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psnet.ahrq.gov/issue/fda-requiring-color-changes-duragesic-fentanyl-pain-patches-aid-safety-emphasizing-accidental
August 05, 2020 - Press Release/Announcement
FDA requiring color changes to Duragesic (fentanyl) pain patches to aid safety―emphasizing that accidental exposure to used patches can cause death.
Citation Text:
FDA requiring color changes to Duragesic (fentanyl) pain patches to aid safety―emphasizing that…
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psnet.ahrq.gov/issue/patient-harm-cardiovascular-medications
August 11, 2021 - Review
Patient harm from cardiovascular medications.
Citation Text:
Paradissis C, Cottrell N, Coombes ID, et al. Patient harm from cardiovascular medications. Ther Adv Drug Saf. 2021;12:204209862110274. doi:10.1177/20420986211027451.
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DOI Google Scholar…
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psnet.ahrq.gov/issue/measuring-faculty-reflection-adverse-patient-events-development-and-initial-validation-case
September 20, 2011 - Study
Measuring faculty reflection on adverse patient events: development and initial validation of a case-based learning system.
Citation Text:
Wittich CM, Lopez-Jimenez F, Decker LK, et al. Measuring faculty reflection on adverse patient events: development and initial validation of a …
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psnet.ahrq.gov/issue/optimising-surgical-training-use-feedback-reduce-errors-during-simulated-surgical-procedure
February 19, 2014 - Study
Optimising surgical training: use of feedback to reduce errors during a simulated surgical procedure.
Citation Text:
Boyle E, Al-Akash M, Gallagher AG, et al. Optimising surgical training: use of feedback to reduce errors during a simulated surgical procedure. Postgrad Med J. 201…
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psnet.ahrq.gov/issue/effects-emergency-department-staff-rounding-patient-safety-and-satisfaction
November 16, 2022 - Study
The effects of emergency department staff rounding on patient safety and satisfaction.
Citation Text:
Meade CM, Kennedy J, Kaplan J. The effects of emergency department staff rounding on patient safety and satisfaction. J Emerg Med. 2010;38(5):666-74. doi:10.1016/j.jemermed.2008.…
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psnet.ahrq.gov/issue/blending-evidence-and-innovation-improving-intershift-handoffs-multihospital-setting
September 23, 2017 - Commentary
Blending evidence and innovation: improving intershift handoffs in a multihospital setting.
Citation Text:
Thomas L, Donohue-Porter P. Blending evidence and innovation: improving intershift handoffs in a multihospital setting. J Nurs Care Qual. 2012;27(2):116-24. doi:10.1097…
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psnet.ahrq.gov/issue/root-cause-analysis-transfusion-error-identifying-causes-implement-changes
August 15, 2018 - Commentary
Root cause analysis of transfusion error: identifying causes to implement changes.
Citation Text:
Elhence P, Veena S, Sharma RK, et al. Root cause analysis of transfusion error: identifying causes to implement changes. Transfusion (Paris). 2010;50(12 Pt 2):2772-2777. doi:10.…
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psnet.ahrq.gov/issue/outcomes-after-out-hospital-endotracheal-intubation-errors
July 20, 2010 - Study
Outcomes after out-of-hospital endotracheal intubation errors.
Citation Text:
Wang HE, Cook LJ, Chang C-CH, et al. Outcomes after out-of-hospital endotracheal intubation errors. Resuscitation. 2009;80(1):50-5. doi:10.1016/j.resuscitation.2008.08.016.
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psnet.ahrq.gov/issue/disparities-diagnostic-timeliness-and-outcomes-pediatric-appendicitis
September 13, 2023 - Study
Disparities in diagnostic timeliness and outcomes of pediatric appendicitis.
Citation Text:
Michelson KA, Bachur RG, Rangel SJ, et al. Disparities in diagnostic timeliness and outcomes of pediatric appendicitis. JAMA Netw Open. 2024;7(1):e2353667. doi:10.1001/jamanetworkopen.2023.5…
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psnet.ahrq.gov/web-mm/diagnostic-overshadowing-dangers
February 12, 2020 - Diagnostic Overshadowing Dangers
Citation Text:
Raven MC. Diagnostic Overshadowing Dangers. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
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psnet.ahrq.gov/node/61061/psn-pdf
October 28, 2020 - Safer prescribing for hospitalized older adults with an
electronic health records?based prescribing context.
October 28, 2020
Drago K, Sharpe J, De Lima B, et al. Safer prescribing for hospitalized older adults with an electronic health
records?based prescribing context. J Am Geriatrics Soc. 2020;68(9):2123-2127. d…
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND_0477_11-01-2011.pdf
January 01, 2011 - inhibitors (SSRIs) such as fluoxetine);
muscle relaxants (e.g., cyclobenzaprine); simple analgesics; opioid … analgesics (e.g.,
tramadol); anti-inflammatory drugs (NSAIDs); pregabalin; gabapentin; nabilone
(synthetic
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psnet.ahrq.gov/node/50927/psn-pdf
February 21, 2020 - These predominantly relate to
inconsistent practices driving the prescribing of opioids and antibiotics
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psnet.ahrq.gov/node/49797/psn-pdf
June 01, 2017 - Diagnostic Overshadowing Dangers
June 1, 2017
Raven MC. Diagnostic Overshadowing Dangers. PSNet [internet]. 2017.
https://psnet.ahrq.gov/web-mm/diagnostic-overshadowing-dangers
The Case
A 72-year-old woman with history of opioid abuse was sent to the emergency department (ED) from a
methadone clinic because she a…
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/suda-final-protocol.pdf
October 02, 2018 - 1 percent of
youth between the ages of 12 and 17 reporting current opioid misuse.11 Youth who use opioids … 1 Substances considered: alcohol, cannabis, opioids, sedatives/hypnotics/anxiolytics, stimulants,
inhalants … alcohol use in the college setting (we will include existing systematic
reviews)
o Cannabis
o Opioids … Acamprosate
• Disulfiram
• Topiramate
• Ondansetron
Cannabis
• N-acetylcysteine (NAC)
Opioids
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digital.ahrq.gov/technology/electronic-health-recordelectronic-medical-record
January 01, 2025 - Electronic Health Record/Electronic Medical Record
Workflow analysis of breast cancer treatment decision-making: Challenges and opportunities for informatics to support patient-centered cancer care.
Citation
Salwei ME, Reale C. Workflow analysis of breast cancer treatment deci…
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs023826-malone-final-report-2017.pdf
January 01, 2017 - Anatomical
Therapeutic Classifications for Ibuprofen
Therapeutic Class
Code
Description
N02AJ08 Opioids … in combination with non-opioid analgesics: codeine and
ibuprofen
M01AE14 Propionic acid derivatives … throat preparations: ibuprofen
M01AE51 Propionic acid derivatives: ibuprofen combinations
N02AJ19 Opioids … in combination with non-opioid analgesics: oxycodone and
ibuprofen
Decision tables were constructed … Interactions with Modifiable Risk Factors
Potential Drug-Drug Interaction Total Warnings Overridden
Opioids
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psnet.ahrq.gov/issue/how-effective-teamwork-really-relationship-between-teamwork-and-performance-healthcare-teams
February 14, 2017 - Review
Classic
How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis.
Citation Text:
Schmutz JB, Meier LL, Manser T. How effective is teamwork really? The relationship betwe…
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integrationacademy.ahrq.gov/products/playbooks/behavioral-health-and-primary-care/implementing-plan-integrating-behavioral-health-your-ambulatory-care-setting
June 01, 2022 - An official website of the Department of Health & Human Services
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psnet.ahrq.gov/issue/perceptions-risk-patient-safety-pediatric-icu-study-american-pediatric-intensivists
August 28, 2017 - Study
Perceptions of risk to patient safety in the pediatric ICU, a study of American pediatric intensivists.
Citation Text:
Bauer P, Hoffmann RG, Bragg D, et al. Perceptions of risk to patient safety in the pediatric ICU, a study of American pediatric intensivists. Saf Sci. 2012;53. d…