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Psn-Pdf (pdf file)
psnet.ahrq.gov/node/72762/psn-pdfFebruary 17, 2021 - Optimizing Health IT for Safe Integration of Behavioral Health and Primary Care. February 17, 2021 Partnership for Health IT Patient Safety. Plymouth Meeting, PA: ECRI Institute; 2021. https://psnet.ahrq.gov/issue/optimizing-health-it-safe-integration-behavioral-health-and-primary-care Effective integration of hea… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/47855/psn-pdfJune 19, 2019 - Medication Overload: America's Other Drug Problem. June 19, 2019 Brownlee S; Garber J. Brookline, MA: Lown Institute; 2019. https://psnet.ahrq.gov/issue/medication-overload-americas-other-drug-problem Overprescribing is a common problem that contributes to patient harm. This report examines financial, clinical, an… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/38326/psn-pdfJanuary 14, 2009 - Results of a medication reconciliation survey from the 2006 Society of Hospital Medicine national meeting. January 14, 2009 Clay BJ, Halasyamani L, Stucky ER, et al. Results of a medication reconciliation survey from the 2006 Society of Hospital Medicine national meeting. J Hosp Med. 2008;3(6). doi:10.1002/jhm.370.… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/45565/psn-pdfMay 24, 2017 - Leading a Culture of Safety: a Blueprint for Success. May 24, 2017 Chicago, IL: American College of Healthcare Executives, National Patient Safety Foundation's Lucian Leape Institute; 2017. https://psnet.ahrq.gov/issue/leading-culture-safety-blueprint-success Health care leadership plays an undeniable role in sust… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/37809/psn-pdfNovember 21, 2016 - Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices. November 21, 2016 Johnson B, Abraham M, Conway J, et al. Bethesda, MD: Institute for Family-Centered Care; April 2008. https://psnet.ahrq.gov/issue/partnering-patients-and-fam… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/837042/psn-pdfApril 04, 2022 - Leadership Response to a Sentinel Event: Respectful, Effective Crisis Management. April 4, 2022 Institute for Healthcare Improvement. https://psnet.ahrq.gov/issue/leadership-response-sentinel-event-respectful-effective-crisis-management Crisis management skills are valuable at both the organizational and clinical … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/43677/psn-pdfNovember 19, 2014 - Reporting and Learning Systems for Medication Errors: The Role of Pharmacovigilance Centres. November 19, 2014 Bencheikh SR, Cousins D, Benabdallah G, et al. Geneva, Switzerland: World Health Organization; October 2014. ISBN: 9789241507943. https://psnet.ahrq.gov/issue/reporting-and-learning-systems-medication-err… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/47627/psn-pdfJanuary 16, 2019 - Safety of overlapping inpatient orthopaedic surgery: a multicenter study. January 16, 2019 Dy CJ, Osei DA, Maak TG, et al. Safety of Overlapping Inpatient Orthopaedic Surgery: A Multicenter Study. J Bone Joint Surg Am. 2018;100(22):1902-1911. doi:10.2106/JBJS.17.01625. https://psnet.ahrq.gov/issue/safety-overlappi… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/44041/psn-pdfApril 01, 2015 - Potentially dangerous confusion between Bloxiverz (neostigmine) injection and Vazculep (phenylephrine) injection. April 1, 2015 National Alert Network. Horsham, PA: Institute for Safe Medication Practices; Bethesda, MD: American Society of Health-System Pharmacists. March 23, 2015 https://psnet.ahrq.gov/issue/pot… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/74762/psn-pdfFebruary 09, 2022 - Start the year off right by addressing these top 10 medication safety concerns from 2021. February 9, 2022 ISMP Medication Safety Alert! Acute care edition. January 27, 2022;27(2):1-6. https://psnet.ahrq.gov/issue/start-year-right-addressing-these-top-10-medication-safety-concerns-2021 Medication errors are a cons… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/73144/psn-pdfApril 14, 2021 - Addressing systemic racism in nursing homes: a time for action. April 14, 2021 Sloane PD, Yearby R, Konetzka RT, et al. Addressing systemic racism in nursing homes: a time for action. J Am Med Dir Assoc. 2021;22(4):886-892. doi:10.1016/j.jamda.2021.02.023. https://psnet.ahrq.gov/issue/addressing-systemic-racism-nu… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/38938/psn-pdfJuly 26, 2023 - ISMP's List of Confused Drug Names. July 26, 2023 Horsham, PA; Institute for Safe Medication Practices: July 2023. https://psnet.ahrq.gov/issue/ismps-list-confused-drug-names Drawing on information gathered from the ISMP Medication Errors Reporting Program, this fact sheet provides a comprehensive list of commonly… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/72865/psn-pdfMarch 17, 2021 - 5 pandemic mistakes we keep repeating. We can learn from our failures. March 17, 2021 Zeynep Tufekci. The Atlantic. February 26, 2021 https://psnet.ahrq.gov/issue/5-pandemic-mistakes-we-keep-repeating-we-can-learn-our-failures Failures in communication have impacts on patients, teams, organizations and society. Th… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46160/psn-pdfJune 07, 2017 - ISMP Guidelines for Optimizing Safe Subcutaneous Insulin Use in Adults. June 7, 2017 Horsham, PA: Institute for Safe Medication Practices; May 2017. https://psnet.ahrq.gov/issue/ismp-guidelines-optimizing-safe-subcutaneous-insulin-use-adults Insulin is a widely used medication that can contribute to serious patien… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/36620/psn-pdfJanuary 14, 2024 - ISMP's List of High-Alert Medications in Acute Care Settings. January 14, 2024 Horsham, PA; Institute for Safe Medication Practices: 2024. https://psnet.ahrq.gov/issue/ismps-list-high-alert-medications-acute-care-settings This fact sheet lists medications with a high risk of causing significant harm to patients wh… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/60972/psn-pdfJanuary 30, 2003 - Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. January 30, 2003 Smedley BD, Stith AY, Nelson AR, eds and Institute of Medicine. Washington, DC; The National Academies Press: 2003. ISBN 9780309082655. https://psnet.ahrq.gov/issue/unequal-treatment-confronting-racial-and-ethnic-dis… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/60574/psn-pdfJune 10, 2020 - Preventing a parallel pandemic - a national strategy to protect clinicians' well-being. June 10, 2020 Dzau VJ, Kirch D, Nasca TJ. Preventing a parallel pandemic - a national strategy to protect clinicians' well- being. N Engl J Med. 2020;383(6):513-515. doi:10.1056/nejmp2011027. https://psnet.ahrq.gov/issue/preven… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/33562/psn-pdfSeptember 15, 2024 - Rapid Response Systems September 15, 2024 Rapid Response Systems. PSNet [internet]. 2019. https://psnet.ahrq.gov/primer/rapid-response-systems PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that they reflect current research and practice in the patient safety field.… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/49744/psn-pdfOctober 01, 2015 - The Risks of Absent Interoperability: Medication-Induced Hemolysis in a Patient With a Known Allergy October 1, 2015 Reider J. The Risks of Absent Interoperability: Medication-Induced Hemolysis in a Patient With a Known Allergy. PSNet [internet]. 2015. https://psnet.ahrq.gov/web-mm/risks-absent-interoperability-me… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/49527/psn-pdfDecember 01, 2006 - Right Patient, Wrong Sample December 1, 2006 Astion ML. Right Patient, Wrong Sample. PSNet [internet]. 2006. https://psnet.ahrq.gov/web-mm/right-patient-wrong-sample The Case A 54-year-old man was admitted to the hospital for preoperative evaluation and elective knee surgery. On the morning of surgery, the patien…
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