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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43299/psn-pdf
    December 23, 2016 - Preventing infection from the misuse of vials. December 23, 2016 Preventing infection from the misuse of vials. Sentinel Event Alert. 2014;June 16(52):1-6. https://psnet.ahrq.gov/issue/preventing-infection-misuse-vials The Joint Commission has issued a sentinel event alert regarding infections caused by the misuse …
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38090/psn-pdf
    February 18, 2011 - Older patients' perceptions of "unnecessary" tests and referrals: a national survey of Medicare beneficiaries. February 18, 2011 Herndon B, Schwartz LM, Woloshin S, et al. Older patients perceptions of "unnecessary" tests and referrals: a national survey of Medicare beneficiaries. J Gen Intern Med. 2008;23(10):1547…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60339/psn-pdf
    May 20, 2020 - We Want to Know-a mixed methods evaluation of a comprehensive program designed to detect and address patient-reported breakdowns in care. May 20, 2020 Fisher KA, Smith KM, Gallagher TH, et al. We Want to Know-a mixed methods evaluation of a comprehensive program designed to detect and address patient-reported brea…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45598/psn-pdf
    November 23, 2016 - AHRQ Nursing Home Survey on Patient Safety Culture: 2016 User Comparative Database Report. November 23, 2016 Famolaro T, Yount ND, Greene, K, Hare R, Thorton S, Sorra J. Rockville, MD: Agency for Healthcare Research and Quality; October 2016. AHRQ Publication No. 17-0004-EF. https://psnet.ahrq.gov/issue/ahrq-nursi…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867350/psn-pdf
    December 11, 2024 - Surveys on Patient Safety Culture (SOPS) Hospital Survey 2.0: User Database Report. December 11, 2024 Tyler ER, Yalden O, Fan L, et al. Surveys On Patient Safety Culture (Sops) Hospital Survey 2.0: User Database Report. Rockville, MD: Agency for Healthcare Research and Quality; November 2024. AHRQ Publication No. …
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45562/psn-pdf
    October 12, 2016 - Characterising the nature of primary care patient safety incident reports in the England and Wales National Reporting and Learning System: a mixed-methods agenda-setting study for general practice. October 12, 2016 Carson-Stevens A, Hibbert P, Williams H, et al. Characterising The Nature Of Primary Care Patient Sa…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867750/psn-pdf
    March 12, 2025 - Doing 'detective work' to find a cancer: how are non- specific symptom pathways for cancer investigation organised, and what are the implications for safety and quality of care? A multisite qualitative approach. March 12, 2025 Black GB, Nicholson BD, Moreland J-A, et al. Doing ‘detective work’ to find a cancer: ho…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40600/psn-pdf
    September 09, 2011 - To make or buy patient safety solutions: a resource dependence and transaction cost economics perspective. September 9, 2011 Fareed N, Mick SS. To make or buy patient safety solutions: a resource dependence and transaction cost economics perspective. Health Care Manage Rev. 2011;36(4):288-298. doi:10.1097/HMR.0b01…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39101/psn-pdf
    March 05, 2010 - Interventions to improve team effectiveness: a systematic review. March 5, 2010 Buljac-Samardzic M, van Doorn CMD-, van Wijngaarden JDH, et al. Interventions to improve team effectiveness: a systematic review. Health Policy (New York). 2010;94(3):183-95. doi:10.1016/j.healthpol.2009.09.015. https://psnet.ahrq.gov…
  10. psnet.ahrq.gov/perspective/establishing-safety-culture-thinking-small
    December 01, 2006 - Establishing a Safety Culture: Thinking Small Timothy J. Hoff, PhD | December 1, 2006  Also Read a Conversation View more articles from the same authors. Citation Text: Hoff TJ. Establishing a Safety Culture: Thinking Small. PSNet [internet]. Rockville (MD): Age…
  11. psnet.ahrq.gov/web-mm/dual-therapy-debacle
    February 01, 2007 - Dual Therapy Debacle Citation Text: Kayser SR. Dual Therapy Debacle. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId …
  12. psnet.ahrq.gov/perspective/conversation-lorri-zipperer-ma
    February 26, 2025 - In Conversation With… Lorri Zipperer, MA November 1, 2015  Citation Text: In Conversation With… Lorri Zipperer, MA. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015. Copy Citation For…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33870/psn-pdf
    November 01, 2018 - The Comprehensivist Model of Care: A Hospitalist's View November 1, 2018 Wachter R. The Comprehensivist Model of Care: A Hospitalist's View. PSNet [internet]. 2018. https://psnet.ahrq.gov/perspective/comprehensivist-model-care-hospitalists-view Perspective In this month's PSNet perspective, I interview Dr. David M…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49812/psn-pdf
    November 01, 2017 - Specimen Almost Lost November 1, 2017 Hehe YK. Specimen Almost Lost. PSNet [internet]. 2017. https://psnet.ahrq.gov/web-mm/specimen-almost-lost The Case A 29-year-old woman presented to the hospital with a rash that had spread across her legs and abdomen. She was admitted to the medicine service for further evalu…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49406/psn-pdf
    June 01, 2003 - The Dangerous Detour June 1, 2003 Gibson J, HTaylor D. The Dangerous Detour. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/dangerous-detour The Case Following an overdose of alcohol and Ativan, a 26-year-old woman was admitted to the Medicine service for observation after being placed on a 72-hour hold by…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49438/psn-pdf
    March 05, 2004 - OR Peeping March 1, 2004 Mackenzie CF. OR Peeping. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/or-peeping The Case A healthy unmarried woman was undergoing a dilation and curettage (D&C) following an incomplete spontaneous abortion (miscarriage). At this community hospital, a new operating room (OR) su…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33640/psn-pdf
    September 01, 2006 - What Can the Rest of the Health Care System Learn from the VA's Quality and Safety Transformation? September 1, 2006 Jha AK. What Can the Rest of the Health Care System Learn from the VA's Quality and Safety Transformation? PSNet [internet]. 2006. https://psnet.ahrq.gov/perspective/what-can-rest-health-care-system…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49449/psn-pdf
    June 01, 2004 - Lethal Vertigo June 1, 2004 Furman JM. Lethal Vertigo. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/lethal-vertigo The Case A 64-year-old woman, with no prior medical history, complained of sudden onset of severe vertigo and vomiting, without headache. Her initial blood pressure in the emergency departme…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49443/psn-pdf
    May 01, 2004 - Privacy Gone Awry May 1, 2004 Pauker SG, Pauker SP. Privacy Gone Awry. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/privacy-gone-awry The Case A 3-year-old child underwent bilateral myringotomies and tube insertion with adenoidectomy. Preoperatively, she had an upper respiratory infection, but was eating…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49414/psn-pdf
    September 01, 2003 - Making Do September 1, 2003 Bradley LD. Making Do. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/making-do The Case A 56-year-old female with dysfunctional uterine bleeding and possible retained intrauterine device (IUD) was scheduled for elective hysteroscopy and dilation and curettage (D&C). Of note, sh…

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