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psnet.ahrq.gov/issue/alarm-system-management-evidence-based-guidance-encouraging-direct-measurement
August 11, 2021 - Review
Alarm system management: evidence-based guidance encouraging direct measurement of informativeness to improve alarm response.
Citation Text:
Rayo MF, Moffatt-Bruce SD. Alarm system management: evidence-based guidance encouraging direct measurement of informativeness to improve ala…
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psnet.ahrq.gov/issue/perruche-case-and-issue-compensation-consequences-medical-error
July 31, 2024 - Commentary
The Perruche case and the issue of compensation for the consequences of medical error.
Citation Text:
Costich JF. The Perruche case and the issue of compensation for the consequences of medical error. Health Policy (New York). 2006;78(1):8-16.
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psnet.ahrq.gov/issue/different-roles-same-goal-risk-and-quality-management-partnering-patient-safety-ashrm
January 27, 2021 - Book/Report
Different roles, same goal: risk and quality management partnering for patient safety. By the ASHRM Monographs Task Force.
Citation Text:
Bokar V, Perry DG. Different Roles, Same Goal: Risk And Quality Management Partnering For Patient Safety. By The Ashrm Monographs Task Fo…
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psnet.ahrq.gov/issue/risks-patient-safety-health-system-expansions
May 13, 2020 - Commentary
Emerging Classic
The risks to patient safety from health system expansions.
Citation Text:
Haas S, Gawande AA, Reynolds ME. The Risks to Patient Safety From Health System Expansions. JAMA. 2018;319(17):1765-1766. doi:10.1001/jama.2018.2074.
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psnet.ahrq.gov/issue/frequency-and-severity-harm-medication-errors-related-parenteral-nutrition-process-large
January 16, 2019 - Study
Frequency and severity of harm of medication errors related to the parenteral nutrition process in a large university teaching hospital.
Citation Text:
Sacks GS, Rough S, Kudsk KA. Frequency and severity of harm of medication errors related to the parenteral nutrition process in a…
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psnet.ahrq.gov/issue/using-multidisciplinary-rounds-improve-patient-safety-through-venous-thromboembolism
April 20, 2016 - Study
Using multidisciplinary rounds to improve patient safety through venous thromboembolism prevention awareness.
Citation Text:
Karasin B, Maund C. Using Multidisciplinary Rounds to Improve Patient Safety Through Venous Thromboembolism Prevention Awareness. Jt Comm J Qual Patient Saf.…
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psnet.ahrq.gov/issue/identifying-vulnerabilities-communication-emergency-department
September 09, 2009 - Study
Identifying vulnerabilities in communication in the emergency department.
Citation Text:
Redfern E, Brown R, Vincent C. Identifying vulnerabilities in communication in the emergency department. Emerg Med J. 2009;26(9):653-7. doi:10.1136/emj.2008.065318.
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psnet.ahrq.gov/issue/you-cant-blame-wreck-train
March 03, 2011 - Commentary
You can't blame the wreck on the train.
Citation Text:
Potts JR. You can't blame the wreck on the train. Am J Surg. 2017;214(5):974-978. doi:10.1016/j.amjsurg.2016.11.046.
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psnet.ahrq.gov/issue/patient-safety-institute-demonstration-project-model-implementing-local-health-information
May 15, 2013 - Commentary
The Patient Safety Institute demonstration project: a model for implementing a local health information infrastructure.
Citation Text:
Classen D, Kanhouwa M, Will D, et al. The patient safety institute demonstration project: a model for implementing a local health informatio…
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psnet.ahrq.gov/issue/reducing-falls-safety-spotter-program
November 16, 2022 - Commentary
Reducing falls with a safety spotter program.
Citation Text:
Primmer P, Borenstein KK, Downing MT, et al. Reducing falls with a safety spotter program. Nursing (Brux). 2015;45(8):16-9. doi:10.1097/01.NURSE.0000469244.89222.27.
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psnet.ahrq.gov/issue/checklists-prevent-diagnostic-errors-pilot-randomized-controlled-trial
October 12, 2016 - Study
Checklists to prevent diagnostic errors: a pilot randomized controlled trial.
Citation Text:
Ely JW, Graber MA. Checklists to prevent diagnostic errors: a pilot randomized controlled trial. Diagnosis (Berl). 2015;2(3):163-169. doi:10.1515/dx-2015-0008.
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psnet.ahrq.gov/issue/banning-handshake-health-care-setting
January 12, 2022 - Commentary
Banning the handshake from the health care setting.
Citation Text:
Sklansky M, Nadkarni N, Ramirez-Avila L. Banning the handshake from the health care setting. JAMA. 2014;311(24):2477-8.
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psnet.ahrq.gov/issue/closed-medical-negligence-claims-can-drive-patient-safety-and-reduce-litigation
February 05, 2020 - Review
Closed medical negligence claims can drive patient safety and reduce litigation.
Citation Text:
Pegalis SE, Bal S. Closed medical negligence claims can drive patient safety and reduce litigation. Clin Orthop Relat Res. 2012;470(5):1398-404. doi:10.1007/s11999-012-2308-5.
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psnet.ahrq.gov/issue/medical-emergency-team-and-rapid-response-system-finding-treating-and-preventing-hypoglycemia
September 23, 2020 - Commentary
The medical emergency team and rapid response system: finding, treating, and preventing hypoglycemia.
Citation Text:
DiNardo M, Noschese M, Korytkowski M, et al. The medical emergency team and rapid response system: finding, treating, and preventing hypoglycemia. Jt Comm J Qua…
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psnet.ahrq.gov/issue/quality-and-safety-artificial-intelligence-generated-health-information
October 19, 2022 - Commentary
Quality and safety of artificial intelligence generated health information.
Citation Text:
Sorich MJ, Menz BD, Hopkins AM. Quality and safety of artificial intelligence generated health information. BMJ. 2024;384:q596. doi:10.1136/bmj.q596.
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psnet.ahrq.gov/issue/organisational-learning-hospitals-concept-analysis
August 21, 2019 - Review
Organisational learning in hospitals: a concept analysis.
Citation Text:
Lyman B, Hammond EL, Cox JR. Organisational learning in hospitals: A concept analysis. J Nurs Manag. 2019;27(3):633-646. doi:10.1111/jonm.12722.
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psnet.ahrq.gov/issue/patients-role-patient-safety
May 01, 2024 - Review
The patient's role in patient safety.
Citation Text:
Corina I, Abram M, Halperin D. The patient's role in patient safety. Obstet Gynecol Clin North Am. 2019;46(2):215-225. doi:10.1016/j.ogc.2019.01.004.
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psnet.ahrq.gov/issue/effect-collaboration-obstetric-patient-safety-three-academic-facilities
October 19, 2022 - Commentary
The effect of collaboration on obstetric patient safety in three academic facilities.
Citation Text:
Raab CA, Will SEB, Richards SL, et al. The Effect of Collaboration on Obstetric Patient Safety in Three Academic Facilities. Journal of Obstetric, Gynecologic & Neonatal Nursi…
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psnet.ahrq.gov/issue/systems-approach-address-impact-second-victim-phenomenon
December 07, 2022 - Commentary
A systems approach to address the impact of second victim phenomenon.
Citation Text:
Gamble B, Gamble KJ. A systems approach to address the impact of second victim phenomenon. Health Serv Manage Res. 2022;35(2):110-113. doi:10.1177/0951484820971455.
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psnet.ahrq.gov/issue/community-validation-approach-detect-delayed-diagnosis-appendicitis-big-databases
October 26, 2022 - Study
Community validation of an approach to detect delayed diagnosis of appendicitis in big databases.
Citation Text:
Michelson KA, McGarghan FLE, Waltzman ML, et al. Community validation of an approach to detect delayed diagnosis of appendicitis in big databases. Hosp Pediatr. 2023;13(…