…
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psnet.ahrq.gov/node/46299/psn-pdf
September 13, 2017 - Simulation-based assessment of the management of
critical events by board-certified anesthesiologists.
September 13, 2017
Weinger MB, Banerjee A, Burden AR, et al. Simulation-based assessment of the management of critical
events by board-certified anesthesiologists. Anesthesiology. 2017;127(3):475-489.
doi:10.1097…
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psnet.ahrq.gov/node/40995/psn-pdf
January 04, 2012 - Effects of the introduction of the WHO "Surgical Safety
Checklist" on in-hospital mortality: a cohort study.
January 4, 2012
van Klei WA, Hoff RG, van Aarnhem EEHL, et al. Effects of the introduction of the WHO "Surgical Safety
Checklist" on in-hospital mortality: a cohort study. Ann Surg. 2012;255(1):44-9.
doi:10…
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psnet.ahrq.gov/node/42423/psn-pdf
July 17, 2013 - National trends in hospital-acquired preventable adverse
events after major cancer surgery in the USA.
July 17, 2013
Sukumar S, Roghmann F, Trinh VQ, et al. National trends in hospital-acquired preventable adverse events
after major cancer surgery in the USA. BMJ Open. 2013;3(6). doi:10.1136/bmjopen-2013-002843.
h…
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psnet.ahrq.gov/node/47666/psn-pdf
January 01, 2020 - A partially structured postoperative handoff protocol
improves communication in 2 mixed surgical intensive
care units: findings from the Handoffs and Transitions in
Critical Care (HATRICC) prospective cohort study.
February 6, 2019
Lane-Fall MB, Pascual JL, Peifer HG, et al. A Partially Structured Postoperative Ha…
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psnet.ahrq.gov/node/46806/psn-pdf
January 01, 2020 - Examining the relationship of an all-cause harm patient
safety measure and critical performance measures at the
frontline of care.
February 28, 2018
Sammer C, Hauck L, Jones C, et al. Examining the Relationship of an All-Cause Harm Patient Safety
Measure and Critical Performance Measures at the Frontline of Care. …
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psnet.ahrq.gov/node/38710/psn-pdf
September 14, 2009 - Patient readmissions, emergency visits, and adverse
events after software-assisted discharge from hospital:
cluster randomized trial.
September 14, 2009
Graumlich JF, Novotny NL, Nace S, et al. Patient readmissions, emergency visits, and adverse events after
software-assisted discharge from hospital: cluster rando…
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psnet.ahrq.gov/node/45255/psn-pdf
January 23, 2017 - Provider risk factors for medication administration error
alerts: analyses of a large-scale closed-loop medication
administration system using RFID and barcode.
January 23, 2017
Hwang Y, Yoon D, Ahn EK, et al. Provider risk factors for medication administration error alerts: analyses
of a large-scale closed-loop m…
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psnet.ahrq.gov/web-mm/cardiac-arrest-woman-uti-case-qt-prolongation
March 27, 2024 - is estimated to be 5.4 cases for every 10 million prescriptions. 6 The overall risk is low, but it increases … associated with a high risk of causing QTc prolongation and recognize that the risk of torsades de pointes increases
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psnet.ahrq.gov/node/74253/psn-pdf
January 12, 2022 - COVID-19 on the safety of care has revealed several areas of
concern and potential root causes for increases … diagnosis and management of COVID-19
or sepsis, or the identification of sepsis among COVID-19 patients, increases
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psnet.ahrq.gov/web-mm/weighing-surgical-safety
August 04, 2021 - and lung volume is further reduced when they lie flat.( 8 ) The supine position causes significant increases … the laryngoscopist's view during direct laryngoscopy, and most importantly recruits lung volume and increases … upper body are elevated so that an imaginary horizontal line can be drawn from the sternum to the ear, increases
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psnet.ahrq.gov/issue/effects-introduction-who-surgical-safety-checklist-hospital-mortality-cohort-study
April 24, 2018 - January 9, 2013
The implementation of a perioperative checklist increases patients' perioperative
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psnet.ahrq.gov/web-mm/insert-omission
May 09, 2014 - The presence of an IUC increases the risk of spontaneous abortion nearly three-fold, so, whether a pregnancy … should be removed as soon as possible because the risk of spontaneous abortion in the presence of an IUC increases
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psnet.ahrq.gov/node/49503/psn-pdf
February 01, 2006 - Nurses feel that they must respond to these interruptions and
hassles (5), but doing so increases the … In addition to interruptions and hassles, another factor that increases the risks to patients is low
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psnet.ahrq.gov/node/49826/psn-pdf
April 01, 2018 - The use of checklists in clinical environments increases adherence to protocols, reduces complications … The use of checklists in clinical environments increases adherence to protocols, reduces
complications
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psnet.ahrq.gov/node/49473/psn-pdf
March 01, 2005 - The tendency to take
shortcuts and save time is a very human one, but it also increases the risk of … Lack of predictability greatly
increases the risk of mistakes.