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  1. New unintended adverse consequences of electronic health records. | PSNet

    psnet.ahrq.gov/issue/new-unintended-adverse-consequences-electronic-health-records
    March 20, 2019 - Review New unintended adverse consequences of electronic health records. Citation Text: Sittig DF, Wright A, Ash J, et al. New Unintended Adverse Consequences of Electronic Health Records. Yearb Med Inform. 2016;(1):7-12. Copy Citation Format: Google Scholar PubMed BibTeX E…

  2. Shortage of perioperative drugs: implications for anesthesia practice and patient safety. | PSNet

    psnet.ahrq.gov/issue/shortage-perioperative-drugs-implications-anesthesia-practice-and-patient-safety
    April 11, 2018 - Commentary Shortage of perioperative drugs: implications for anesthesia practice and patient safety. Citation Text: De Oliveira GS, Theilken LS, McCarthy R. Shortage of perioperative drugs: implications for anesthesia practice and patient safety. Anesth Analg. 2011;113(6):1429-35. doi:10…

  3. Confirming delivery: understanding the role of the hospitalized patient in medication administration safety. | PSNet

    psnet.ahrq.gov/issue/confirming-delivery-understanding-role-hospitalized-patient-medication-administration-safety
    March 02, 2016 - Study Confirming delivery: understanding the role of the hospitalized patient in medication administration safety. Citation Text: Macdonald M, Heilemann MS, MacKinnon NJ, et al. Confirming delivery: understanding the role of the hospitalized patient in medication administration safety. Q…

  4. Lost, mislabeled, and mishandled surgical and clinical pathology specimens: a systematic review of published literature. | PSNet

    psnet.ahrq.gov/issue/lost-mislabeled-and-mishandled-surgical-and-clinical-pathology-specimens-systematic-review
    September 23, 2020 - Review Lost, mislabeled, and mishandled surgical and clinical pathology specimens: a systematic review of published literature. Citation Text: Carmack HJ, Lazenby BS, Wilson KJ, et al. Lost, mislabeled, and mishandled surgical and clinical pathology specimens: a systematic review of publ…

  5. Patient safety in nursing education: contexts, tensions and feeling safe to learn. | PSNet

    psnet.ahrq.gov/issue/patient-safety-nursing-education-contexts-tensions-and-feeling-safe-learn
    September 19, 2013 - Study Patient safety in nursing education: contexts, tensions and feeling safe to learn. Citation Text: Steven A, Magnusson C, Smith P, et al. Patient safety in nursing education: contexts, tensions and feeling safe to learn. Nurse Educ Today. 2014;34(2):277-84. doi:10.1016/j.nedt.2013…

  6. Do safety briefings improve patient safety in the acute hospital setting? A systematic review. | PSNet

    psnet.ahrq.gov/issue/do-safety-briefings-improve-patient-safety-acute-hospital-setting-systematic-review
    August 14, 2024 - Review Do safety briefings improve patient safety in the acute hospital setting? A systematic review. Citation Text: Ryan S, Ward M, Vaughan D, et al. Do safety briefings improve patient safety in the acute hospital setting? A systematic review. J Adv Nurs. 2019;75(10):2085-2098. doi:10.…

  7. Using medicolegal data to support safe medical care: a contributing factor coding framework. | PSNet

    psnet.ahrq.gov/issue/using-medicolegal-data-support-safe-medical-care-contributing-factor-coding-framework
    April 03, 2024 - Commentary Using medicolegal data to support safe medical care: a contributing factor coding framework. Citation Text: McCleery A, Devenny K, Ogilby C, et al. Using medicolegal data to support safe medical care: A contributing factor coding framework. J Healthc Risk Manag. 2019;38(4):11-…

  8. A randomized controlled trial on the effect of a double check on the detection of medication errors. | PSNet

    psnet.ahrq.gov/issue/randomized-controlled-trial-effect-double-check-detection-medication-errors
    June 07, 2016 - Study A randomized controlled trial on the effect of a double check on the detection of medication errors. Citation Text: Douglass AM, Elder J, Watson R, et al. A Randomized Controlled Trial on the Effect of a Double Check on the Detection of Medication Errors. Ann Emerg Med. 2018;71(1):…

  9. Medication safety in a psychiatric hospital. | PSNet

    psnet.ahrq.gov/issue/medication-safety-psychiatric-hospital
    September 27, 2017 - Study Medication safety in a psychiatric hospital. Citation Text: Rothschild JM, Mann K, Keohane C, et al. Medication safety in a psychiatric hospital. Gen Hosp Psychiatry. 2007;29(2):156-62. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML En…

  10. Enhancing healthcare process design with human factors engineering and reliability science, part 2: applying the knowledge to clinical documentation systems. | PSNet

    psnet.ahrq.gov/issue/enhancing-healthcare-process-design-human-factors-engineering-and-reliability-science-part-2
    January 16, 2008 - Commentary Enhancing healthcare process design with human factors engineering and reliability science, part 2: applying the knowledge to clinical documentation systems. Citation Text: Boston-Fleischhauer C. Enhancing healthcare process design with human factors engineering and reliabilit…

  11. The spectrum of harm associated with modern medicine. | PSNet

    psnet.ahrq.gov/issue/spectrum-harm-associated-modern-medicine
    July 26, 2023 - Commentary The spectrum of harm associated with modern medicine. Citation Text: Schattner A. The spectrum of harm associated with modern medicine. J Gen Intern Med. 2022;37(3):664-667. doi:10.1007/s11606-021-06997-x. Copy Citation Format: DOI Google Scholar BibTeX EndNote X…

  12. In-facility delirium programs as a patient safety strategy: a systematic review. | PSNet

    psnet.ahrq.gov/issue/facility-delirium-programs-patient-safety-strategy-systematic-review
    March 13, 2013 - Review In-facility delirium programs as a patient safety strategy: a systematic review. Citation Text: Reston JT, Schoelles KM. In-facility delirium prevention programs as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158(5 Pt 2):375-80. doi:10.7326/0003-4819-158…

  13. Improving handoff communications in critical care: utilizing simulation-based training toward process improvement in managing patient risk. | PSNet

    psnet.ahrq.gov/issue/improving-handoff-communications-critical-care-utilizing-simulation-based-training-toward
    February 16, 2011 - Study Improving handoff communications in critical care: utilizing simulation-based training toward process improvement in managing patient risk. Citation Text: Berkenstadt H, Haviv Y, Tuval A, et al. Improving handoff communications in critical care: utilizing simulation-based training …

  14. The Daily Plan: including patients for safety's sake. | PSNet

    psnet.ahrq.gov/issue/daily-plan-including-patients-safetys-sake
    March 13, 2013 - Study The Daily Plan: including patients for safety's sake. Citation Text: King BJ, Mills PD, Fore AM, et al. The Daily Plan®: Including patients for safety's sake. Nurs Manage. 2012;43(3):15-8. doi:10.1097/01.NUMA.0000412229.53136.3e. Copy Citation Format: DOI Google Sch…

  15. Understanding pharmacist decision making for adverse drug event (ADE) detection. | PSNet

    psnet.ahrq.gov/issue/understanding-pharmacist-decision-making-adverse-drug-event-ade-detection
    May 27, 2011 - Study Understanding pharmacist decision making for adverse drug event (ADE) detection. Citation Text: Phansalkar S, Hoffman JM, Hurdle JF, et al. Understanding pharmacist decision making for adverse drug event (ADE) detection. J Eval Clin Pract. 2009;15(2):266-75. doi:10.1111/j.1365-27…

  16. Stop the line: interventions to prevent retained surgical items. | PSNet

    psnet.ahrq.gov/issue/stop-line-interventions-prevent-retained-surgical-items
    July 10, 2024 - Commentary Stop the line: interventions to prevent retained surgical items. Citation Text: Angelilli S. Stop the line: interventions to prevent retained surgical items. AORN J. 2024;120(2):71-81. doi:10.1002/aorn.14190. Copy Citation Format: DOI Google Scholar BibTeX EndNot…

  17. High reliability pediatric heart centers: always working toward getting better. | PSNet

    psnet.ahrq.gov/issue/high-reliability-pediatric-heart-centers-always-working-toward-getting-better
    September 18, 2024 - Commentary High reliability pediatric heart centers: always working toward getting better. Citation Text: Torzone A, Birely A. High reliability pediatric heart centers: always working toward getting better. Curr Opin Cardiol. 2024;39(4):356-363. doi:10.1097/hco.0000000000001143. Copy C…

  18. Inter- and intra-rater reliability for classification of medication related events in paediatric inpatients. | PSNet

    psnet.ahrq.gov/issue/inter-and-intra-rater-reliability-classification-medication-related-events-paediatric
    August 20, 2018 - Study Inter- and intra-rater reliability for classification of medication related events in paediatric inpatients. Citation Text: Kunac DL, Reith DM, Kennedy J, et al. Inter- and intra-rater reliability for classification of medication related events in paediatric inpatients. Qual Saf …

  19. Serious adverse drug events reported to the Food and Drug Administration, 1998-2005. | PSNet

    psnet.ahrq.gov/issue/serious-adverse-drug-events-reported-food-and-drug-administration-1998-2005
    June 07, 2016 - Study Serious adverse drug events reported to the Food and Drug Administration, 1998-2005. Citation Text: Moore TJ, Cohen MR, Furberg CD. Serious adverse drug events reported to the Food and Drug Administration, 1998-2005. Arch Intern Med. 2007;167(16):1752-9. Copy Citation Forma…

  20. Current approaches to punitive action for medication errors by boards of pharmacy. | PSNet

    psnet.ahrq.gov/issue/current-approaches-punitive-action-medication-errors-boards-pharmacy
    May 26, 2011 - Study Current approaches to punitive action for medication errors by boards of pharmacy. Citation Text: Holdsworth M, Wittstrom K, Yeitrakis T. Current approaches to punitive action for medication errors by boards of pharmacy. Ann Pharmacother. 2013;47(4):475-81. doi:10.1345/aph.1R668. …
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