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2221. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46340/psn-pdf
      September 27, 2017 - A systematic review of the effectiveness of interruptive medication prescribing alerts in hospital CPOE systems to change prescriber behavior and improve patient safety. September 27, 2017 Page N, Baysari MT, Westbrook JI. A systematic review of the effectiveness of interruptive medication prescribing alerts in ho…

2222. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/45714/psn-pdf
      December 20, 2017 - US emergency department visits for outpatient adverse drug events, 2013–2014. December 20, 2017 Shehab N, Lovegrove MC, Geller AI, et al. US Emergency Department Visits for Outpatient Adverse Drug Events, 2013-2014. JAMA. 2016;316(20):2115-2125. doi:10.1001/jama.2016.16201. https://psnet.ahrq.gov/issue/us-emergenc…

2223. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46507/psn-pdf
      October 11, 2017 - Outcomes in two Massachusetts hospital systems give reason for optimism about communication-and-resolution programs. October 11, 2017 Mello MM, Kachalia A, Roche S, et al. Outcomes In Two Massachusetts Hospital Systems Give Reason For Optimism About Communication-And-Resolution Programs. Health Aff (Millwood). 201…

2224. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/43629/psn-pdf
      May 01, 2015 - Exposing physicians to reduced residency work hours did not adversely affect patient outcomes after residency. May 1, 2015 Jena AB, Schoemaker L, Bhattacharya J. Exposing physicians to reduced residency work hours did not adversely affect patient outcomes after residency. Health Aff (Millwood). 2014;33(10):1832-40.…

2225. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39654/psn-pdf
      September 20, 2011 - Accountability measures—using measurement to promote quality improvement. September 20, 2011 Chassin MR, Loeb JM, Schmaltz SP, et al. Accountability measures--using measurement to promote quality improvement. N Engl J Med. 2010;363(7):683-8. doi:10.1056/NEJMsb1002320. https://psnet.ahrq.gov/issue/accountability-me…

2226. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/48007/psn-pdf
      May 21, 2019 - Structured override reasons for drug–drug interaction alerts in electronic health records. May 21, 2019 Wright A, McEvoy D, Aaron S, et al. Structured override reasons for drug-drug interaction alerts in electronic health records. J Am Med Info Asso. 2019;26(10):934-942. doi:10.1093/jamia/ocz033. https://psnet.ahr…

2227. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/43049/psn-pdf
      October 31, 2014 - Vital signs: improving antibiotic use among hospitalized patients. October 31, 2014 Fridkin SK, Baggs J, Fagan R, et al. Vital signs: improving antibiotic use among hospitalized patients. MMWR Morb Mortal Wkly Rep. 2014;63(9):194-200. https://psnet.ahrq.gov/issue/vital-signs-improving-antibiotic-use-among-hospital…

2228. Copy and Paste | PSNet
      psnet.ahrq.gov/web-mm/copy-and-paste
      December 10, 2014 - Copy and Paste Citation Text: Hersh WR. Copy and Paste. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …

2229. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33825/psn-pdf
      January 01, 2017 - Rethinking Root Cause Analysis January 1, 2016 Gupta K, Lyndon A. Rethinking Root Cause Analysis. PSNet [internet]. 2016. https://psnet.ahrq.gov/perspective/rethinking-root-cause-analysis Annual Perspective 2016 Introduction Root cause analysis (RCA) is a systematic process to analyze adverse events and near miss…

2230. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/867655/psn-pdf
      February 26, 2025 - Learning Health Systems for Patient Safety February 26, 2025 Savitz LA, Sousane Z, Mossburg SE. Learning Health Systems for Patient Safety. PSNet [internet]. 2025. https://psnet.ahrq.gov/perspective/learning-health-systems-patient-safety Despite an observable decrease in adverse events in health care over time, rat…

2231. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49542/psn-pdf
      August 21, 2007 - Copy and Paste August 21, 2007 Hersh WR. Copy and Paste. PSNet [internet]. 2007. https://psnet.ahrq.gov/web-mm/copy-and-paste The Case A 77-year-old woman was admitted to a teaching hospital with diarrhea and dehydration after completing her fifth cycle of chemotherapy for ovarian cancer. Her only relevant past m…

2232. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49456/psn-pdf
      July 12, 2004 - Glucose Roller Coaster July 1, 2004 Sharpe B. Glucose Roller Coaster. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/glucose-roller-coaster The Case A 71-year-old woman with congestive heart failure was admitted to the hospital. Her medical history was significant for dialysis-dependent, end-stage kidney d…

2233. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/612828/psn-pdf
      February 23, 2022 - Delayed Diagnosis of Kidney Transplant Complications February 23, 2022 Kapa N, Morfín JA. Delayed Diagnosis of Kidney Transplant Complications. PSNet [internet]. 2022. https://psnet.ahrq.gov/web-mm/delayed-diagnosis-kidney-transplant-complications Objectives Recognition, early evaluation, and management of kidney …

2234. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33684/psn-pdf
      May 01, 2009 - Patient Safety: A Perspective from Office Practice May 1, 2009 Baron RJ. Patient Safety: A Perspective from Office Practice. PSNet [internet]. 2009. https://psnet.ahrq.gov/perspective/patient-safety-perspective-office-practice Perspective Most patient interactions with the health care system occur in the outpatien…

2235. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49755/psn-pdf
      February 01, 2016 - Good Night's Sleep Gone Wrong February 1, 2016 Gillis CM, Degrado J, Anger KE. Good Night's Sleep Gone Wrong. PSNet [internet]. 2016. https://psnet.ahrq.gov/web-mm/good-nights-sleep-gone-wrong The Case A 64-year-old woman came to the emergency department complaining of cough and shortness of breath, along with an…

2236. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33638/psn-pdf
      August 01, 2006 - Getting Into Patient Safety: A Personal Story August 1, 2006 Cooper JB. Getting Into Patient Safety: A Personal Story. PSNet [internet]. 2006. https://psnet.ahrq.gov/perspective/getting-patient-safety-personal-story Perspective My journey into patient safety began in 1972. It was born of serendipity enabled by the…

2237. The Hidden Harms of Hand Sanitizer | PSNet
      psnet.ahrq.gov/web-mm/hidden-harms-hand-sanitizer
      March 04, 2020 - The Hidden Harms of Hand Sanitizer Citation Text: Stewart S. The Hidden Harms of Hand Sanitizer. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 …

2238. In Conversation with...Katie Boston-Leary about Patient Safety Amid Nursing Workforce Challenges | PSNet
      psnet.ahrq.gov/perspective/conversation-withkatie-boston-leary-about-patient-safety-amid-nursing-workforce
      April 24, 2024 - Health Aff (Millwood). 2022;41(2):265-272. doi:10.1377/hlthaff.2021.01400 5 ANA Enterprise Leads National

2239. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/60611/psn-pdf
      June 24, 2020 - Thrombosis involving either the arterial or venous circulation is the principal pathologic event that leads

2240. Patient Safety Amid Nursing Workforce Challenges | PSNet
      psnet.ahrq.gov/perspective/patient-safety-amid-nursing-workforce-challenges
      April 24, 2024 - Health Aff (Millwood). 2022;41(2):265-272. doi:10.1377/hlthaff.2021.01400 5 ANA Enterprise Leads National