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psnet.ahrq.gov/node/867594/psn-pdf
January 22, 2025 - A systematic review on the evidence of misdiagnosis in
dementia and its impact on accessing dementia care.
January 22, 2025
Giebel C, Silva?Ribeiro W, Watson J, et al. A systematic review on the evidence of misdiagnosis in
dementia and its impact on accessing dementia care. Int J Geriat Psychiatry. 2024;39(10):e615…
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psnet.ahrq.gov/node/37241/psn-pdf
December 16, 2011 - The impact of safety organizing, trusted leadership, and
care pathways on reported medication errors in hospital
nursing units.
December 16, 2011
Vogus TJ, Sutcliffe K. The impact of safety organizing, trusted leadership, and care pathways on reported
medication errors in hospital nursing units. Med Care. 2007;45(…
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psnet.ahrq.gov/node/72820/psn-pdf
March 10, 2021 - Medication errors related to computerized provider order
entry systems in hospitals and how they change over
time: a narrative review.
March 10, 2021
Kinlay M, Zheng WY, Burke R, et al. Medication errors related to computerized provider order entry
systems in hospitals and how they change over time: A narrative re…
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psnet.ahrq.gov/node/60047/psn-pdf
March 18, 2020 - A systematic review exploring the content and outcomes
of interventions to improve psychological safety,
speaking up and voice behaviour.
March 18, 2020
O’Donovan R, McAuliffe E. A systematic review exploring the content and outcomes of interventions to
improve psychological safety, speaking up and voice behaviour…
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psnet.ahrq.gov/node/73425/psn-pdf
June 23, 2021 - A qualitative study of what care workers do to provide
patient safety at home through telecare.
June 23, 2021
Stokke R, Melby L, Isaksen J, et al. A qualitative study of what care workers do to provide patient safety at
home through telecare. BMC Health Serv Res. 2021;21(1):553. doi:10.1186/s12913-021-06556-4.
htt…
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psnet.ahrq.gov/node/73188/psn-pdf
April 28, 2021 - Enhancing patient safety by integrating ethical
dimensions to critical incident reporting systems.
April 28, 2021
Wehkamp K, Kuhn E, Petzina R, et al. Enhancing patient safety by integrating ethical dimensions to Critical
Incident Reporting Systems. BMC Med Ethics. 2021;22(1):26. doi:10.1186/s12910-021-00593-8.
ht…
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psnet.ahrq.gov/node/48181/psn-pdf
August 07, 2019 - Managing the risks of direct oral anticoagulants.
August 7, 2019
Sentinel Event Alert. July 30, 2019;(61):1-5.
https://psnet.ahrq.gov/issue/managing-risks-direct-oral-anticoagulants
Anticoagulant medications are known to be high-risk for adverse drug events. Although direct oral
anticoagulants (DOACs) require less…
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hcup-us.ahrq.gov/datainnovations/MNAbstractFinal.pdf
September 29, 2013 - Title:
State: Minnesota
Title: Using Clinically Enhanced Claims Data to Guide Treatment of
Acute Heart Failure
Principal Investigator: Mark Sonneborn
Organization: Minnesota Hospital Association
Project Dates: September 30, 2010, to September 29, 2013
Grant Number: R01 HS20043-01
The long-term objec…
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psnet.ahrq.gov/node/61044/psn-pdf
January 01, 2021 - Seven features of safety in maternity units: a framework
based on multisite ethnography and stakeholder
consultation.
October 21, 2020
Liberati EG, Tarrant C, Willars J, et al. Seven features of safety in maternity units: a framework based on
multisite ethnography and stakeholder consultation. BMJ Qual Saf. 2021;3…
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psnet.ahrq.gov/node/866902/psn-pdf
October 09, 2024 - Why do acute healthcare staff behave unprofessionally
towards each other and how can these behaviours be
reduced? A realist review.
October 9, 2024
Aunger JA, Abrams R, Westbrook JI, et al. Why do acute healthcare staff behave unprofessionally towards
each other and how can these behaviours be reduced? A realist r…
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psnet.ahrq.gov/node/837595/psn-pdf
June 29, 2022 - Changes to primary care delivery during the COVID-19
pandemic and perceived impact on medication safety: a
survey study.
June 29, 2022
Gleeson LL, Ludlow A, Wallace E, et al. Changes to primary care delivery during the COVID-19 pandemic
and perceived impact on medication safety: a survey study. Explor Res Clin Soc…
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psnet.ahrq.gov/node/45238/psn-pdf
September 29, 2017 - Unprofessional behaviors among tomorrow's physicians:
review of the literature with a focus on risk factors,
temporal trends, and future directions.
September 29, 2017
Fargen KM, Drolet BC, Philibert I. Unprofessional Behaviors Among Tomorrow's Physicians: Review of the
Literature With a Focus on Risk Factors, Tem…
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psnet.ahrq.gov/node/855425/psn-pdf
January 01, 2024 - Detection rates of mild cognitive impairment in primary
care for the United States Medicare population.
November 15, 2023
Liu Y, Jun H, Becker A, et al. Detection rates of mild cognitive impairment in primary care for the United
States Medicare population. J Prev Alz Dis. 2024;11:7–12. doi:10.14283/jpad.2023.131.
…
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psnet.ahrq.gov/node/74866/psn-pdf
February 23, 2022 - Eliminating explicit and implicit biases in health care:
evidence and research needs.
February 23, 2022
Vela MB, Erondu AI, Smith NA, et al. Eliminating explicit and implicit biases in health care: evidence and
research needs. Annu Rev Public Health. 2022;43(1):477-501. doi:10.1146/annurev-publhealth-052620-
10352…
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psnet.ahrq.gov/node/864854/psn-pdf
March 20, 2024 - Mortality and risk factors associated with misdiagnosis of
acute aortic syndrome in Ontario, Canada: a population-
based study.
March 20, 2024
Ohle R, Savage DW, Caswell J, et al. Mortality and risk factors associated with misdiagnosis of acute aortic
syndrome in Ontario, Canada: a population-based study. Emerg Me…
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psnet.ahrq.gov/node/851446/psn-pdf
July 19, 2023 - Physician and nurse well-being and preferred
interventions to address burnout in hospital practice:
factors associated with turnover, outcomes, and patient
safety.
July 19, 2023
Aiken LH, Lasater KB, Sloane DM, et al. Physician and nurse well-being and preferred interventions to
address burnout in hospital practi…
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psnet.ahrq.gov/node/37927/psn-pdf
March 10, 2011 - A randomized trial of electronic clinical reminders to
improve medication laboratory monitoring.
March 10, 2011
Matheny ME, Sequist TD, Seger AC, et al. A randomized trial of electronic clinical reminders to improve
medication laboratory monitoring. J Am Med Inform Assoc. 2008;15(4):424-9. doi:10.1197/jamia.M2602.
…
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psnet.ahrq.gov/node/40254/psn-pdf
September 19, 2016 - Medical error: the second victim.
September 19, 2016
Wu AW. Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ.
2000;320(7237):726-727.
https://psnet.ahrq.gov/issue/medical-error-second-victim
This editorial coined the term "second victim" to describe clinicians who commit error…
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psnet.ahrq.gov/node/41587/psn-pdf
September 19, 2016 - Supporting involved health care professionals (second
victims) following an adverse health event: a literature
review.
September 19, 2016
Seys D, Scott SD, Wu AW, et al. Supporting involved health care professionals (second victims) following
an adverse health event: a literature review. Int J Nurs Stud. 2013;50(5…
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psnet.ahrq.gov/node/72544/psn-pdf
December 09, 2020 - Design and implementation of an analgesia, sedation, and
paralysis order set to enhance compliance of pro re nata
medication orders with Joint Commission medication
management standards in a pediatric ICU.
December 9, 2020
Procaccini D, Rapaport R, Petty BG, et al. Design and Implementation of an analgesia, sedati…