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psnet.ahrq.gov/issue/adverse-events-neonatal-intensive-care-unit-development-testing-and-findings-nicu-focused
April 11, 2011 - This AHRQ–funded study used methodology similar to a prior study in adult intensive care unit patients … AEs and help target patient safety efforts. … Performance characteristics of a methodology to quantify adverse events over time in hospitalized patients … September 6, 2016
Perceptions of risk to patient safety in the pediatric ICU, a study … safety alert.
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psnet.ahrq.gov/issue/characteristics-initial-prescription-episodes-and-likelihood-long-term-opioid-use-united
April 24, 2018 - Opioid use has become a growing patient safety concern. … with younger, male, and privately insured patients. … March 14, 2018
Patient safety after implementation of a coproduced family centered communication … November 12, 2014
Patient safety climate in 92 US hospitals: differences by work area … February 4, 2009
A case for safety leadership team training of hospital managers.
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.464_slideshow.ppt
January 01, 2019 - *
Patient Safety Events in Psychiatry
Safety events in inpatient psychiatry are similar to those … Defining patient safety events in inpatient psychiatry. … Patient Safety Events in Psychiatry (2)
Examples of safety events particular to psychiatry
Self-harm … Defining patient safety events in inpatient psychiatry. … Rates of Patient Safety Events
Rates of safety events in inpatient psychiatry have been reported from
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psnet.ahrq.gov/node/837628/psn-pdf
July 06, 2022 - multilevel-factors-associated-time-biopsy-after-abnormal-screening-
mammography-results-race
Delays in breast cancer diagnosis and treatment can threaten patient … safety.
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psnet.ahrq.gov/node/841149/psn-pdf
December 07, 2022 - performance of two validated tools (Safer Dx
and the DEER taxonomy) to identify diagnostic errors among patients … https://psnet.ahrq.gov/issue/application-electronic-trigger-tools-identify-targets-improving-diagnostic-safety
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psnet.ahrq.gov/node/73427/psn-pdf
June 23, 2021 - Patient Saf Surg. 2021;15(1):14.
doi:10.1186/s13037-021-00287-5. … sentinel-event-statistics-1995-2019
https://psnet.ahrq.gov/issue/are-we-missing-near-misses-or-underreporting-safety-incidents-pediatric-surgery
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psnet.ahrq.gov/node/50886/psn-pdf
February 12, 2020 - Results indicate that checking patient allergies and medication doses, especially for
intravenous and … transdermal medications, should be a focus of efforts to increase medication
administration safety.
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psnet.ahrq.gov/issue/occurrence-prevention-and-management-psychological-effects-emerging-virus-outbreaks
July 19, 2023 - Compared with clinicians at lower risk, those in contact with affected patients had greater levels of … interventions to address burnout in hospital practice: factors associated with turnover, outcomes, and patient … safety. … July 19, 2023
The challenges in monitoring and preventing patient safety incidents for … May 29, 2013
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Patient Safety
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psnet.ahrq.gov/issue/comparing-variability-ingredient-strength-and-dose-form-information-electronic-prescriptions
March 20, 2024 - Although e-prescribing has improved the safety of medication ordering, preventable errors persist … standardization of terminology in e-prescription programs can lead to incorrect medication order and patient … October 31, 2011
Work effort, readability and quality of pharmacy transcription of patient … Annual Perspective
Technology as a Tool for Improving Patient … 10, 2017
Impact of computerized physician order entry alerts on prescribing in older patients
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psnet.ahrq.gov/issue/blinded-prospective-study-error-detection-during-physician-chart-rounds-radiation-oncology
November 16, 2022 - Peer review of radiation oncology patient treatment plans can help prevent harm and reduce errors. … May 19, 2021
Patient and physician perspectives of deprescribing potentially inappropriate … March 9, 2022
Preliminary study of patient safety and quality use cases for ICD-11 MMS … A radiation oncology-specific automated trigger indicator tool for high-risk near-miss safety … January 29, 2020
Patient-reported safety and quality of care in outpatient oncology.
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psnet.ahrq.gov/node/72739/psn-pdf
February 10, 2021 - safety
https://psnet.ahrq.gov/web-mm/delay-appropriate-diagnosis-and-treatment-leading-death-pulmonary-embolism … safety, ACR places shared responsibility on ordering physicians for timely follow-up of diagnostic … Approach to Improving Safety
This case represents a classic Swiss cheese model in which several, small … radiologic findings
Failure of the primary team to review imaging studies
Failure to recognize multiple indicators … safety and minimize diagnostic error.
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psnet.ahrq.gov/perspective/conversation-withjanet-corrigan-phd-mba
April 01, 2010 - The end of the beginning: patient safety five years after 'to err is human.' … The long road to patient safety: a status report on patient safety systems. … Patient safety: a call to action: a consensus statement from the National Quality Forum. … Leapfrog patient-safety standards are a stretch for most hospitals. … Safety Initiatives
July 10, 2024
Advances in Patient Safety: New Directions
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psnet.ahrq.gov/web-mm/other-hand
December 12, 2012 - This case raises multiple patient safety concerns. … Timely access to critical information is an important patient safety concern. … into the patient safety goals of many organizations.( 6 ) Although the nurse caring for the patient … Joint Commission National Patient Safety Goals. … Patient Safety Innovations
Ambulatory Safety Nets to Reduce
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psnet.ahrq.gov/issue/resident-faculty-overnight-discrepancy-rates-function-number-consecutive-nights-during-week
November 16, 2022 - Recent duty hour reforms are intended to improve patient safety and resident well-being . … Missing Suction Tip
November 1, 2003
Pharmaceutical interventions to improve safety … of chemotherapy-treated cancer patients: a cross-sectional study. … right things and doing them the right way: association between hospital guideline adherence, dosing safety … , and outcomes among patients with acute coronary syndrome.
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psnet.ahrq.gov/issue/national-mixed-methods-evaluation-preparedness-general-surgery-residency-and-association
September 02, 2020 - comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety … September 2, 2020
Association between surgeon technical skills and patient outcomes. … September 9, 2020
Association of surgical resident wellness with medical errors and patient … December 13, 2017
Development and validation of a brief culture-of-safety survey. … March 22, 2023
Impact of medical education on patient safety: finding the signal through
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psnet.ahrq.gov/issue/developing-cancer-specific-trigger-tool-identify-treatment-related-adverse-events-using
May 20, 2020 - trigger burden varied by disease, stage, and patient demographics. … 13, 2020
The business case for quality: economic analysis of the Michigan Keystone Patient … Safety Program in ICUs. … April 22, 2020
Patient safety in marginalised groups: a narrative scoping review … A radiation oncology-specific automated trigger indicator tool for high-risk near-miss safety
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psnet.ahrq.gov/issue/development-and-evaluation-i-pass-picu-standard-electronic-template-improve-referral
June 14, 2023 - Jt Comm J Qual Patient Saf . 2024; 50 (5) :338-347 . … April 24, 2018
Patient safety after implementation of a coproduced family centered communication … March 13, 2019
Association of patient and family reports of hospital safety climate with … July 5, 2023
Patient Safety Innovations
Remote Response … March 23, 2022
Care transition of trauma patients: processes with articulation work before
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psnet.ahrq.gov/issue/association-adverse-events-opioid-addiction-treatment-quality-measure-continuity
March 09, 2022 - randomized quality improvement study
February 12, 2020
A mixed-methods analysis of patient … safety incidents involving opioid substitution treatment with methadone or buprenorphine in community-based … October 14, 2020
Care quality, patient safety, and nurse outcomes at hospitals serving … 19, 2022
Staffing, teamwork and scope of practice: analysis of the association with patient … safety in the context of rehabilitation.
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psnet.ahrq.gov/node/49864/psn-pdf
June 01, 2019 - Speaking Up for Patient Safety: What They Don't Tell You
in Training About Feedback and Burnout
June … Speaking Up for Patient Safety: What They Don't Tell You in Training About
Feedback and Burnout. … https://psnet.ahrq.gov/web-mm/speaking-patient-safety-what-they-dont-tell-you-training-about-feedback … Patients often have many complex illnesses; treatments have the ability to be extraordinarily precise … to do so, especially when one is in a busy work setting, enduring lots of
change, and managing sick patients
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psnet.ahrq.gov/web-mm/feeling-no-pain
August 30, 2023 - This understanding is critical to the study of error and patient safety because a basic tenet of psychology … The pervasive attitude that technology is the solution to all problems can compromise patient safety … Such factors can promote the enhancement of patient safety. … Enhancing patient safety by effectively reducing the likelihood of error necessitates that actions be … 30, 2023
What Happened to Patient Safety.