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1981. Comparison of medication safety effectiveness among nine critical access hospitals. | PSNet
      psnet.ahrq.gov/issue/comparison-medication-safety-effectiveness-among-nine-critical-access-hospitals
      September 07, 2022 - Study Comparison of medication safety effectiveness among nine critical access hospitals. Citation Text: Cochran GL, Haynatzki G. Comparison of medication safety effectiveness among nine critical access hospitals. Am J Health Syst Pharm. 2013;70(24):2218-24. doi:10.2146/ajhp130067. Co…

1982. Barriers and facilitators to incident reporting in mental healthcare settings: a qualitative study. | PSNet
      psnet.ahrq.gov/issue/barriers-and-facilitators-incident-reporting-mental-healthcare-settings-qualitative-study
      February 05, 2020 - Study Barriers and facilitators to incident reporting in mental healthcare settings: a qualitative study. Citation Text: Archer S, Thibaut BI, Dewa LH, et al. Barriers and facilitators to incident reporting in mental healthcare settings: a qualitative study. J Psychiatr Ment Health Nurs.…

1983. Critical events during land-based interfacility transport. | PSNet
      psnet.ahrq.gov/issue/critical-events-during-land-based-interfacility-transport
      April 15, 2019 - Study Critical events during land-based interfacility transport. Citation Text: Singh JM, MacDonald RD, Ahghari M. Critical events during land-based interfacility transport. Ann Emerg Med. 2014;64(1):9-15.e2. doi:10.1016/j.annemergmed.2013.12.009. Copy Citation Format: DOI …

1984. Assessing frequency and risk of weight entry errors in pediatrics. | PSNet
      psnet.ahrq.gov/issue/assessing-frequency-and-risk-weight-entry-errors-pediatrics
      December 21, 2018 - Study Assessing frequency and risk of weight entry errors in pediatrics. Citation Text: Hagedorn PA, Kirkendall E, Kouril M, et al. Assessing Frequency and Risk of Weight Entry Errors in Pediatrics. JAMA Pediatr. 2017;171(4):392-393. doi:10.1001/jamapediatrics.2016.3865. Copy Citation …

1985. Can aviation-based team training elicit sustainable behavioral change? | PSNet
      psnet.ahrq.gov/issue/can-aviation-based-team-training-elicit-sustainable-behavioral-change
      July 19, 2023 - Study Can aviation-based team training elicit sustainable behavioral change? Citation Text: Sax HC, Browne P, Mayewski RJ, et al. Can aviation-based team training elicit sustainable behavioral change? Arch Surg. 2009;144(12):1133-1137. doi:10.1001/archsurg.2009.207. Copy Citation …

1986. Encouraging resident adverse event reporting: a qualitative study of suggestions from the front lines. | PSNet
      psnet.ahrq.gov/issue/encouraging-resident-adverse-event-reporting-qualitative-study-suggestions-front-lines
      July 19, 2023 - Study Encouraging resident adverse event reporting: a qualitative study of suggestions from the front lines. Citation Text: Szymusiak J, Walk TJ, Benson M, et al. Encouraging Resident Adverse Event Reporting: A Qualitative Study of Suggestions from the Front Lines. Ped Qual Saf. 2019;4(3…

1987. Ensuring access to medications in the US during the COVID-19 pandemic. | PSNet
      psnet.ahrq.gov/issue/ensuring-access-medications-us-during-covid-19-pandemic
      May 08, 2017 - March 30, 2022 Prescription opioid analgesics commonly unused after surgery: a systematic

1988. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/867649/psn-pdf
      January 01, 2015 - Improving Pain Management for Hospitalized Medical Patients. January 1, 2015 Society of Hospital Medicine. Improving Pain Management for Hospitalized Medical Patients. https://psnet.ahrq.gov/issue/improving-pain-management-hospitalized-medical-patients Pain management presents complex patient safety concerns. Info…

1989. Anesthesia: A Weighty Issue | PSNet
      psnet.ahrq.gov/web-mm/anesthesia-weighty-issue
      September 01, 2006 - Anesthesia: A Weighty Issue Citation Text: Sinha AC. Anesthesia: A Weighty Issue. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2013. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tag…

1990. Nudge Unit Supports Physician, Patient Behavioral Changes Towards Medical Decisions that Improve Care Value and Quality of Care | PSNet
      psnet.ahrq.gov/innovation/nudge-unit-supports-physician-patient-behavioral-changes-towards-medical-decisions
      July 23, 2024 - Nudge Unit Supports Physician, Patient Behavioral Changes Towards Medical Decisions that Improve Care Value and Quality of Care Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL December 23, 2020 …

1991. Medication/Drug Errors | PSNet
      psnet.ahrq.gov/curated-library/medicationdrug-errors
      March 12, 2021 - In light of the current opioid crisis, the use of opioids to manage noncancer-related chronic pain in

1992. Surveillance Monitoring to Improve Patient Safety in Acute Hospital Care Units | PSNet
      psnet.ahrq.gov/perspective/surveillance-monitoring-improve-patient-safety-acute-hospital-care-units
      April 26, 2023 - We did a ten-year review study, looking at death and harm related to administration of opioids, and no … one died in that inpatient setting from opioids when using this system. … A lot of patients in the hospital are on opioids. … This is the idea of serious but treatable complications, and respiratory arrests due to opioids are a

1993. In Conversation with... Susan McGrath, PhD and George Blike, MD about Surveillance Monitoring | PSNet
      psnet.ahrq.gov/perspective/conversation-susan-mcgrath-phd-and-george-blike-md-about-surveillance-monitoring
      April 26, 2023 - We did a ten-year review study, looking at death and harm related to administration of opioids, and no … one died in that inpatient setting from opioids when using this system. … A lot of patients in the hospital are on opioids. … This is the idea of serious but treatable complications, and respiratory arrests due to opioids are a

1994. Diagnostic errors reported in primary healthcare and emergency departments: a retrospective and descriptive cohort study of 4830 reported cases of preventable harm in Sweden. | PSNet
      psnet.ahrq.gov/issue/diagnostic-errors-reported-primary-healthcare-and-emergency-departments-retrospective-and
      March 11, 2020 - Study Diagnostic errors reported in primary healthcare and emergency departments: a retrospective and descriptive cohort study of 4830 reported cases of preventable harm in Sweden. Citation Text: Fernholm R, Pukk Härenstam K, Wachtler C, et al. Diagnostic errors reported in primary healt…

1995. Missed acute myocardial infarction in the emergency department-standardizing measurement of misdiagnosis-related harms using the SPADE method. | PSNet
      psnet.ahrq.gov/issue/missed-acute-myocardial-infarction-emergency-department-standardizing-measurement
      May 12, 2021 - Study Missed acute myocardial infarction in the emergency department-standardizing measurement of misdiagnosis-related harms using the SPADE method. Citation Text: Sharp AL, Baecker A, Nassery N, et al. Missed acute myocardial infarction in the emergency department–standardizing measurem…

1996. Patient-related factors associated with an increased risk of being a reported case of preventable harm in first-line health care: a case-control study | PSNet
      psnet.ahrq.gov/issue/patient-related-factors-associated-increased-risk-being-reported-case-preventable-harm-first
      October 09, 2019 - Study Patient-related factors associated with an increased risk of being a reported case of preventable harm in first-line health care: a case-control study Citation Text: Fernholm R, Holzmann MJ, Wachtler C, et al. Patient-related factors associated with an increased risk of being a rep…

1997. From physician intent to the pharmacy label: prevalence and description of discrepancies from a cross-sectional evaluation of electronic prescriptions. | PSNet
      psnet.ahrq.gov/issue/physician-intent-pharmacy-label-prevalence-and-description-discrepancies-cross-sectional
      July 22, 2020 - Study From physician intent to the pharmacy label: prevalence and description of discrepancies from a cross-sectional evaluation of electronic prescriptions. Citation Text: Cochran GL, Klepser DG, Morien M, et al. From physician intent to the pharmacy label: prevalence and description o…

1998. The critical role of health information technology in the safe integration of behavioral health and primary care to improve patient care. | PSNet
      psnet.ahrq.gov/issue/critical-role-health-information-technology-safe-integration-behavioral-health-and-primary
      February 22, 2023 - Commentary The critical role of health information technology in the safe integration of behavioral health and primary care to improve patient care. Citation Text: Segal M, Giuffrida P, Possanza L, et al. The critical role of health information technology in the safe integration of behav…

1999. Association of changing hospital readmission rates with mortality rates after hospital discharge. | PSNet
      psnet.ahrq.gov/issue/association-changing-hospital-readmission-rates-mortality-rates-after-hospital-discharge
      August 20, 2018 - Study Classic Association of changing hospital readmission rates with mortality rates after hospital discharge. Citation Text: Dharmarajan K, Wang Y, Lin Z, et al. Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge. …

2000. Scaling-up a pharmacist-led information technology intervention (PINCER) to reduce hazardous prescribing in general practices: multiple interrupted time series study. | PSNet
      psnet.ahrq.gov/issue/scaling-pharmacist-led-information-technology-intervention-pincer-reduce-hazardous
      December 16, 2020 - Study Scaling-up a pharmacist-led information technology intervention (PINCER) to reduce hazardous prescribing in general practices: multiple interrupted time series study. Citation Text: Rodgers S, Taylor AC, Roberts SA, et al. Scaling-up a pharmacist-led information technology interven…