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  1. Quality measures for patients at risk of adverse outcomes in the Veterans Health Administration: expert panel recommendations. | PSNet

    psnet.ahrq.gov/issue/quality-measures-patients-risk-adverse-outcomes-veterans-health-administration-expert-panel
    June 22, 2022 - Commentary Quality measures for patients at risk of adverse outcomes in the Veterans Health Administration: expert panel recommendations. Citation Text: Chang ET, Newberry S, Rubenstein LV, et al. Quality Measures for Patients at Risk of Adverse Outcomes in the Veterans Health Administra…

  2. Lost in translation--silent reporting and electronic patient records in nursing handovers: an ethnographic study. | PSNet

    psnet.ahrq.gov/issue/lost-translation-silent-reporting-and-electronic-patient-records-nursing-handovers
    October 20, 2021 - Study Lost in translation--silent reporting and electronic patient records in nursing handovers: an ethnographic study. Citation Text: Ihlebæk HM. Lost in translation--silent reporting and electronic patient records in nursing handovers: an ethnographic study. Int J Nurs Stud. 2020;109:1…

  3. A mixed-methods systematic review of interventions to address incivility in nursing. | PSNet

    psnet.ahrq.gov/issue/mixed-methods-systematic-review-interventions-address-incivility-nursing
    December 02, 2020 - Review A mixed-methods systematic review of interventions to address incivility in nursing. Citation Text: Olsen JM, Aschenbrenner A, Merkel R, et al. A mixed-methods systematic review of interventions to address incivility in nursing. J Nurs Educ. 2020;59(6):319-326. doi:10.3928/0148483…

  4. Fighting MRSA infections in hospital care: how organizational factors matter. | PSNet

    psnet.ahrq.gov/issue/fighting-mrsa-infections-hospital-care-how-organizational-factors-matter
    July 10, 2008 - Study Fighting MRSA infections in hospital care: how organizational factors matter. Citation Text: Salge TO, Vera A, Antons D, et al. Fighting MRSA Infections in Hospital Care: How Organizational Factors Matter. Health Serv Res. 2016;52(3):959-983. doi:10.1111/1475-6773.12521. Copy Cit…

  5. The medication reconciliation process and classification of discrepancies: a systematic review. | PSNet

    psnet.ahrq.gov/issue/medication-reconciliation-process-and-classification-discrepancies-systematic-review
    May 03, 2023 - Review The medication reconciliation process and classification of discrepancies: a systematic review. Citation Text: Almanasreh E, Moles R, Chen TF. The medication reconciliation process and classification of discrepancies: a systematic review. Br J Clin Pharmacol. 2016;82(3):645-658. d…

  6. How should U.S. hospitals prepare for Coronavirus disease 2019 (COVID-19)? | PSNet

    psnet.ahrq.gov/issue/how-should-us-hospitals-prepare-coronavirus-disease-2019-covid-19
    June 14, 2017 - Commentary How should U.S. hospitals prepare for Coronavirus disease 2019 (COVID-19)? Citation Text: Chopra V, Toner E, Waldhorn R, et al. How Should U.S. Hospitals Prepare for Coronavirus Disease 2019 (COVID-19)? Ann Intern Med. 2020;172(9):621-622. doi:10.7326/m20-0907. Copy Citation…

  7. Why an open disclosure procedure is and is not followed after an avoidable adverse event. | PSNet

    psnet.ahrq.gov/issue/why-open-disclosure-procedure-and-not-followed-after-avoidable-adverse-event
    August 11, 2021 - Study Why an open disclosure procedure is and is not followed after an avoidable adverse event. Citation Text: Carrillo I, Mira JJ, Guilabert M, et al. Why an open disclosure procedure is and is not followed after an avoidable adverse event. J Patient Saf. 2021;17(6):e529-e533. doi:10.10…

  8. Medication-administration errors in an urban mental health hospital: a direct observation study. | PSNet

    psnet.ahrq.gov/issue/medication-administration-errors-urban-mental-health-hospital-direct-observation-study
    September 03, 2014 - Study Medication-administration errors in an urban mental health hospital: a direct observation study. Citation Text: Cottney A, Innes J. Medication-administration errors in an urban mental health hospital: a direct observation study. Int J Ment Health Nurs. 2015;24(1):65-74. doi:10.1111…

  9. When do supervising physicians decide to entrust residents with unsupervised tasks? | PSNet

    psnet.ahrq.gov/issue/when-do-supervising-physicians-decide-entrust-residents-unsupervised-tasks
    October 03, 2012 - Study When do supervising physicians decide to entrust residents with unsupervised tasks? Citation Text: Sterkenburg A, Barach P, Kalkman CJ, et al. When do supervising physicians decide to entrust residents with unsupervised tasks? Acad Med. 2010;85(9):1408-1417. doi:10.1097/ACM.0b013…

  10. Threats to patient safety in primary care reported by older people with multimorbidity: baseline findings from a longitudinal qualitative study and implications for intervention. | PSNet

    psnet.ahrq.gov/issue/threats-patient-safety-primary-care-reported-older-people-multimorbidity-baseline-findings
    November 14, 2018 - Study Threats to patient safety in primary care reported by older people with multimorbidity: baseline findings from a longitudinal qualitative study and implications for intervention. Citation Text: Hays R, Daker-White G, Esmail A, et al. Threats to patient safety in primary care report…

  11. Pharmacist medication reviews to improve safety monitoring in primary care patients. | PSNet

    psnet.ahrq.gov/issue/pharmacist-medication-reviews-improve-safety-monitoring-primary-care-patients
    April 24, 2018 - Study Pharmacist medication reviews to improve safety monitoring in primary care patients. Citation Text: Gallimore CE, Sokhal D, Schreiter EZ, et al. Pharmacist medication reviews to improve safety monitoring in primary care patients. Fam Syst Health. 2016;34(2):104-113. doi:10.1037/fsh…

  12. Chemotherapy regimen checks performed by pharmacists contribute to safe administration of chemotherapy. | PSNet

    psnet.ahrq.gov/issue/chemotherapy-regimen-checks-performed-pharmacists-contribute-safe-administration-chemotherapy
    April 01, 2010 - Study Chemotherapy regimen checks performed by pharmacists contribute to safe administration of chemotherapy. Citation Text: Suzuki S, Chan A, Nomura H, et al. Chemotherapy regimen checks performed by pharmacists contribute to safe administration of chemotherapy. J Oncol Pract. 2017;23(1…

  13. Factors differentiating nursing homes with strong resident safety climate: a qualitative study of leadership and staff perspectives. | PSNet

    psnet.ahrq.gov/issue/factors-differentiating-nursing-homes-strong-resident-safety-climate-qualitative-study
    August 26, 2020 - Study Factors differentiating nursing homes with strong resident safety climate: a qualitative study of leadership and staff perspectives. Citation Text: Engle RL, Gillespie C, Clark VA, et al. Factors differentiating nursing homes with strong resident safety climate: a qualitative study…

  14. Challenges with implementing the Centers for Disease Control and Prevention opioid guideline: a consensus panel report. | PSNet

    psnet.ahrq.gov/issue/challenges-implementing-centers-disease-control-and-prevention-opioid-guideline-consensus
    January 25, 2017 - Commentary Challenges with implementing the Centers for Disease Control and Prevention opioid guideline: a consensus panel report. Citation Text: Kroenke K, Alford DP, Argoff C, et al. Challenges with Implementing the Centers for Disease Control and Prevention Opioid Guideline: A Consens…

  15. Economic evaluation of pharmacist-led medication reviews in residential aged care facilities. | PSNet

    psnet.ahrq.gov/issue/economic-evaluation-pharmacist-led-medication-reviews-residential-aged-care-facilities
    September 21, 2022 - Review Economic evaluation of pharmacist-led medication reviews in residential aged care facilities. Citation Text: Hasan SS, Thiruchelvam K, Kow CS, et al. Economic evaluation of pharmacist-led medication reviews in residential aged care facilities. Expert Rev Pharmacoecon Outcomes Res.…

  16. Work environment and operational failures associated with nurse outcomes, patient safety, and patient satisfaction. | PSNet

    psnet.ahrq.gov/issue/work-environment-and-operational-failures-associated-nurse-outcomes-patient-safety-and
    March 17, 2021 - Study Work environment and operational failures associated with nurse outcomes, patient safety, and patient satisfaction. Citation Text: Riman KA, Harrison JM, Sloane DM, et al. Work environment and operational failures associated with nurse outcomes, patient safety, and patient satisfac…

  17. Supporting clinicians after adverse events: development of a clinician peer support program. | PSNet

    psnet.ahrq.gov/issue/supporting-clinicians-after-adverse-events-development-clinician-peer-support-program
    April 24, 2018 - Study Emerging Classic Supporting clinicians after adverse events: development of a clinician peer support program. Citation Text: Lane MA, Newman BM, Taylor MZ, et al. Supporting Clinicians After Adverse Events: Development of a Clinician Peer Support Program. …

  18. Serious adverse events in pediatric procedural sedation before and after the implementation of a pre-sedation checklist. | PSNet

    psnet.ahrq.gov/issue/serious-adverse-events-pediatric-procedural-sedation-and-after-implementation-pre-sedation
    February 12, 2020 - Study Serious adverse events in pediatric procedural sedation before and after the implementation of a pre-sedation checklist. Citation Text: Librov S, Shavit I. Serious adverse events in pediatric procedural sedation before and after the implementation of a pre-sedation checklist. J Pai…

  19. Implementing the RISE second victim support programme at the Johns Hopkins Hospital: a case study. | PSNet

    psnet.ahrq.gov/issue/implementing-rise-second-victim-support-programme-johns-hopkins-hospital-case-study
    March 03, 2019 - Study Implementing the RISE second victim support programme at the Johns Hopkins Hospital: a case study. Citation Text: Edrees HH, Connors C, Paine LA, et al. Implementing the RISE second victim support programme at the Johns Hopkins Hospital: a case study. BMJ Open. 2016;6(9):e011708. d…

  20. Intraoperative sentinel events in the era of surgical safety checklists: results of a national survey. | PSNet

    psnet.ahrq.gov/issue/intraoperative-sentinel-events-era-surgical-safety-checklists-results-national-survey
    August 04, 2021 - Study Intraoperative sentinel events in the era of surgical safety checklists: results of a national survey. Citation Text: Cramer JD, Balakrishnan K, Roy S, et al. Intraoperative sentinel events in the era of surgical safety checklists: results of a national survey. OTO Open. 2020;4(4):…
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