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psnet.ahrq.gov/web-mm/fumbled-handoff-inpatient-rehab
December 21, 2018 - A Fumbled Handoff to Inpatient Rehab
Citation Text:
Ashcraft LE, Kahn JM. A Fumbled Handoff to Inpatient Rehab. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015.
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www.ahrq.gov/sites/default/files/2024-01/mastrangelo-report.pdf
January 01, 2024 - AHRQ Final Progress Report: Developing an Integrated Engineering-Based Model to Reduce Infections in the ICU
AHRQ Final Progress Report
Title: Developing an Integrated Engineering-Based Model to Reduce Infections in the ICU
PI: Christina Mastrangelo
Additional Team Members: Danielle Zerr & Shreyas Limaye
Org…
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psnet.ahrq.gov/node/836978/psn-pdf
May 16, 2022 - Check Twice, Transport Once
May 16, 2022
DePew A, Rice J, Chou J. Check Twice, Transport Once. PSNet [internet]. 2022.
https://psnet.ahrq.gov/web-mm/check-twice-transport-once
The Case
Case #1: A 26-year-old woman (Patient A) presented to the Emergency Department (ED) with abdominal
pain and was diagnosed with “s…
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/engaging-caregivers-rapid-review.pdf
April 01, 2024 - Pediatrics. 2021
Apr;147(4):e20200031. doi:
10.1542/peds.2020-0031. PMID: 33707198.
39. … Assistant Professor of Pediatrics
University of Washington School of Medicine
Seattle Children’s … Pediatrics. 2017 Aug;140(2):e20164165.
doi: 10.1542/peds.2016-4165. PMID:
28739657. … Pediatrics. 2023
Apr;151(4):e2022056617. doi:
10.1542/peds.2022-056617. PMID:
36896569.
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www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-hit-hie-rev-0724update.pdf
July 01, 2024 - AHRQ-Funded Patient Safety Project Highlights
AHRQ-Funded Patient Safety
Project Highlights
Improving Healthcare Safety by
Enhancing Health Information Technology
and Health Information Exchange
Overview
Research has shown that health information technology (HIT)i and health information exchange (HIE)ii
make it p…
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs018158-stockwell-final-report-2013.pdf
January 01, 2013 - Flu Alert: Influenza Vaccine Alerts for Providers in the Electronic Health - Final Report
Grant Final Report
Grant ID: 5R18HS018158
Flu Alert: Influenza Vaccine Alerts for Providers in the
Electronic Health
Inclusive Project Dates: 09/30/09 - 07/31/13
Principal Investigator:
Melissa S. S…
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www.ahrq.gov/sites/default/files/2024-01/dresselhaus-report.pdf
January 01, 2024 - Final Progress Report: Real-time assessment of risk factors for medication errors
Title of Project
Real-time assessment of risk factors for medication errors
Principle Investigator and Team Members
Timothy Dresselhaus, MD, MPH (principal investigator)
Matthew Weinger, MD (co-principal investigator)
Thomas Rutled…
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psnet.ahrq.gov/web-mm/coming-short-maintaining-safety-face-drug-shortages
November 01, 2012 - November 15, 2018
Diagnostic errors in primary care pediatrics: Project RedDE.
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/aom-children-guide.docx
September 01, 2022 - The American Academy of Pediatrics 2013 Otitis Media clinical practice guidelines state that high-dose
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psnet.ahrq.gov/node/49569/psn-pdf
September 01, 2008 - Meert, MD Professor of Pediatrics Wayne State University School of Medicine Pediatric Critical
Care
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psnet.ahrq.gov/issue/medication-errors-involving-overrides-healthcare-technology
January 11, 2017 - Newspaper/Magazine Article
Medication errors involving overrides of healthcare technology.
Citation Text:
Medication errors involving overrides of healthcare technology. Grissinger M. PA-PSRS Patient Saf Advis. December 2015;12:141-148.
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psnet.ahrq.gov/issue/avoiding-errors-associated-insulin-therapy
April 06, 2022 - Commentary
Avoiding errors associated with insulin therapy.
Citation Text:
Avoiding errors associated with insulin therapy. Cohen H. Medscape CME/CE. May 14, 2009.
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psnet.ahrq.gov/issue/emergency-nursing-and-medical-error-survey-two-states
January 25, 2010 - Study
Emergency nursing and medical error—a survey of two states.
Citation Text:
Emergency nursing and medical error—a survey of two states. Hohenhaus SM.
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psnet.ahrq.gov/issue/washington-hospital-center-safety-program-seeks-catch-near-misses
November 29, 2016 - Newspaper/Magazine Article
Washington Hospital Center safety program seeks to catch 'near-misses.'
Citation Text:
Washington Hospital Center safety program seeks to catch 'near-misses.' Sun LH.
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psnet.ahrq.gov/issue/errors-injectable-medications-unlabeled-syringes-are-surprisingly-common
December 27, 2018 - Newspaper/Magazine Article
Errors with injectable medications: unlabeled syringes are surprisingly common!
Citation Text:
Errors with injectable medications: unlabeled syringes are surprisingly common! ISMP Medication Safety Alert! Acute care edition. November 15, 2007.
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psnet.ahrq.gov/issue/healthgrades-eighth-annual-patient-safety-american-hospitals-study
January 04, 2017 - Book/Report
HealthGrades Eighth Annual Patient Safety in American Hospitals Study.
Citation Text:
HealthGrades Eighth Annual Patient Safety in American Hospitals Study. Reed K, May R. Denver, CO: HealthGrades, Inc.; March 2011.
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psnet.ahrq.gov/issue/recognizing-unsafe-care-what-it-and-how-report-it
April 22, 2020 - Webinar
Recognizing Unsafe Care: What It Is and How to Report It.
Citation Text:
Recognizing Unsafe Care: What It Is and How to Report It. Patient Safety Foundation. August 26, 2021.
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psnet.ahrq.gov/issue/toward-improving-outcome-pregnancy-enhancing-perinatal-health-through-quality-safety-and
June 24, 2015 - Book/Report
Toward Improving the Outcome of Pregnancy: Enhancing Perinatal Health Through Quality, Safety and Performance Initiatives (TIOP III).
Citation Text:
Toward Improving the Outcome of Pregnancy: Enhancing Perinatal Health Through Quality, Safety and Performance Initiatives (T…
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psnet.ahrq.gov/issue/nurse-accidentally-kills-premature-son-swine-flu-victim-spain
July 17, 2013 - Newspaper/Magazine Article
Nurse accidentally kills premature son of swine flu victim in Spain.
Citation Text:
Nurse accidentally kills premature son of swine flu victim in Spain. Tremlett G. Guardian.co.uk; July 13, 2009.
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psnet.ahrq.gov/issue/variation-patient-safety-outcomes-and-importance-being-informed
July 02, 2014 - Book/Report
Variation in Patient Safety Outcomes and the Importance of Being Informed.
Citation Text:
Variation in Patient Safety Outcomes and the Importance of Being Informed. Golden, CO: Healthgrades; 2013.
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