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psnet.ahrq.gov/node/72911/psn-pdf
March 15, 2021 - expectations between sender and receiver, cultural
differences, inadequate time, and lack of standardized procedures … allows providers to review potential drug-drug or drug-disease
interactions.16
The “brown bag” method … Additionally, healthcare providers can adopt evidence-based best practices like the
teach-back method … “A Method for Assessing Drug Therapy Appropriateness.” … “The
Effectiveness of the Teach-Back Method on Adherence and Self-Management in Health Education
for
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psnet.ahrq.gov/node/73434/psn-pdf
June 30, 2021 - delays in diagnosing malignancies or other conditions warranting urgent
interventions such as surgical procedures … Newer electronic methods can also be used to help ensure effective
communication at the systems level … Although this
safeguard is a one-way method of communication, the communication loop could be closed … Secure text messaging platforms offer another e-method that can be used by radiologists to
communicate … Improving communication by implementing multiple systems-based changes, using both e-methods
and more
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psnet.ahrq.gov/issue/adaption-trigger-tool-identify-harmful-incidents-no-harm-incidents-and-near-misses
May 25, 2022 - Reasons for bias in ambulance clinicians' assessments of non-conveyed patients: a mixed-methods … implementation of proposed actions for improvement with the Healthcare Failure Mode Effect Analysis method … Factors influencing medication errors in the prehospital paramedic environment: a mixed method … September 15, 2021
Methods used to obtain pediatric patient weights, their accuracy and
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psnet.ahrq.gov/node/44037/psn-pdf
March 14, 2018 - elimination-emergency-department-medication-errors-due-estimated-weights
https://psnet.ahrq.gov/issue/effect-weight-based-prescribing-method-within-electronic-health-record-prescribing-errors … https://psnet.ahrq.gov/issue/effect-weight-based-prescribing-method-within-electronic-health-record-prescribing-errors
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psnet.ahrq.gov/node/44195/psn-pdf
June 06, 2018 - Prior research has demonstrated
the effectiveness of simulation as an instructional method for teaching … issue/hand-hygiene-healthcare-settings
https://psnet.ahrq.gov/issue/patient-safety-room-horrors-novel-method-assess-medical-students-and-entering-residents
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psnet.ahrq.gov/issue/negative-emotions-experienced-healthcare-staff-following-medication-administration-errors
December 18, 2019 - Using qualitative methods and text mining of medication error incident reports, researchers in this study … analysis of medication administration errors using incident reports, the Global Trigger Tool method, … February 15, 2023
Toward the translation of systems thinking methods in patient safety … July 29, 2020
Differences between methods of detecting medication errors: a secondary … analysis of medication administration errors using incident reports, the Global Trigger Tool method,
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psnet.ahrq.gov/issue/nurse-staffing-and-medication-errors-cross-sectional-or-longitudinal-relationships
February 15, 2011 - This study describes the use of autoregressive latent trajectory modeling as a method to better understand … While the method failed to demonstrate the hypothesized relationship in this study, the authors advocate
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psnet.ahrq.gov/issue/effectiveness-do-not-interrupt-bundled-intervention-reduce-interruptions-during-medication
August 26, 2020 - 2020
Use of patient complaints to identify diagnosis-related safety concerns: a mixed-method … April 26, 2023
Impact of interruptions, distractions, and cognitive load on procedure … A mixed method study.
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psnet.ahrq.gov/issue/reviewing-deaths-british-and-us-hospitals-study-two-scales-assessing-preventability
April 03, 2019 - April 8, 2020
Using snowball sampling method with nurses to understand medication administration … February 19, 2014
A structured judgement method to enhance mortality case note review … October 16, 2012
Integration of prospective and retrospective methods for risk analysis
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psnet.ahrq.gov/issue/racialethnic-inequities-pregnancy-related-morbidity-and-mortality
August 10, 2022 - 2022
Implementation and sustainability of a medication reconciliation toolkit: a mixed methods … August 5, 2020
Nurses as 'second victims' to their patients' suicidal attempts: a mixed-method … November 13, 2011
In situ simulation: a method of experiential learning to promote safety
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psnet.ahrq.gov/issue/near-miss-events-detected-using-emergency-department-trigger-tool
August 24, 2022 - September 2, 2020
Differences between methods of detecting medication errors: a secondary … analysis of medication administration errors using incident reports, the Global Trigger Tool method, … December 15, 2021
The trigger tool as a method to measure harmful medication errors in
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psnet.ahrq.gov/issue/patient-safety-factors-and-perceived-consequences-nursing-errors-nursing-staff-home-care
May 18, 2022 - 2022
Use of patient complaints to identify diagnosis-related safety concerns: a mixed-method … August 5, 2020
Differences between methods of detecting medication errors: a secondary … analysis of medication administration errors using incident reports, the Global Trigger Tool method,
-
psnet.ahrq.gov/issue/longitudinal-medication-reconciliation-hospital-admission-discharge-and-post-discharge
August 19, 2020 - Differences in medication reconciliation interventions between six hospitals: a mixed method … Differences in medication reconciliation interventions between six hospitals: a mixed method … 2021
Implementation and sustainability of a medication reconciliation toolkit: a mixed methods
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psnet.ahrq.gov/issue/prevalence-and-severity-patient-harm-sample-uk-hospitalised-children-detected-paediatric
February 15, 2023 - Differences in hospitals' workplace violence incident reporting practices: a mixed methods … Development of an electronic pediatric all-cause harm measurement tool using a modified Delphi method … Characterisations of adverse events detected in a university hospital: a 4-year study using the Global Trigger Tool method
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psnet.ahrq.gov/node/843413/psn-pdf
February 01, 2023 - Toward the translation of systems thinking methods in
patient safety practice: assessing the validity … Toward the translation of systems thinking methods in patient safety
practice: assessing the validity … https://psnet.ahrq.gov/issue/toward-translation-systems-thinking-methods-patient-safety-practice-
assessing-validity-net … Net-HARMS) to identify risks associated
with patient medication administration and an accident analysis method … https://psnet.ahrq.gov/issue/toward-translation-systems-thinking-methods-patient-safety-practice-assessing-validity-net
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psnet.ahrq.gov/node/45680/psn-pdf
February 22, 2017 - medication-errors-and-adverse-drug-events
https://psnet.ahrq.gov/issue/effect-weight-based-prescribing-method-within-electronic-health-record-prescribing-errors … https://psnet.ahrq.gov/issue/effect-weight-based-prescribing-method-within-electronic-health-record-prescribing-errors
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psnet.ahrq.gov/node/45645/psn-pdf
November 16, 2016 - A mixed method study.
November 16, 2016
Reime MH, Johnsgaard T, Kvam FI, et al. … A mixed method study. Nurse Educ Pract.
2016;21:75-82. doi:10.1016/j.nepr.2016.10.003.
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psnet.ahrq.gov/node/42626/psn-pdf
October 02, 2013 - improving-patient-safety-icu-prospective-identification-missing-safety-barriers-
using-bow-tie
Conceptually analogous to failure mode and effect analysis, the Bow-Tie method … In this study, the Bow-Tie method was used to identify latent safety hazards in
intrahospital transport
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psnet.ahrq.gov/issue/performing-wrong-procedure
April 24, 2018 - Commentary
Performing the wrong procedure. … Performing the Wrong Procedure. JAMA. 2016;316(11):1207-1208. doi:10.1001/jama.2016.9134. … Describing an incorrect procedure incident which involved placement of a dialysis catheter instead … Performing the Wrong Procedure. JAMA. 2016;316(11):1207-1208. doi:10.1001/jama.2016.9134. … October 19, 2016
A method for prioritizing interventions following root cause analysis
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psnet.ahrq.gov/issue/medical-device-use-error-root-cause-analysis
January 10, 2018 - The book includes examples of RCAs to illustrate how the method can uncover flaws that contribute to … May 3, 2023
Using the Generic Analysis Method to analyze sentinel event reports across