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psnet.ahrq.gov/node/50378/psn-pdf
September 25, 2019 - Evaluating horizontal violence and bullying in the nursing
workforce of an oncology academic medical center.
September 25, 2019
Lewis-Pierre LT, Anglade D, Saber D, et al. Evaluating horizontal violence and bullying in the nursing
workforce of an oncology academic medical center. J Nurs Manag. 2019;27(5):1005-1010.…
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psnet.ahrq.gov/node/47279/psn-pdf
July 23, 2018 - No Place Like Home: Advancing the Safety of Care in the
Home.
July 23, 2018
Boston, MA: Institute for Healthcare Improvement; 2018.
https://psnet.ahrq.gov/issue/no-place-home-advancing-safety-care-home
The home care setting harbors unique challenges to patient safety. This report builds on a previous
evidence ass…
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psnet.ahrq.gov/node/46821/psn-pdf
June 06, 2018 - Focus on the Quadruple Aim: development of a resiliency
center to promote faculty and staff wellness initiatives.
June 6, 2018
Morrow E, Call M, Marcus R, et al. Focus on the Quadruple Aim: Development of a Resiliency Center to
Promote Faculty and Staff Wellness Initiatives. Jt Comm J Qual Patient Saf. 2018;44(5):2…
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psnet.ahrq.gov/node/36045/psn-pdf
November 10, 2011 - IHI announces that hospitals participating in 100,000
Lives Campaign have saved an estimated 122,300 lives.
November 10, 2011
https://psnet.ahrq.gov/issue/ihi-announces-hospitals-participating-100000-lives-campaign-have-saved-
estimated-122300-lives
In December 2004, the Institute for Healthcare Improvement (IHI) …
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psnet.ahrq.gov/node/866254/psn-pdf
July 10, 2024 - Top Penn State Health surgeon warned leaders about
transplant problems months before shutdown. Then he
was let go.
July 10, 2024
Massey W, Keith C. Spotlight PA: June 20, 2024.
https://psnet.ahrq.gov/issue/top-penn-state-health-surgeon-warned-leaders-about-transplant-problems-
months-shutdown-then
Whistleblowers…
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psnet.ahrq.gov/node/35762/psn-pdf
January 02, 2017 - Using Failure Mode and Effects Analysis for safe
administration of chemotherapy to hospitalized children
with cancer.
January 2, 2017
Robinson DL, Heigham M, Clark J. Using Failure Mode and Effects Analysis for safe administration of
chemotherapy to hospitalized children with cancer. Jt Comm J Qual Patient Saf. 20…
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psnet.ahrq.gov/node/73316/psn-pdf
May 26, 2021 - Racial bias among emergency providers: strategies to
mitigate its adverse effects.
May 26, 2021
Brockett-Walker C, Lall M, Evans DD, et al. Racial bias among emergency providers: strategies to mitigate
its adverse effects. Adv Emerg Nurs J. 2021;43(2):89-101. doi:10.1097/tme.0000000000000352.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/47257/psn-pdf
September 26, 2018 - The Psychiatry Morbidity and Mortality Incident Reporting
Tool increases psychiatrist participation in reporting
adverse events.
September 26, 2018
Kroll DS, Shellman AD, Gitlin DF. The Psychiatry Morbidity and Mortality Incident Reporting Tool Increases
Psychiatrist Participation in Reporting Adverse Events. J Pa…
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psnet.ahrq.gov/node/45464/psn-pdf
September 07, 2016 - Measuring adverse events in hospitalized patients: an
administrative method for measuring harm.
September 7, 2016
Martin J, Benjamin EM, Craver C, et al. Measuring Adverse Events in Hospitalized Patients: An
Administrative Method for Measuring Harm. J Patient Saf. 2016;12(3):125-31.
doi:10.1097/PTS.000000000000007…
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digital.ahrq.gov/ahrq-funded-projects/ehr-based-screening-tool-support-safe-discharges-covid-19-patients-emergency-department/final-report
January 01, 2023 - An Electronic Health Record-Based Screening Tool to Support Safe Discharges of COVID-19 Patients in the Emergency Department – Final Report
Citation
Galarraga J. An Electronic Health Record-Based Screening Tool to Support Safe Discharges of COVID-19 Patients in the Emergency Department – Final Report.…
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digital.ahrq.gov/principal-investigator/galarraga-jessica-e
January 01, 2023 - Galarraga, Jessica E.
An Electronic Health Record-Based Screening Tool to Support Safe Discharges of COVID-19 Patients in the Emergency Department – Final Report
Citation
Galarraga J. An Electronic Health Record-Based Screening Tool to Support Safe Discharges of COVID-19 Patie…
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psnet.ahrq.gov/node/852282/psn-pdf
August 09, 2023 - Implementation of medication reconciliation in outpatient
cancer care.
August 9, 2023
Powis M, Dara C, Macedo A, et al. Implementation of medication reconciliation in outpatient cancer care.
BMJ Open Quality. 2023;12(2):e002211. doi:10.1136/bmjoq-2022-002211.
https://psnet.ahrq.gov/issue/implementation-medication-…
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psnet.ahrq.gov/node/837666/psn-pdf
July 13, 2022 - Developing and aligning a safety event taxonomy for
inpatient psychiatry.
July 13, 2022
Barnes T, Fontaine T, Bautista C, et al. Developing and aligning a safety event taxonomy for inpatient
psychiatry. J Patient Saf. 2022;18(4):e704-e713. doi:10.1097/pts.0000000000000935.
https://psnet.ahrq.gov/issue/developing-a…
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psnet.ahrq.gov/node/60152/psn-pdf
March 25, 2020 - Errors during resuscitation: the impact of perceived
authority on delivery of care.
March 25, 2020
Delaloye NJ, Tobler K, O?Neill T, et al. Errors during resuscitation: the impact of perceived authority on
delivery of care. J Patient Saf. 2020;16(1). doi:10.1097/pts.0000000000000359.
https://psnet.ahrq.gov/issue/e…
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digital.ahrq.gov/2018-year-review/research-summary/emerging-innovative-newly-funded-research/advancing-research-evidence-into-clinical-practie-through-cds
January 01, 2018 - Advancing Research Evidence into Clinical Practice through Clinical Decision Support (CDS)
CDS helps clinicians, patients, and others on the care team by delivering the right information at the right time so they can make the best care decisions. When developed and implemented well, CDS us…
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www.ahrq.gov/hai/tools/ambulatory-surgery/sections.html
May 01, 2017 - Toolkit Sections
Implementation
Implementation Guide : It may be helpful to review this guide before starting a project to reduce infections and other complications in your ambulatory surgery center. The guide takes users step by step through the execution of technical and cultural interventions surroundi…
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www.ahrq.gov/cpi/about/nac/snac-smith.html
December 01, 2021 - SNAC Member: Mark D. Smith, M.D., M.B.A.
Professor of Clinical Medicine
University of California, San Francisco
Mark D. Smith, M.D., M.B.A., is a professor of clinical medicine at the University of California, San Francisco. From 2015 to 2019, he served as co-chair of the Guiding Committee of the Health Care…
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/UaT8AVUSVQwSduNs8TA-_e
June 09, 2020 - JAMA
Screening for Unhealthy Drug Use
US Preventive Services Task Force Recommendation Statement
US Preventive Services Task Force
Summary of Recommendations
Importance
Many people in the US experience problems related to unhealthy
drug use, defined in this recommendation statement as the use of
illegal drugs and …
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psnet.ahrq.gov/web-mm/right-patient-wrong-sample
June 01, 2004 - Right Patient, Wrong Sample
Citation Text:
Astion ML. Right Patient, Wrong Sample. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2006.
Copy Citation
Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote ta…
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www.ahrq.gov/downloads/pub/advances2/vol1/Advances-Ruddick_61.pdf
March 09, 2008 - Using Root Cause Analysis to Reduce Falls in Rural Health Care Facilities
Using Root Cause Analysis to Reduce Falls
in Rural Health Care Facilities
Patricia Ruddick, RN, MSN; Karen Hannah, MBA; Charles P. Schade, MD; Gail Bellamy, PhD;
John Brehm, MD; David Lomely, BA.
Abstract
Prevention of patient falls i…