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psnet.ahrq.gov/node/865344/psn-pdf
March 27, 2024 - Use of computerized physician order entry with clinical
decision support to prevent dose errors in pediatric
medication orders: a systematic review.
March 27, 2024
Ruutiainen H, Holmström A-R, Kunnola E, et al. Use of computerized physician order entry with clinical
decision support to prevent dose errors in pedia…
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psnet.ahrq.gov/node/851054/psn-pdf
June 28, 2023 - Understanding the medication safety challenges for
patients with mental illness in primary care: a scoping
review.
June 28, 2023
Ayre MJ, Lewis PJ, Keers RN. Understanding the medication safety challenges for patients with mental
illness in primary care: a scoping review. BMC Psychiatry. 2023;23(1):417. doi:10.118…
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psnet.ahrq.gov/node/38538/psn-pdf
January 02, 2017 - Rating recommendations for consumers about patient
safety: sense, common sense, or nonsense?
January 2, 2017
Weingart SN, Morway L, Brouillard D, et al. Rating recommendations for consumers about patient safety:
sense, common sense, or nonsense? Jt Comm J Qual Patient Saf. 2009;35(4):206-15.
https://psnet.ahrq.gov…
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psnet.ahrq.gov/node/860715/psn-pdf
January 17, 2024 - Development of prescribing indicators related to opioid-
related harm in patients with chronic pain in primary care-
a modified e-Delphi study.
January 17, 2024
Bansal N, Campbell SM, Lin C-Y, et al. Development of prescribing indicators related to opioid-related
harm in patients with chronic pain in primary care—…
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psnet.ahrq.gov/node/42669/psn-pdf
September 27, 2017 - Patient-reported missed nursing care correlated with
adverse events.
September 27, 2017
Kalisch BJ, Xie B, Dabney BW. Patient-reported missed nursing care correlated with adverse events. Am J
Med Qual. 2014;29(5):415-22. doi:10.1177/1062860613501715.
https://psnet.ahrq.gov/issue/patient-reported-missed-nursing-car…
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psnet.ahrq.gov/node/44494/psn-pdf
June 21, 2016 - Electronic trigger-based intervention to reduce delays in
diagnostic evaluation for cancer: a cluster randomized
controlled trial.
June 21, 2016
Murphy DR, Wu L, Thomas EJ, et al. Electronic Trigger-Based Intervention to Reduce Delays in Diagnostic
Evaluation for Cancer: A Cluster Randomized Controlled Trial. J Cl…
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psnet.ahrq.gov/node/47787/psn-pdf
February 20, 2019 - How to be a very safe maternity unit: an ethnographic
study.
February 20, 2019
Liberati EG, Tarrant C, Willars J, et al. How to be a very safe maternity unit: An ethnographic study. Soc
Sci Med. 2019;223:64-72. doi:10.1016/j.socscimed.2019.01.035.
https://psnet.ahrq.gov/issue/how-be-very-safe-maternity-unit-ethnog…
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psnet.ahrq.gov/node/50775/psn-pdf
January 01, 2021 - Content analysis of patient safety incident reports for
older adult patient transfers, handovers, and discharges:
do they serve organizations, staff, or patients?
January 8, 2020
Scott J, Dawson P, Heavey E, et al. Content analysis of patient safety incident reports for older adult
patient transfers, handovers, an…
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psnet.ahrq.gov/node/837424/psn-pdf
June 15, 2022 - Allergy safety events in healthcare: development and
application of a classification schema based on
retrospective review.
June 15, 2022
Phadke NA, Wickner PG, Wang L, et al. Allergy safety events in healthcare: development and application
of a classification schema based on retrospective review. J Allergy Clin Im…
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psnet.ahrq.gov/node/72649/psn-pdf
January 20, 2021 - Wrong-site surgery in Pennsylvania during 2015–2019: a
study of variables associated with 368 events from 178
facilities.
January 20, 2021
Yonash RA, Taylor M. Wrong-Site Surgery in Pennsylvania During 2015–2019: A Study of Variables
Associated With 368 Events From 178 Facilities. Patient Safety. 2020;2(4):24-39.
…
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psnet.ahrq.gov/node/45754/psn-pdf
September 01, 2018 - Addressing ambulatory safety and malpractice: the
Massachusetts PROMISES project.
September 1, 2018
Schiff G, Nieva HR, Griswold P, et al. Addressing Ambulatory Safety and Malpractice: The Massachusetts
PROMISES Project. Health Serv Res. 2016;51 Suppl 3:2634-2641. doi:10.1111/1475-6773.12621.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/39985/psn-pdf
November 10, 2010 - Establishing a global learning community for incident-
reporting systems.
November 10, 2010
Pham JC, Gianci S, Battles J, et al. Establishing a global learning community for incident-reporting
systems. Qual Saf Health Care. 2010;19(5):446-51. doi:10.1136/qshc.2009.037739.
https://psnet.ahrq.gov/issue/establishing-…
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psnet.ahrq.gov/node/866864/psn-pdf
October 02, 2024 - Patient safety in actioning and communicating blood test
results in primary care: a UK wide audit using the Primary
Care Academic CollaboraTive (PACT).
October 2, 2024
Watson J, Duncan P, Burrell A, et al. Patient safety in actioning and communicating blood test results in
primary care: a UK wide audit using the P…
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psnet.ahrq.gov/node/61114/psn-pdf
November 11, 2020 - A mixed-methods analysis of patient safety incidents
involving opioid substitution treatment with methadone or
buprenorphine in community-based care in England and
Wales.
November 11, 2020
Gibson R, MacLeod N, Donaldson LJ, et al. A mixed?methods analysis of patient safety incidents involving
opioid substitution …
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psnet.ahrq.gov/node/842764/psn-pdf
January 18, 2023 - Medication use evaluation of high-dose long-term opioid
de-prescribing in multiple Veterans Affairs medical
centers.
January 18, 2023
Barrett AK, Sandbrink F, Mardian A, et al. Medication use evaluation of high-dose long-term opioid de-
prescribing in multiple Veterans Affairs medical centers. J Gen Intern Med. 20…
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psnet.ahrq.gov/node/42178/psn-pdf
April 10, 2013 - Outside case review of surgical pathology for referred
patients: the impact on patient care.
April 10, 2013
Swapp RE, Aubry MC, Salomão DR, et al. Outside case review of surgical pathology for referred patients:
the impact on patient care. Arch Pathol Lab Med. 2013;137(2):233-40. doi:10.5858/arpa.2012-0088-OA.
htt…
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psnet.ahrq.gov/node/764402/psn-pdf
March 02, 2022 - A systematic review of methods for medical record
analysis to detect adverse events in hospitalized patients.
March 2, 2022
Klein DO, Rennenberg RJMW, Koopmans RP, et al. A systematic review of methods for medical record
analysis to detect adverse events in hospitalized patients. J Patient Saf. 2021;17(8):e1234-e12…
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psnet.ahrq.gov/node/46450/psn-pdf
August 20, 2018 - Improving Diagnostic Quality and Safety Final Report.
August 20, 2018
Washington, DC: National Quality Forum. September 19, 2017.
https://psnet.ahrq.gov/issue/improving-diagnostic-quality-and-safety-final-report
Although diagnostic error is a well-recognized source of preventable patient harm, measuring and
mitiga…
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psnet.ahrq.gov/issue/shakespeare-was-target-dont-be-borrower-or-lender
May 11, 2022 - Newspaper/Magazine Article
Shakespeare was on target—don't be a borrower or lender.
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June 10, 2018
This piece describes the dangers…
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psnet.ahrq.gov/node/40561/psn-pdf
March 23, 2012 - Principles of conservative prescribing.
March 23, 2012
Schiff G, Galanter W, Duhig J, et al. Principles of conservative prescribing. Arch Intern Med.
2011;171(16):1433-1440. doi:10.1001/archinternmed.2011.256.
https://psnet.ahrq.gov/issue/principles-conservative-prescribing
Strategies to prevent medication errors …