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psnet.ahrq.gov/issue/improving-team-members-attention-during-or-briefing-or-time-out
November 10, 2021 - Study
Improving team members' attention during the OR briefing or time out.
Citation Text:
Braverman A. Improving team members' attention during the OR briefing or time out. AORN Journal. 2024;119(6):421-427. doi:10.1002/aorn.14144.
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psnet.ahrq.gov/issue/safety-personal-partnering-patients-and-families-safest-care
January 06, 2015 - Book/Report
Safety Is Personal: Partnering With Patients and Families for the Safest Care.
Citation Text:
Safety Is Personal: Partnering With Patients and Families for the Safest Care. NPSF Lucian Leape Institute Roundtable on Consumer Engagement in Patient Safety. Boston, MA: National P…
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psnet.ahrq.gov/issue/3-year-study-medication-incidents-acute-general-hospital
July 15, 2020 - Study
A 3-year study of medication incidents in an acute general hospital.
Citation Text:
Song L, Chui WCM, Lau CP, et al. A 3-year study of medication incidents in an acute general hospital. J Clin Pharm Ther. 2008;33(2):109-14. doi:10.1111/j.1365-2710.2007.00880.x.
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psnet.ahrq.gov/issue/capturing-essential-information-achieve-safe-interoperability
February 23, 2015 - Commentary
Capturing essential information to achieve safe interoperability.
Citation Text:
Weininger S, Jaffe MB, Rausch T, et al. Capturing Essential Information to Achieve Safe Interoperability. Anesth Analg. 2017;124(1):83-94.
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psnet.ahrq.gov/issue/development-pediatric-adverse-events-terminology
November 16, 2022 - Commentary
Development of a pediatric adverse events terminology.
Citation Text:
Gipson DS, Kirkendall E, Gumbs-Petty B, et al. Development of a Pediatric Adverse Events Terminology. Pediatrics. 2017;139(1). doi:10.1542/peds.2016-0985.
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psnet.ahrq.gov/issue/frequency-medication-administration-timing-error-hospitals-systematic-review
March 15, 2023 - Review
Frequency of medication administration timing error in hospitals: a systematic review.
Citation Text:
Pullam T, Russell CL, White-Lewis S. Frequency of medication administration timing error in hospitals: a systematic review. J Nurs Care Qual. 2023;38(2):126-133. doi:10.1097/ncq.0…
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psnet.ahrq.gov/issue/just-time-training-high-risk-low-volume-therapies-approach-ensure-patient-safety
April 24, 2018 - Commentary
Just-in-time training for high-risk low-volume therapies: an approach to ensure patient safety.
Citation Text:
Helman S, Lisanti AJ, Adams A, et al. Just-in-Time Training for High-Risk Low-Volume Therapies: An Approach to Ensure Patient Safety. J Nurs Care Qual. 2016;31(1):33-…
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psnet.ahrq.gov/issue/shift-shift-handoff-effects-patient-safety-and-outcomes-systematic-review
January 22, 2016 - Review
Shift-to-shift handoff effects on patient safety and outcomes: a systematic review.
Citation Text:
Mardis M, Davis JJ, Benningfield B, et al. Shift-to-Shift Handoff Effects on Patient Safety and Outcomes. Am J Med Qual. 2017;32(1):34-42. doi:10.1177/1062860615612923.
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psnet.ahrq.gov/issue/reactive-proactive-safety-approach-analysis-medication-errors-chemotherapy-using-general
November 02, 2022 - Study
From a reactive to a proactive safety approach. Analysis of medication errors in chemotherapy using general failure types.
Citation Text:
Fyhr A, Ternov S, Ek Å. From a reactive to a proactive safety approach. Analysis of medication errors in chemotherapy using general failure type…
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psnet.ahrq.gov/issue/using-modified-a3-lean-framework-identify-ways-increase-students-reporting-mistreatment
May 25, 2010 - Commentary
Using a modified A3 lean framework to identify ways to increase students' reporting of mistreatment behaviors.
Citation Text:
Ross PT, Abdoler E, Flygt LA, et al. Using a Modified A3 Lean Framework to Identify Ways to Increase Students' Reporting of Mistreatment Behaviors. Aca…
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psnet.ahrq.gov/issue/ashp-national-survey-pharmacy-practice-hospital-settings-dispensing-and-administration-2017
September 30, 2020 - Study
ASHP national survey of pharmacy practice in hospital settings: dispensing and administration—2017.
Citation Text:
Schneider PJ, Pedersen CA, Scheckelhoff DJ. ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration-2017. Am J Health Syst Pharm.…
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psnet.ahrq.gov/issue/all-clear-preparing-it-downtime
November 16, 2022 - Commentary
All CLEAR? Preparing for IT downtime.
Citation Text:
Kashiwagi DT, Sexton MD, Graves ES, et al. All CLEAR? Preparing for IT Downtime. Am J Med Qual. 2017;32(5):547-551. doi:10.1177/1062860616667546.
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psnet.ahrq.gov/issue/understanding-test-results-follow-ambulatory-setting-analysis-multiple-perspectives
May 20, 2019 - Study
Understanding test results follow-up in the ambulatory setting: analysis of multiple perspectives.
Citation Text:
Ai A, Desai S, Shellman A, et al. Understanding Test Results Follow-Up in the Ambulatory Setting: Analysis of Multiple Perspectives. Jt Comm J Qual Patient Saf. 2018;44…
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psnet.ahrq.gov/issue/patient-died-what-about-involvement-investigation-process
June 24, 2020 - Commentary
The patient died: what about involvement in the investigation process?
Citation Text:
Wiig S, Hibbert PD, Braithwaite J. The patient died: what about involvement in the investigation process? Int J Qual Health Care. 2020;32(5):342-346. doi:10.1093/intqhc/mzaa034.
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psnet.ahrq.gov/issue/observational-study-postoperative-handoff-standardization-failures
March 10, 2021 - Study
An observational study of postoperative handoff standardization failures.
Citation Text:
Abraham J, Meng A, Sona C, et al. An observational study of postoperative handoff standardization failures. Int J Med Inform. 2021;151:104458. doi:10.1016/j.ijmedinf.2021.104458.
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psnet.ahrq.gov/issue/medication-administration-aged-care-facilities-mixed-methods-systematic-review
March 05, 2025 - Review
Medication administration in aged care facilities: a mixed-methods systematic review.
Citation Text:
Garratt S, Dowling A, Manias E. Medication administration in aged care facilities: a mixed‐methods systematic review. J Adv Nurs. 2025;81(2):621-640. doi:10.1111/jan.16318.
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psnet.ahrq.gov/issue/practical-implementation-artificial-intelligence-technologies-medicine
March 24, 2019 - Commentary
The practical implementation of artificial intelligence technologies in medicine.
Citation Text:
He J, Baxter SL, Xu J, et al. The practical implementation of artificial intelligence technologies in medicine. Nat Med. 2019;25(1):30-36. doi:10.1038/s41591-018-0307-0.
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psnet.ahrq.gov/issue/near-miss-research-healthcare-system-scoping-review
July 15, 2020 - Review
Near miss research in the healthcare system: a scoping review.
Citation Text:
Feng T-ting, Zhang X, Tan L-ling, et al. Near miss research in the healthcare system: a scoping review. J Nurs Adm. 2022;52(3):160-166. doi:10.1097/nna.0000000000001124.
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psnet.ahrq.gov/issue/reducing-inappropriate-outpatient-medication-prescribing-older-adults-across-electronic
September 29, 2021 - Study
Reducing inappropriate outpatient medication prescribing in older adults across electronic health record systems.
Citation Text:
Friebe MP, LeGrand JR, Shepherd BE, et al. Reducing inappropriate outpatient medication prescribing in older adults across electronic health record syste…
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psnet.ahrq.gov/issue/danger-discharge-summaries-abbreviations-create-confusion-both-author-and-recipient
March 15, 2017 - Study
Danger in discharge summaries: abbreviations create confusion for both author and recipient.
Citation Text:
Coghlan A, Turner S, Coverdale S. Danger in discharge summaries: abbreviations create confusion for both author and recipient. Intern Med J. 2023;53(4):550-558. doi:10.1111/i…