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Total Results: 2,574 records

Showing results for "occurrence".

  1. A comparison of voluntarily reported medication errors in intensive care and general care units. | PSNet

    psnet.ahrq.gov/issue/comparison-voluntarily-reported-medication-errors-intensive-care-and-general-care-units
    October 26, 2010 - September 27, 2017 Impact of contact isolation for multidrug-resistant organisms on the occurrence

  2. The role of surgeon error in withdrawal of postoperative life support. | PSNet

    psnet.ahrq.gov/issue/role-surgeon-error-withdrawal-postoperative-life-support
    July 03, 2014 - September 18, 2019 Association between night-time surgery and occurrence of intraoperative

  3. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. | PSNet

    psnet.ahrq.gov/issue/association-perceived-medical-errors-resident-distress-and-empathy-prospective-longitudinal
    February 03, 2011 - June 2, 2019 Is physician mentorship associated with the occurrence of adverse patient

  4. Change in intern calls at night after a work hour restriction process change. | PSNet

    psnet.ahrq.gov/issue/change-intern-calls-night-after-work-hour-restriction-process-change
    September 01, 2017 - October 27, 2021 Maximum emergency department overcrowding is correlated with occurrence

  5. What's the difference between a hospital and a bottling factory? | PSNet

    psnet.ahrq.gov/issue/whats-difference-between-hospital-and-bottling-factory
    October 08, 2008 - July 19, 2018 The occurrence of potential patient safety events among trauma patients

  6. Medication reconciliation performed by pharmacy technicians at the time of preoperative screening. | PSNet

    psnet.ahrq.gov/issue/medication-reconciliation-performed-pharmacy-technicians-time-preoperative-screening
    August 18, 2010 - May 26, 2021 The effect of a transitional pharmaceutical care program on the occurrence

  7. Exploring how nursing schools handle student errors and near misses. | PSNet

    psnet.ahrq.gov/issue/exploring-how-nursing-schools-handle-student-errors-and-near-misses
    May 28, 2014 - October 31, 2018 The relationship between nursing experience and education and the occurrence

  8. Just culture: it's more than policy. | PSNet

    psnet.ahrq.gov/issue/just-culture-its-more-policy
    July 05, 2017 - July 12, 2017 The relationship between nursing experience and education and the occurrence

  9. Patient safety in nursing education: contexts, tensions and feeling safe to learn. | PSNet

    psnet.ahrq.gov/issue/patient-safety-nursing-education-contexts-tensions-and-feeling-safe-learn
    September 19, 2013 - September 27, 2016 The relationship between nursing experience and education and the occurrence

  10. The nature and causes of unintended events reported at ten emergency departments. | PSNet

    psnet.ahrq.gov/issue/nature-and-causes-unintended-events-reported-ten-emergency-departments
    February 20, 2013 - December 29, 2014 Design of a retrospective patient record study on the occurrence of

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35160/psn-pdf
    January 02, 2017 - Unlabeled containers lead to patient's death. January 2, 2017 Cohen MR, Smetzer JL. Unlabeled containers lead to patient's death. Jt Comm J Qual Patient Saf. 2005;31(7):414-7. https://psnet.ahrq.gov/issue/unlabeled-containers-lead-patients-death The authors review selected incidents of harm involving unlabeled con…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35161/psn-pdf
    March 13, 2016 - The forgotten tourniquet—an update. March 13, 2016 PA Patient Saf Advis. 2016;13(1):4. http://patientsafety.pa.gov/ADVISORIES/Pages/201603_32.aspx. https://psnet.ahrq.gov/issue/forgotten-tourniquet-update This advisory from the Pennsylvania Patient Safety Reporting System discusses 1079 reports of tourniquets bein…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35932/psn-pdf
    October 03, 2017 - Injury to research volunteers—the clinical-research nightmare. October 3, 2017 Wood AJJ, Darbyshire J. Injury to research volunteers--the clinical-research nightmare. N Engl J Med. 2006;354(18):1869-71. https://psnet.ahrq.gov/issue/injury-research-volunteers-clinical-research-nightmare The authors discuss a high-…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37915/psn-pdf
    January 27, 2009 - Barcode technology flaws put some patients at risk. January 27, 2009 Preidt R. ABC News. July 4, 2008. https://psnet.ahrq.gov/issue/barcode-technology-flaws-put-some-patients-risk This article discusses the findings of a recent study that reported deficiencies in barcode systems requiring numerous overrides a…

  15. Wrong-side thoracentesis: lessons learned from root cause analysis. | PSNet

    psnet.ahrq.gov/issue/wrong-side-thoracentesis-lessons-learned-root-cause-analysis
    July 16, 2015 - Study Wrong-side thoracentesis: lessons learned from root cause analysis. Citation Text: Miller K, Mims M, Paull DE, et al. Wrong-side thoracentesis: lessons learned from root cause analysis. JAMA Surg. 2014;149(8):774-9. doi:10.1001/jamasurg.2014.146. Copy Citation Format: …

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38348/psn-pdf
    December 30, 2014 - Implementing a bar-code medication administration system. December 30, 2014 Weber RJ. Implementing a Bar-Code Medication Administration System. Hosp Pharm. 2010;43(12):1016- 1022. doi:10.1310/hpj4312-1016. https://psnet.ahrq.gov/issue/implementing-bar-code-medication-administration-system This commentary discusse…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/849613/psn-pdf
    May 31, 2023 - Smart infusion pump investigations after an unexplained over-infusion. May 31, 2023 ISMP Patient Safety Alert! Acute care edition. May 18, 2023;28(10);1-3. https://psnet.ahrq.gov/issue/smart-infusion-pump-investigations-after-unexplained-over-infusion Dose error-reduction systems (DERS) and drug libraries are tool…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42767/psn-pdf
    November 27, 2013 - Barcode medication administration work-arounds: a systematic review and implications for nurse executives. November 27, 2013 Voshall B, Piscotty R, Lawrence J, et al. Barcode medication administration work-arounds: a systematic review and implications for nurse executives. J Nurs Adm. 2013;43(10):530-535. doi:10.1…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46593/psn-pdf
    November 08, 2017 - Unreadable barcodes and multiple barcodes on packages can lead to errors. November 8, 2017 ISMP Medication Safety Alert! Acute care edition. October 19, 2017;22:1-3. https://psnet.ahrq.gov/issue/unreadable-barcodes-and-multiple-barcodes-packages-can-lead-errors Barcodes can both enhance and degrade the medication …

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45249/psn-pdf
    June 22, 2016 - PHSO Review: Quality of NHS Complaints Investigations. June 22, 2016 First Report of Session 2016–17 Report. House of Commons Public Administration and Constitutional Affairs Committee. London, England: The Stationery Office; May 24, 2016. Publication HC 94. https://psnet.ahrq.gov/issue/phso-review-quality-nhs-comp…
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