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psnet.ahrq.gov/node/43673/psn-pdf
November 19, 2014 - Work-arounds observed by fourth-year nursing students.
November 19, 2014
Westphal J, Lancaster R, Park D. Work-Arounds Observed by Fourth-Year Nursing Students. West J Nurs
Res. 2014;36(8):1002-18. doi:10.1177/0193945913511707.
https://psnet.ahrq.gov/issue/work-arounds-observed-fourth-year-nursing-students
Accordi…
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psnet.ahrq.gov/node/839316/psn-pdf
January 01, 2023 - Patient voices in hospital safety during the COVID-19
pandemic.
November 2, 2022
Groves PS, Bunch JL, Hanrahan KM, et al. Patient voices in hospital safety during the COVID-19
pandemic. Clin Nurs Res. 2023;32(1):105-114. doi:10.1177/10547738221129711.
https://psnet.ahrq.gov/issue/patient-voices-hospital-safety-dur…
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psnet.ahrq.gov/node/72650/psn-pdf
January 20, 2021 - A roadmap to advance patient safety in ambulatory care.
January 20, 2021
Singh H, Carayon P. A roadmap to advance patient safety in ambulatory care. JAMA. 2020;324(24):2481-
2482. doi:10.1001/jama.2020.18551.
https://psnet.ahrq.gov/issue/roadmap-advance-patient-safety-ambulatory-care
Preventable harm, such as diag…
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psnet.ahrq.gov/node/45203/psn-pdf
August 24, 2016 - Giving voice to quality and safety matters at board level: a
qualitative study of the experiences of executive nurses
working in England and Wales.
August 24, 2016
Jones A, Lankshear A, Kelly D. Giving voice to quality and safety matters at board level: A qualitative study
of the experiences of executive nurses wo…
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psnet.ahrq.gov/node/47659/psn-pdf
January 27, 2019 - Medical overuse as a physician cognitive error: looking
under the hood.
January 27, 2019
Korenstein D. Medical overuse as a physician cognitive error: looking under the hood. JAMA Intern Med.
2019;179(1):26-27. doi:10.1001/jamainternmed.2018.5136.
https://psnet.ahrq.gov/issue/medical-overuse-physician-cognitive-er…
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psnet.ahrq.gov/node/46273/psn-pdf
August 30, 2017 - Increasing patient safety with neonates via handoff
communication during delivery: a call for
interprofessional health care team training across GME
and CME.
August 30, 2017
Vanderbilt AA, Pappada SM, Stein H, et al. Increasing patient safety with neonates via handoff
communication during delivery: a call for int…
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psnet.ahrq.gov/node/47864/psn-pdf
April 08, 2019 - Healthcare scandals and the failings of doctors: do
official inquiries hold the profession to account?
April 8, 2019
Mannion R, Davies H, Powell M, et al. Healthcare scandals and the failings of doctors. J Health Organ
Manag. 2019;33(2):221-240. doi:10.1108/JHOM-04-2018-0126.
https://psnet.ahrq.gov/issue/healthcar…
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psnet.ahrq.gov/node/855424/psn-pdf
November 15, 2023 - Medical students' experiences, perceptions, and
management of second victim: an interview study.
November 15, 2023
Krogh TB, Mielke-Christensen A, Madsen MD, et al. Medical students’ experiences, perceptions, and
management of second victim: an interview study. BMC Med Educ. 2023;23(1):786. doi:10.1186/s12909-
023…
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psnet.ahrq.gov/node/43722/psn-pdf
November 26, 2014 - Reporting medication errors: residents with diabetes.
November 26, 2014
Milligan F, Gadsby R, Ghaleb MA, et al. Reporting medication errors: residents with diabetes. Nursing and
Residential Care. 2014;16(11). doi:10.12968/nrec.2014.16.11.617.
https://psnet.ahrq.gov/issue/reporting-medication-errors-residents-diabet…
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psnet.ahrq.gov/node/838257/psn-pdf
October 05, 2022 - Fatal Solutions: How a Healthcare System Used Tragedy
to Transform Itself and Redefine Just Culture.
October 5, 2022
Davies JM, Steinke C, Flemons WW. New York, NY: Productivity Press; 2022. ISBN: 9781032028132.
https://psnet.ahrq.gov/issue/fatal-solutions-how-healthcare-system-used-tragedy-transform-itself-and-
r…
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psnet.ahrq.gov/node/851916/psn-pdf
August 02, 2023 - Measurement and Monitoring of Safety Framework: a
qualitative study of implementation through a Canadian
learning collaborative.
August 2, 2023
Goldman J, Rotteau L, Flintoft V, et al. Measurement and Monitoring of Safety Framework: a qualitative
study of implementation through a Canadian learning collaborative. B…
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psnet.ahrq.gov/node/45983/psn-pdf
June 27, 2018 - Educating for the 21st-century health care system: an
interdependent framework of basic, clinical, and systems
sciences.
June 27, 2018
Gonzalo JD, Haidet P, Papp KK, et al. Educating for the 21st-Century Health Care System: An
Interdependent Framework of Basic, Clinical, and Systems Sciences. Acad Med. 2017;92(1):…
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psnet.ahrq.gov/node/842773/psn-pdf
January 01, 2009 - Dissemination of Lean methods to improve Pap testing
quality and patient safety.
April 8, 2008
Raab SS, Andrew-JaJa C, Grzybicki DM, et al. Dissemination of Lean methods to improve Pap testing
quality and patient safety. J Low Genit Tract Dis. 2009;12(2):103-110. doi:10.1097/lgt.0b013e31815ae9a1.
https://psnet.ahr…
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psnet.ahrq.gov/node/60603/psn-pdf
June 17, 2020 - Promoting psychosocial well-being of health care staff
during crisis.
June 17, 2020
Promoting psychosocial well-being of health care staff during crisis.
https://psnet.ahrq.gov/issue/promoting-psychosocial-well-being-health-care-staff-during-crisis
Effective practice in times of crisis is reliant on a workforce th…
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psnet.ahrq.gov/node/73708/psn-pdf
September 15, 2021 - Patient safety and ethical implications of healthcare sick
leave policies in the pandemic era.
September 15, 2021
Preston-Suni K, Celedon MA, Cordasco KM. Patient safety and ethical implications of healthcare sick leave
policies in the pandemic era. Jt Comm J Qual Patient Saf. 2021;47(10):673-676.
doi:10.1016/j.jc…
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psnet.ahrq.gov/node/46228/psn-pdf
August 23, 2017 - Technology-induced errors associated with computerized
provider order entry software for older patients.
August 23, 2017
Vélez-Díaz-Pallarés M, Díaz AMÁ, Caro TG, et al. Technology-induced errors associated with
computerized provider order entry software for older patients. Int J Clin Pharm. 2017;39(4):729-742.
do…
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psnet.ahrq.gov/node/46969/psn-pdf
July 25, 2018 - Supporting doctors as healthcare quality and safety
advocates: recommendations from the Association of
Surgeons in Training (ASiT).
July 25, 2018
Fleming CA, Humm G, Wild JR, et al. Supporting doctors as healthcare quality and safety advocates:
Recommendations from the Association of Surgeons in Training (ASiT). I…
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psnet.ahrq.gov/node/867702/psn-pdf
September 01, 2021 - Toolkit To Reduce CAUTI and Other HAIs in Long-Term
Care Facilities.
September 1, 2021
Agency for Healthcare Research and Quality. Toolkit To Reduce CAUTI and Other HAIs in Long-Term
Care Facilities. September 2021.
https://psnet.ahrq.gov/issue/toolkit-reduce-cauti-and-other-hais-long-term-care-facilities
Cathete…
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psnet.ahrq.gov/node/47096/psn-pdf
November 14, 2018 - An analysis of adverse events in the rehabilitation
department: using the Veterans Affairs root cause
analysis system.
November 14, 2018
Hagley GW, Mills PD, Shiner B, et al. An Analysis of Adverse Events in the Rehabilitation Department:
Using the Veterans Affairs Root Cause Analysis System. Phys Ther. 2018;98(4)…
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psnet.ahrq.gov/issue/san-diego-center-patient-safety
March 09, 2025 - Multi-use Website
San Diego Center for Patient Safety.
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March 17, 2011
The San Diego Center for Patient Safety (SDCPS) consists o…