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9761. Medication errors in pediatric emergency departments: a systematic review and recommendations for enhancing medication safety. | PSNet
      psnet.ahrq.gov/issue/medication-errors-pediatric-emergency-departments-systematic-review-and-recommendations
      January 11, 2023 - Review Medication errors in pediatric emergency departments: a systematic review and recommendations for enhancing medication safety. Citation Text: Alsabri M, Eapen D, Sabesan V, et al. Medication errors in pediatric emergency departments: a systematic review and recommendations for enh…

9762. Psychological safety and infection prevention practices: results from a national survey. | PSNet
      psnet.ahrq.gov/issue/psychological-safety-and-infection-prevention-practices-results-national-survey
      September 27, 2023 - Study Psychological safety and infection prevention practices: results from a national survey. Citation Text: Greene MT, Gilmartin HM, Saint S. Psychological safety and infection prevention practices: results from a national survey. Am J Infect Control. 2020;48(1):2-6. doi:10.1016/j.ajic…

9763. Missing diagnoses during the COVID-19 pandemic: a year in review. | PSNet
      psnet.ahrq.gov/issue/missing-diagnoses-during-covid-19-pandemic-year-review
      December 23, 2020 - Commentary Missing diagnoses during the COVID-19 pandemic: a year in review. Citation Text: Pifarré i Arolas H, Vidal-Alaball J, Gil J, et al. Missing diagnoses during the COVID-19 pandemic: a year in review. Int J Environ Res Public Health. 2021;18(10):5335. doi:10.3390/ijerph18105335. …

9764. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/853774/psn-pdf
      September 27, 2023 - She was seen by a triage nurse at 2000H and again reported generalized abdominal pain, which she rated … The ED physician informed the assigned nurse that the patient was in critical condition. … It is imperative that physicians and nurses recognize these differences across age groups and adapt … space located at the entrance to the ED where patients are quickly assessed by an experienced triage nurse … Our RME process includes alerts in the electronic health record that notify a dedicated flow nurse when

9765. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49612/psn-pdf
      November 01, 2010 - transfer of care involves standardized communication between each team's respective physician and nurse … transfer of care is done poorly, the patient still is in the hospital and is surrounded by physicians, nurses … The admitting nurse noticed that the urine culture results from his prior hospital admission indicated … This need for transitional care is evidenced by the fact that timely follow-up with a nurse or primary

9766. Geisinger’s Outpatient Addiction Medicine Specialty Program Uses Data-Driven Decision Making and MAT to Reduce Mortality Rates | PSNet
      psnet.ahrq.gov/innovation/geisingers-outpatient-addiction-medicine-specialty-program-uses-data-driven-decision
      October 30, 2024 - and composition of the team may vary, typically a team consists of an Advanced Practice Provider, a nurse … and composition of the team may vary, typically a team consists of an Advanced Practice Provider, a nurse … Innovations Team-Developed Care Plan and Ongoing Care Management by Social Workers and Nurse

9767. The Risks of Absent Interoperability: Medication-Induced Hemolysis in a Patient With a Known Allergy | PSNet
      psnet.ahrq.gov/web-mm/risks-absent-interoperability-medication-induced-hemolysis-patient-known-allergy
      April 08, 2019 - At approximately 3 AM, the patient was found unresponsive by his nurse. … For brevity, let's just assume that an ED nurse in Hospital Y called another nurse in Hospital X and … In most systems, this involves a clerk or nurse comparing the name, address, phone number, and birthdate … February 21, 2024 Examining the relationship between nurse fatigue, alertness, and medication … December 13, 2023 Wake-up call: night shifts adversely affect nurse health and retention

9768. Becoming a Certified Professional in Patient Safety—A Pharmacist's Perspective | PSNet
      psnet.ahrq.gov/perspective/becoming-certified-professional-patient-safety-pharmacists-perspective
      June 01, 2016 - the late 1990s, if I stood up in front of a group of residents, fellows, junior physicians, or young nurse … self-reported quality of patient care and adverse events during COVID-19: a cross-sectional online survey among nurses … April 26, 2017 Occupational stress and cognitive failure of nurses and associations with

9769. Digital Health Literacy | PSNet
      psnet.ahrq.gov/primer/digital-health-literacy
      August 30, 2023 - Digital Health Literacy Citation Text: Seidel E, Cortes T, Chong C. Digital Health Literacy. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2023. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML …

9770. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/849660/psn-pdf
      May 31, 2023 - Strategies to Improve Organizational Health Literacy. May 31, 2023 Seidel E, Cortes T, Chong C. Strategies to Improve Organizational Health Literacy. PSNet [internet]. 2023. https://psnet.ahrq.gov/primer/strategies-improve-organizational-health-literacy Background Health literacy is important at both the personal …

9771. Patient Safety in Frail Older Patients | PSNet
      psnet.ahrq.gov/perspective/patient-safety-frail-older-patients
      November 26, 2019 - In these cases, they are training their nurses on recognition of delirium, implementing mobility programs … We don’t want patients falling and breaking a bone while in the hospital under nurse supervision.

9772. Hold That Order | PSNet
      psnet.ahrq.gov/web-mm/hold-order
      December 19, 2018 - Therefore, the nurse gave the medication to the patient when he returned to the intensive care unit ( … If a hold order does not provide specific restarting parameters, the nurse or pharmacist should clarify … These types of orders transfer the responsibility of determining the patients' medications to nurses

9773. Electronic Err | PSNet
      psnet.ahrq.gov/web-mm/electronic-err
      April 01, 2014 - The nurse informed him that the patient had developed a junctional rhythm with a heart rate less than … discussion of this case at the clinic's monthly safety and quality improvement meeting, a physician and nurse … In the meantime, clinic nurses added a medication review to vital signs and weight prior to each patient's

9774. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33784/psn-pdf
      April 01, 2015 - It had a lot of credibility with nurses and administrators, but there was resistance early on. … The bodies that mandated the use of checklists didn't do it because they felt it integrated nurses and … Suddenly all of the nurses, anesthesia assistants, respiratory therapists, everyone's in the room; everyone

9775. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33787/psn-pdf
      January 01, 2018 - We also saw energy from frontline physicians, nurses, and pharmacists who came together to work in multi-professional … When I interviewed Gilbert in front of several hundred leaders, nurses, doctors, pharmacists, Gilbert … One of the nurses jumped up from the audience and said, "I got a flat tire last night.

9776. New Insights on Safety and Health IT | PSNet
      psnet.ahrq.gov/perspective/new-insights-safety-and-health-it
      August 01, 2015 - the cognitive needs of the frontline users in mind for each specialty and each user role (physician, nurse … that I had not anticipated: changes in the doctor–patient relationship, changes in the way doctors and nurses … In the book I had a couple of chapters on the history of the note, and if you talk to doctors and nurses … have to begin asking, have you created a Frankenstein where you're making the job of the doctors and nurses … It might be a doctor–patient interaction, a doctor–nurse interaction.

9777. In Conversation With… Robert M. Wachter, MD | PSNet
      psnet.ahrq.gov/perspective/conversation-robert-m-wachter-md
      August 01, 2015 - that I had not anticipated: changes in the doctor–patient relationship, changes in the way doctors and nurses … If an error happened on the floor in the old days, the nurse would have tapped the doctor on the shoulder … In the book I had a couple of chapters on the history of the note, and if you talk to doctors and nurses … have to begin asking, have you created a Frankenstein where you're making the job of the doctors and nurses … It might be a doctor–patient interaction, a doctor–nurse interaction.

9778. E-prescribing: E for error? | PSNet
      psnet.ahrq.gov/web-mm/e-prescribing-e-error
      February 03, 2021 - electronic media, of prescriptions or prescription-related information from a prescriber (physician, nurse … Case & Commentary- Part 2: The clinic nurse entered the medications into the computer system. … Unfortunately, the clinic nurse entered the atenolol without checking the name and date of birth on the … In addition, the system allowed the nurse to prescribe on behalf of the doctor and transmit without first … A return receipt of prescriptions that reach the pharmacy would also have alerted the nurse that two

9779. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49488/psn-pdf
      August 21, 2005 - If nurses mistakenly accept the initially displayed minimal value (eg, 0.1 mg/mL) instead of changing

9780. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/843414/psn-pdf
      February 01, 2023 - leadership-behavior-associations-domains-safety-culture-engagement-and-healthcare-worker-well https://psnet.ahrq.gov/issue/nurse-managers-leadership-patient-safety-and-quality-care-systematic-review