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psnet.ahrq.gov/issue/root-cause-analysis-adverse-events-involving-opioid-overdoses-veterans-health-administration
November 17, 2021 - Study
Root cause analysis of adverse events involving opioid overdoses in the Veterans Health Administration.
Citation Text:
Norris B, Soncrant C, Mills PD, et al. Root cause analysis of adverse events involving opioid overdoses in the Veterans Health Administration. Jt Comm J Qual Patie…
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psnet.ahrq.gov/issue/injury-and-liability-associated-monitored-anesthesia-care-closed-claims-analysis
June 23, 2009 - Study
Injury and liability associated with monitored anesthesia care: a closed claims analysis.
Citation Text:
Bhananker SM, Posner KL, Cheney FW, et al. Injury and liability associated with monitored anesthesia care: a closed claims analysis. Anesthesiology. 2006;104(2):228-234.
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psnet.ahrq.gov/issue/measuring-rate-manual-transcription-error-outpatient-point-care-testing
August 20, 2018 - Study
Measuring the rate of manual transcription error in outpatient point-of-care testing.
Citation Text:
Mays JA, Mathias PC. Measuring the rate of manual transcription error in outpatient point-of-care testing. J Am Med Inform Assoc. 2019;26(3):269-272. doi:10.1093/jamia/ocy170.
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psnet.ahrq.gov/issue/effectiveness-acute-care-remote-triage-systems-systematic-review
March 14, 2022 - Review
Emerging Classic
Effectiveness of acute care remote triage systems: a systematic review.
Citation Text:
Boggan JC, Shoup JP, Whited JD, et al. Effectiveness of acute care remote triage systems: a systematic review. J Gen Intern Med. 2020;35(7):2136-2145.…
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psnet.ahrq.gov/issue/slow-progress-meeting-hospital-safety-standards-learning-leapfrog-groups-efforts
May 13, 2020 - Government Resource
Slow progress on meeting hospital safety standards: learning from the Leapfrog Group's efforts.
Citation Text:
Moran J, Scanlon D. Slow progress on meeting hospital safety standards: learning from the Leapfrog Group's efforts. Health Aff (Millwood). 2013;32(1):27-35…
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psnet.ahrq.gov/issue/missed-rationed-or-unfinished-nursing-care-scoping-review-patient-outcomes
May 29, 2024 - Review
Missed, rationed or unfinished nursing care: a scoping review of patient outcomes.
Citation Text:
Kalánková D, Kirwan M, Bartoníčková D, et al. Missed, rationed or unfinished nursing care: A scoping review of patient outcomes. J Nurs Manag. 2020;28(8):1783-1797. doi:10.1111/jonm.1…
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psnet.ahrq.gov/issue/changes-error-patterns-unanticipated-trauma-deaths-during-20-years-pursuit-zero-preventable
March 23, 2022 - Study
Changes in error patterns in unanticipated trauma deaths during 20 years: in pursuit of zero preventable deaths.
Citation Text:
LaGrone LN, McIntyre LK, Riggle A, et al. Changes in error patterns in unanticipated trauma deaths during 20 years: In pursuit of zero preventable deaths.…
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psnet.ahrq.gov/issue/medication-misadventures-resulting-emergency-department-visits-hmo-medical-center
March 16, 2022 - Study
Classic
Medication misadventures resulting in emergency department visits at an HMO medical center.
Citation Text:
Medication misadventures resulting in emergency department visits at an HMO medical center. Schneitman-McIntire O, Farnen TA, Gordon N, et al…
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psnet.ahrq.gov/issue/dropping-baton-qualitative-analysis-failures-during-transition-emergency-department-inpatient
September 26, 2012 - Study
Dropping the baton: a qualitative analysis of failures during the transition from emergency department to inpatient care.
Citation Text:
Horwitz LI, Meredith T, Schuur JD, et al. Dropping the baton: a qualitative analysis of failures during the transition from emergency departmen…
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psnet.ahrq.gov/issue/how-accurately-do-older-adult-emergency-department-patients-recall-their-medications
September 02, 2020 - Study
How accurately do older adult emergency department patients recall their medications?
Citation Text:
Goldberg EM, Marks SJ, Merchant RC, et al. How accurately do older adult emergency department patients recall their medications? Acad Emerg Med. 2021;28(2):248-252. doi:10.1111/acem…
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psnet.ahrq.gov/issue/computer-assisted-process-modeling-enhance-intraoperative-safety-cardiac-surgery
July 19, 2023 - Study
Computer-assisted process modeling to enhance intraoperative safety in cardiac surgery.
Citation Text:
Tarola CL, Quin JA, Haime ME, et al. Computer-Assisted Process Modeling to Enhance Intraoperative Safety in Cardiac Surgery. JAMA Surg. 2016;151(12):1183-1186. doi:10.1001/jamasur…
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psnet.ahrq.gov/issue/influence-surgeon-behavior-trainee-willingness-speak-randomized-controlled-trial
February 22, 2019 - Study
Influence of surgeon behavior on trainee willingness to speak up: a randomized controlled trial.
Citation Text:
Salazar MJB, Minkoff H, Bayya J, et al. Influence of surgeon behavior on trainee willingness to speak up: a randomized controlled trial. J Am Coll Surg. 2014;219(5):1001-…
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psnet.ahrq.gov/issue/patient-safety-orthopedic-surgery-prioritizing-key-areas-iatrogenic-harm-through-analysis
December 18, 2013 - Study
Patient safety in orthopedic surgery: prioritizing key areas of iatrogenic harm through an analysis of 48,095 incidents reported to a national database of errors.
Citation Text:
Panesar S, Carson-Stevens A, Salvilla SA, et al. Patient safety in orthopedic surgery: prioritizing ke…
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psnet.ahrq.gov/issue/using-data-matrix-coded-sponge-counting-system-across-surgical-practice-impact-after-18
January 02, 2017 - Study
Using a data-matrix–coded sponge counting system across a surgical practice: impact after 18 months.
Citation Text:
Cima RR, Kollengode A, Clark J, et al. Using a data-matrix-coded sponge counting system across a surgical practice: impact after 18 months. Jt Comm J Qual Patient S…
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psnet.ahrq.gov/issue/organizational-climate-determinants-resident-safety-culture-nursing-homes
June 24, 2020 - Study
Organizational climate determinants of resident safety culture in nursing homes.
Citation Text:
Arnetz JE, Zhdanova LS, Elsouhag D, et al. Organizational climate determinants of resident safety culture in nursing homes. Gerontologist. 2011;51(6):739-49. doi:10.1093/geront/gnr053.…
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psnet.ahrq.gov/issue/enhanced-end-life-care-associated-deploying-rapid-response-team-pilot-study
December 24, 2008 - Study
Enhanced end-of-life care associated with deploying a rapid response team: a pilot study.
Citation Text:
Vazquez R, Gheorghe C, Grigoriyan A, et al. Enhanced end-of-life care associated with deploying a rapid response team: a pilot study. J Hosp Med. 2009;4(7):449-52. doi:10.1002…
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psnet.ahrq.gov/issue/association-hospital-participation-surgical-outcomes-monitoring-program-inpatient
August 20, 2018 - Study
Association of hospital participation in a surgical outcomes monitoring program with inpatient complications and mortality.
Citation Text:
Etzioni DA, Wasif N, Dueck AC, et al. Association of hospital participation in a surgical outcomes monitoring program with inpatient complicati…
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psnet.ahrq.gov/issue/updating-eindhoven-clarifying-features-patient-safety-near-miss
March 13, 2024 - Study
Updating Eindhoven: clarifying the features of a patient safety near miss.
Citation Text:
Woodier N, Burnett C, Sampson P, et al. Updating Eindhoven: clarifying the features of a patient safety near miss. J Patient Saf Risk Manag. 2024;29(4):195-201. doi:10.1177/25160435241247096. …
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psnet.ahrq.gov/issue/vital-signs-changes-opioid-prescribing-united-states-2006-2015
June 10, 2020 - Study
Vital signs: changes in opioid prescribing in the United States, 2006-2015.
Citation Text:
Guy GP, Zhang K, Bohm MK, et al. Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2017;66(26):697-704. doi:10.15585/mmwr.mm6626a4.
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psnet.ahrq.gov/issue/effect-us-drug-enforcement-administrations-rescheduling-hydrocodone-combination-analgesic
August 04, 2021 - Study
Effect of US Drug Enforcement Administration's rescheduling of hydrocodone combination analgesic products on opioid analgesic prescribing.
Citation Text:
Jones CM, Lurie PG, Throckmorton DC. Effect of US Drug Enforcement Administration's Rescheduling of Hydrocodone Combination Anal…