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psnet.ahrq.gov/issue/thematic-analysis-nurses-experiences-joint-commissions-medication-management-titration
November 03, 2021 - Study
Thematic analysis of nurses' experiences with The Joint Commission's medication management titration standards.
Citation Text:
Davidson JE, Chechel L, Chavez J, et al. Thematic analysis of nurses' experiences with The Joint Commission's medication management titration standards. Am…
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psnet.ahrq.gov/issue/assessing-patient-work-system-factors-medication-management-during-transition-care-among
July 20, 2022 - Study
Assessing patient work system factors for medication management during transition of care among older adults: an observational study.
Citation Text:
Xiao Y, Hsu Y-J, Hannum SM, et al. Assessing patient work system factors for medication management during transition of care among ol…
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psnet.ahrq.gov/issue/situ-simulation-quality-improvement-tool-identify-and-mitigate-latent-safety-threats
February 22, 2023 - Study
In situ simulation as a quality improvement tool to identify and mitigate latent safety threats for emergency department SARS-CoV-2 airway management: a multi-institutional initiative.
Citation Text:
Yang CJ, Saggar V, Seneviratne N, et al. In situ simulation as a quality improveme…
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psnet.ahrq.gov/issue/fdasia-health-it-report-proposed-strategy-and-recommendations-risk-based-framework
June 29, 2016 - Government Resource
FDASIA Health IT Report: Proposed Strategy and Recommendations for a Risk-Based Framework.
Citation Text:
FDASIA Health IT Report: Proposed Strategy and Recommendations for a Risk-Based Framework. Washington, DC: Office of the National Coordinator for Health Informati…
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psnet.ahrq.gov/issue/opioids-iatrogenic-harm-and-disclosure-medical-error
November 21, 2021 - Commentary
Opioids, iatrogenic harm and disclosure of medical error.
Citation Text:
Blinderman CD. Opioids, iatrogenic harm and disclosure of medical error. J Pain Symptom Manage. 2010;39(2):309-13. doi:10.1016/j.jpainsymman.2009.11.242.
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DOI Google Sc…
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psnet.ahrq.gov/issue/isnt-my-information-impact-accurate-identity-management-patient-safety
January 29, 2020 - Newspaper/Magazine Article
This isn't my information! The impact of accurate identity management on patient safety.
Citation Text:
Garcia R. This isn't my information! The impact of accurate identity management on patient safety. Health management technology. 2013;34(3):10-1.
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psnet.ahrq.gov/node/43200/psn-pdf
May 21, 2014 - How Does Hospital Quality Management Drive Quality?
Results From the "Deepening Our Understanding of
Quality Improvement (DUQuE)" Project.
May 21, 2014
Schneider EC, ed. Int J Qual Healthc. 2014;26(suppl 1):1-115.
https://psnet.ahrq.gov/issue/how-does-hospital-quality-management-drive-quality-results-deepening-our…
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psnet.ahrq.gov/node/47068/psn-pdf
June 25, 2018 - The need for closed-loop systems for management of
abnormal test results.
June 25, 2018
Zuccotti G, Samal L, Maloney FL, et al. The Need for Closed-Loop Systems for Management of Abnormal
Test Results. Ann Intern Med. 2018;168(11):820-821. doi:10.7326/M17-2425.
https://psnet.ahrq.gov/issue/need-closed-loop-systems…
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psnet.ahrq.gov/node/849122/psn-pdf
May 17, 2023 - Structural racism in behavioral health presentation and
management.
May 17, 2023
Rainer T, Lim JK, He Y, et al. Structural racism in behavioral health presentation and management. Hosp
Pediatr. 2023;13(5):461-470. doi:10.1542/hpeds.2023-007133.
https://psnet.ahrq.gov/issue/structural-racism-behavioral-health-prese…
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psnet.ahrq.gov/node/46270/psn-pdf
April 16, 2018 - Impact of a restraint management bundle on restraint use
in an intensive care unit.
April 16, 2018
Hall DK, Zimbro KS, Maduro RS, et al. Impact of a Restraint Management Bundle on Restraint Use in an
Intensive Care Unit. J Nurs Care Qual. 2018;33(2):143-148. doi:10.1097/NCQ.0000000000000273.
https://psnet.ahrq.gov…
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psnet.ahrq.gov/sites/default/files/2023-07/spotlight_a_complicated_course.pdf
January 01, 2023 - Deb Bakerjian, PhD, APRN, RN
o Spotlight Editors: Patrick Romano, MD, MPH and Ulfat Shaikh, MD
o Managing
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psnet.ahrq.gov/innovation/statewide-telehealth-program-enhances-access-care-improves-outcomes-high-risk
November 13, 2024 - the High-Risk Pregnancy Program explored the outcomes of late prenatal care and its ongoing costs of managing
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psnet.ahrq.gov/node/866868/psn-pdf
October 02, 2024 - Integrating Safety-I and Safety-II conceptual frameworks
to enhance safety measurement and management.
October 2, 2024
Lounsbury O, Brant K, Stockwell DC. Integrating Safety-I and Safety-II conceptual frameworks to enhance
safety measurement and management. J Patient Saf Risk Manag. 2024;29(3):128-130.
doi:10.1177…
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psnet.ahrq.gov/node/61101/psn-pdf
November 04, 2020 - Investigation into Management of Venous
Thromboembolism Risk in Patients Following
Thrombolysis for an Acute Stroke.
November 4, 2020
Farnborough, UK; Healthcare Safety Investigation Branch. October 2020
https://psnet.ahrq.gov/issue/investigation-management-venous-thromboembolism-risk-patients-following-
thrombol…
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psnet.ahrq.gov/node/837432/psn-pdf
June 15, 2022 - Adopt strategies to manage look-alike and/or sound-alike
medication name mix-ups.
June 15, 2022
ISMP Medication Safety Alert! Acute care edition. June 2, 2022;27(11):1-4.
https://psnet.ahrq.gov/issue/adopt-strategies-manage-look-alike-andor-sound-alike-medication-name-mix-
ups
Minimizing look-alike/sound-alike me…
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psnet.ahrq.gov/node/856637/psn-pdf
November 29, 2023 - Deficiencies in Quality Management Processes and
Delays in the Communication of Test Results and Follow-
Up Care at the Phoenix VA Health Care System in Arizona.
November 29, 2023
Washington DC; VA Office of the Inspector General; October 31, 2023; Report no. 22-03599-07.
https://psnet.ahrq.gov/issue/deficiencies-…
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psnet.ahrq.gov/node/866904/psn-pdf
October 09, 2024 - Crying wolf, alarm safety and management in paediatrics:
a scoping review.
October 9, 2024
Cole R, Roderick G, Cheema O, et al. Crying wolf, alarm safety and management in paediatrics: a scoping
review. J Adv Nurs. 2024;Epub Sep 25. doi:10.1111/jan.16398.
https://psnet.ahrq.gov/issue/crying-wolf-alarm-safety-and-m…
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psnet.ahrq.gov/node/44165/psn-pdf
May 27, 2015 - Unplanned return to theater: a quality of care and risk
management index?
May 27, 2015
Pujol N, Merrer J, Lemaire B, et al. Unplanned return to theater: A quality of care and risk management
index? Orthop Traumatol Surg Res. 2015;101(4):399-403. doi:10.1016/j.otsr.2015.03.013.
https://psnet.ahrq.gov/issue/unplanne…
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psnet.ahrq.gov/node/37640/psn-pdf
April 02, 2008 - An observational analysis of surgical team compliance
with perioperative safety practices after crew resource
management training.
April 2, 2008
France DJ, Leming-Lee S, Jackson T, et al. An observational analysis of surgical team compliance with
perioperative safety practices after crew resource management traini…
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psnet.ahrq.gov/node/33687/psn-pdf
August 01, 2009 - Workarounds and Resiliency on the Front Lines of Health
Care
August 1, 2009
Tucker AL. Workarounds and Resiliency on the Front Lines of Health Care. PSNet [internet]. 2009.
https://psnet.ahrq.gov/perspective/workarounds-and-resiliency-front-lines-health-care
Perspective
Frontline health care providers are challen…