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psnet.ahrq.gov/node/47962/psn-pdf
May 01, 2019 - Understanding the clinical implications of resident
involvement in uncommon operations.
May 1, 2019
Dasani SS, Simmons KD, Wirtalla CJ, et al. Understanding the Clinical Implications of Resident
Involvement in Uncommon Operations. J Surg Educ. 2019;76(5):1319-1328.
doi:10.1016/j.jsurg.2019.03.011.
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psnet.ahrq.gov/node/42699/psn-pdf
October 30, 2013 - A prospective, observational study of the effects of
implementation strategy on compliance with a surgical
safety checklist.
October 30, 2013
Hannam JA, Glass L, Kwon J, et al. A prospective, observational study of the effects of implementation
strategy on compliance with a surgical safety checklist. BMJ Qual Saf.…
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psnet.ahrq.gov/node/60251/psn-pdf
April 22, 2020 - Exploring the association between organizational culture
and large-scale adverse events: evidence from the
Veterans Health Administration.
April 22, 2020
George J, Elwy AR, Charns MP, et al. Exploring the Association Between Organizational Culture and
Large-Scale Adverse Events: Evidence from the Veterans Health A…
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psnet.ahrq.gov/node/847050/psn-pdf
April 05, 2023 - CHaMP: A model for building a center to support health
care worker well-being after experiencing an adverse
event.
April 5, 2023
McIntosh MS, Garvan C, Kalynych CJ, et al. CHaMP: A model for building a center to support health care
worker well-being after experiencing an adverse event. Jt Comm J Qual Patient Saf. …
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psnet.ahrq.gov/node/73917/psn-pdf
October 06, 2021 - Reporting of health information technology system-
related patient safety incidents: the effects of
organizational justice.
October 6, 2021
Gluschkoff K, Kaihlanen A, Palojoki S, et al. Reporting of health information technology system-related
patient safety incidents: the effects of organizational justice. Safety…
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psnet.ahrq.gov/node/40596/psn-pdf
December 31, 2014 - Errors associated with outpatient computerized
prescribing systems.
December 31, 2014
Nanji KC, Rothschild JM, Salzberg C, et al. Errors associated with outpatient computerized prescribing
systems. J Am Med Inform Assoc. 2011;18(6):767-73. doi:10.1136/amiajnl-2011-000205.
https://psnet.ahrq.gov/issue/errors-associ…
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psnet.ahrq.gov/node/36833/psn-pdf
March 03, 2011 - Achieving the National Quality Forum's "Never Events":
prevention of wrong site, wrong procedure, and wrong
patient operations.
March 3, 2011
Michaels RK, Makary MA, Dahab Y, et al. Achieving the National Quality Forum's "Never Events":
prevention of wrong site, wrong procedure, and wrong patient operations. Ann S…
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psnet.ahrq.gov/node/853959/psn-pdf
September 27, 2023 - Scaling up a diagnostic pause at the ICU-to-ward
transition: an exploration of barriers and facilitators to
implementation of the ICU-PAUSE handoff tool.
September 27, 2023
Cornell EG, Harris E, McCune E, et al. Scaling up a diagnostic pause at the ICU-to-ward transition: an
exploration of barriers and facilitator…
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psnet.ahrq.gov/node/837761/psn-pdf
August 03, 2022 - The effectiveness of improving healthcare teams' human
factor skills using simulation-based training: a systematic
review.
August 3, 2022
Abildgren L, Lebahn-Hadidi M, Mogensen CB, et al. The effectiveness of improving healthcare teams’
human factor skills using simulation-based training: a systematic review. Adv …
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psnet.ahrq.gov/node/41951/psn-pdf
September 07, 2016 - The impact of drug shortages on children with
cancer—the example of mechlorethamine.
September 7, 2016
Metzger ML, Billett A, Link MP. The impact of drug shortages on children with cancer--the example of
mechlorethamine. N Engl J Med. 2012;367(26):2461-2463. doi:10.1056/NEJMp1212468.
https://psnet.ahrq.gov/issue/i…
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psnet.ahrq.gov/node/42484/psn-pdf
August 14, 2013 - Parent willingness to remind health care workers to
perform hand hygiene.
August 14, 2013
Buser GL, Fisher BT, Shea JA, et al. Parent willingness to remind health care workers to perform hand
hygiene. Am J Infect Control. 2013;41(6):492-6. doi:10.1016/j.ajic.2012.08.006.
https://psnet.ahrq.gov/issue/parent-willing…
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psnet.ahrq.gov/node/43173/psn-pdf
June 04, 2014 - Barriers to the implementation of checklists in the office-
based procedural setting.
June 4, 2014
Shapiro FE, Fernando RJ, Urman RD. Barriers to the implementation of checklists in the office-based
procedural setting. J Healthc Risk Manag. 2014;33(4):35-43. doi:10.1002/jhrm.21141.
https://psnet.ahrq.gov/issue/bar…
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psnet.ahrq.gov/node/46419/psn-pdf
April 12, 2019 - Medical malpractice lawsuits involving surgical residents.
April 12, 2019
Thiels CA, Choudhry AJ, Ray-Zack MD, et al. Medical Malpractice Lawsuits Involving Surgical Residents.
JAMA Surg. 2017;153(1). doi:10.1001/jamasurg.2017.2979.
https://psnet.ahrq.gov/issue/medical-malpractice-lawsuits-involving-surgical-reside…
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psnet.ahrq.gov/node/44779/psn-pdf
May 20, 2016 - Fifteen years after To Err Is Human: a success story to
learn from.
May 20, 2016
Pronovost P, Cleeman JI, Wright D, et al. Fifteen years after To Err is Human: a success story to learn
from. BMJ Qual Saf. 2016;25(6):396-9. doi:10.1136/bmjqs-2015-004720.
https://psnet.ahrq.gov/issue/fifteen-years-after-err-human-su…
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psnet.ahrq.gov/node/73348/psn-pdf
June 02, 2021 - Association of opioid consumption profiles after
hospitalization with risk of adverse health care events.
June 2, 2021
Kurteva S, Abrahamowicz M, Gomes T, et al. Association of opioid consumption profiles after
hospitalization with risk of adverse health care events. JAMA Netw Open. 2021;4(5):e218782.
doi:10.1001/…
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psnet.ahrq.gov/node/45434/psn-pdf
September 22, 2017 - Organisational strategies to implement hospital pressure
ulcer prevention programmes: findings from a national
survey.
September 22, 2017
Soban LM, Kim L, Yuan AH, et al. Organisational strategies to implement hospital pressure ulcer
prevention programmes: findings from a national survey. J Nurs Manag. 2017;25(6):…
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psnet.ahrq.gov/node/47806/psn-pdf
January 01, 2021 - Pursuing patient safety at the intersection of design,
systems engineering, and health care delivery research:
an ongoing assessment.
February 27, 2019
Henriksen K, Rodrick D, Grace EN, et al. Pursuing Patient Safety at the Intersection of Design, Systems
Engineering, and Health Care Delivery Research: An Ongoing …
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psnet.ahrq.gov/node/867338/psn-pdf
December 11, 2024 - Using patient experience surveys to identify potential
diagnostic safety breakdowns: a mixed methods study.
December 11, 2024
Baker KM, Brahier M, Penne M, et al. Using patient experience surveys to identify potential diagnostic
safety breakdowns: a mixed methods study. J Patient Saf. 2024;20(8):556-563.
doi:10.10…
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psnet.ahrq.gov/node/43856/psn-pdf
March 18, 2015 - Factors contributing to Registered Nurse medication
administration error: a narrative review.
March 18, 2015
Parry AM, Barriball L, While AE. Factors contributing to registered nurse medication administration error: a
narrative review. Int J Nurs Stud. 2015;52(1):403-20. doi:10.1016/j.ijnurstu.2014.07.003.
https:/…
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psnet.ahrq.gov/node/38625/psn-pdf
November 19, 2009 - The design of the SAFE or SORRY? study: a cluster
randomised trial on the development and testing of an
evidence based inpatient safety program for the
prevention of adverse events.
November 19, 2009
van Gaal BGI, Schoonhoven L, Hulscher M, et al. The design of the SAFE or SORRY? study: a cluster
randomised trial…