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digital.ahrq.gov/ahrq-funded-projects/clinical-decision-support-optimizing-necrotizing-enterocolitis-prevention/citation/feasability
January 01, 2023 - Feasibility and acceptability of a neonatal project ECHO (NeoECHO) as a dissemination and implementation strategy to prevent necrotizing enterocolitis.
Citation
Gephart SM, Newnam K, Weiss A, Wyles C, Shea K. Feasibility and acceptability of a neonatal project ECHO (NeoECHO) as a dissemination and imp…
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digital.ahrq.gov/ahrq-funded-projects/clinical-decision-support-optimizing-necrotizing-enterocolitis-prevention/citation/exploring
January 01, 2023 - Exploring internal facilitators' experience with NeoECHO to foster NEC prevention and timely recognition through the iPARIHS lens.
Citation
Weiss AB, Newnam KM, Wyles C, Shea K, Gephart SM. Exploring internal facilitators' experience with NeoECHO to foster NEC prevention and timely recognition through…
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digital.ahrq.gov/ahrq-funded-projects/health-information-technology-and-improving-medication-use/citation-2
January 01, 2023 - Preventability of adverse drug events involving multiple drugs using publicly available clinical decision support tools.
Citation
Wright A, Felbowitz J, Phansalkar S, et al. Preventability of adverse drug events involving multiple drugs using publicly available clinical decision support tools. Am J He…
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digital.ahrq.gov/ahrq-funded-projects/using-evidence-based-nursing-practices-and-electronic-health-record-decision-3
January 01, 2023 - A Patient and Family Member Fall Prevention Educational (ED) tool to identify fall risk and engage them in creating individualized plan to reduce risks (Chapter 3; Figures 13 and 14; separate specifications document)
Citation
A Patient and Family Member Fall Prevention Educational (ED) tool to identif…
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psnet.ahrq.gov/node/44068/psn-pdf
April 15, 2015 - Contemporary View of Medication-Related Harm. A New
Paradigm.
April 15, 2015
National Coordinating Council for Medication Error Reporting and Prevention; NCCMERP.
https://psnet.ahrq.gov/issue/contemporary-view-medication-related-harm-new-paradigm
Medication errors are a common factor in health care–associated harm…
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digital.ahrq.gov/ahrq-funded-projects/preventing-perioperative-medication-errors-and-adverse-drug-events-through-use/citation/development
January 01, 2023 - Development of a perioperative medication-related clinical decision support tool to prevent medication errors: An analysis of user feedback.
Citation
Nanji KC, Garabedian PM, Shaikh SD, Langlieb ME, Boxwala A, Gordon WJ, Bates DW. Development of a perioperative medication-related clinical decision su…
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digital.ahrq.gov/ahrq-funded-projects/harnessing-health-information-technology-prevent-medication-induced-birth/final-report
January 01, 2023 - Harnessing Health Information Technology to Prevent Medication-Induced Birth Defects - Final Report
Citation
Schwarz, E. Harnessing Health Information Technology to Prevent Medication-Induced Birth Defects - Final Report. (Prepared by the University of Pittsburgh under Grant No. R18 HS017093). Rockvil…
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psnet.ahrq.gov/node/866638/psn-pdf
September 04, 2024 - The problem with 'never events'.
September 4, 2024
Zaslow J, Fortier J, Garber G. The problem with ‘never events’. BMJ Qual Saf. 2024;33(9):613-616.
doi:10.1136/bmjqs-2023-016981.
https://psnet.ahrq.gov/issue/problem-never-events
Never events are serious, but preventable, adverse events that result in serious pati…
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psnet.ahrq.gov/node/48054/psn-pdf
June 26, 2019 - Lessons learned from a death outside a hospital's
doorstep.
June 26, 2019
Palmer J. Patient Saf Qual Healthc. May/June 2019.
https://psnet.ahrq.gov/issue/lessons-learned-death-outside-hospitals-doorstep
Organizations must learn from adverse events to prevent similar incidents. Reporting on lessons to be
learned f…
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www.ahrq.gov/hai/cusp/clabsi-hpwpreport/index.html
August 01, 2015 - High-Performance Work Practices in CLABSI Prevention Interventions
Next Page
Table of Contents
High-Performance Work Practices in CLABSI Prevention Interventions
Case Studies
Key Findings
Conclusions
References
Table 1. Case Study Sites
Table 2. Summary of Key Informants, All Sites
Tabl…
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psnet.ahrq.gov/issue/associations-between-negative-patient-safety-climate-and-infection-prevention-practices
May 10, 2023 - Study
Associations between negative patient safety climate and infection prevention practices.
Citation Text:
Johnson CT, Hessels AJ. Associations between negative patient safety climate and infection prevention practices. Am J Infect Control. 2024;52(9):1102-1104. doi:10.1016/j.ajic.202…
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psnet.ahrq.gov/issue/hospital-process-compliance-and-surgical-outcomes-medicare-beneficiaries
May 01, 2015 - Study
Hospital process compliance and surgical outcomes in Medicare beneficiaries.
Citation Text:
Nicholas LH, Osborne NH, Birkmeyer JD, et al. Hospital process compliance and surgical outcomes in medicare beneficiaries. Arch Surg. 2010;145(10):999-1004. doi:10.1001/archsurg.2010.191.
…
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psnet.ahrq.gov/issue/patient-who-falls-its-always-trade
February 17, 2011 - Commentary
The patient who falls: "It's always a trade-off."
Citation Text:
Tinetti ME, Kumar C. The patient who falls: "It's always a trade-off". JAMA. 2010;303(3):258-66. doi:10.1001/jama.2009.2024.
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psnet.ahrq.gov/issue/addressing-prehospital-patient-safety-using-science-injury-prevention-and-control
April 12, 2019 - Commentary
Addressing prehospital patient safety using the science of injury prevention and control.
Citation Text:
Meisel ZF, Hargarten S, Vernick J. Addressing prehospital patient safety using the science of injury prevention and control. Prehosp Emerg Care. 2008;12(4):411-6. doi:10.1…
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psnet.ahrq.gov/issue/tune-and-time-out-toward-surgeon-led-prevention-never-events
July 24, 2024 - Study
Tune-in and time-out: toward surgeon-led prevention of "never" events.
Citation Text:
Jones N. Tune-In and Time-Out: Toward Surgeon-Led Prevention of "Never" Events. J Patient Saf. 2019;15(4):e36-e39. doi:10.1097/PTS.0000000000000259.
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psnet.ahrq.gov/issue/model-chemotherapy-education-novice-oncology-nurses-supports-culture-safety
September 24, 2010 - Commentary
A model of chemotherapy education for novice oncology nurses that supports a culture of safety.
Citation Text:
Sheridan-Leos N. A model of chemotherapy education for novice oncology nurses that supports a culture of safety. Clin J Oncol Nurs. 2007;11(4):545-51.
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psnet.ahrq.gov/issue/using-change-model-reduce-risk-surgical-site-infection
June 06, 2018 - Commentary
Using a change model to reduce the risk of surgical site infection.
Citation Text:
Burden M. Using a change model to reduce the risk of surgical site infection. Br J Nurs. 2016;25(17):949-955.
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psnet.ahrq.gov/issue/scientific-inquiry-100000-lives-campaign-and-application-children
April 05, 2017 - Commentary
Scientific inquiry. 100,000 lives campaign and the application to children.
Citation Text:
Edson BS, Williams MC. Scientific Inquiry . 100,000 Lives Campaign and the Application to Children. Journal for Specialists in Pediatric Nursing. 2006;11(2). doi:10.1111/j.1744-6155.20…
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psnet.ahrq.gov/issue/medical-emergency-team-and-rapid-response-system-finding-treating-and-preventing-hypoglycemia
September 23, 2020 - Commentary
The medical emergency team and rapid response system: finding, treating, and preventing hypoglycemia.
Citation Text:
DiNardo M, Noschese M, Korytkowski M, et al. The medical emergency team and rapid response system: finding, treating, and preventing hypoglycemia. Jt Comm J Qua…
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psnet.ahrq.gov/issue/morbidity-and-mortality-meeting-time-different-approach
August 30, 2023 - Commentary
The morbidity and mortality meeting: time for a different approach?
Citation Text:
Fraser J. The morbidity and mortality meeting: time for a different approach? Arch Dis Child. 2016;101(1):4-8. doi:10.1136/archdischild-2015-309536.
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