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ReCASTing the RCA: an improved model for performing root cause analyses. | PSNet

psnet.ahrq.gov/issue/recasting-rca-improved-model-performing-root-cause-analyses

November 10, 2010 - Commentary ReCASTing the RCA: an improved model for performing root cause analyses. Citation Text: Pham JC, Kim GR, Natterman JP, et al. ReCASTing the RCA: An Improved Model for Performing Root Cause Analyses. American Journal of Medical Quality. 2010;25(3). doi:10.1177/1062860609359533…

Hospital RNs' experiences with disruptive behavior: a qualitative study. | PSNet

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September 09, 2015 - Study Hospital RNs' experiences with disruptive behavior: a qualitative study. Citation Text: Walrath JM, Dang D, Nyberg D. Hospital RNs' experiences with disruptive behavior: a qualitative study. J Nurs Care Qual. 2010;25(2):105-116. doi:10.1097/NCQ.0b013e3181c7b58e. Copy Citation …

Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems. | PSNet

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April 06, 2022 - Study Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems. Citation Text: Balla U, Malnick S, Schattner A. Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems. Medicine (Ba…

Communication outcomes of critical imaging results in a computerized notification system. | PSNet

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April 04, 2011 - Study Communication outcomes of critical imaging results in a computerized notification system. Citation Text: Singh H, Arora HS, Vij MS, et al. Communication outcomes of critical imaging results in a computerized notification system. J Am Med Inform Assoc. 2007;14(4):459-66. Copy Ci…

Preventing patient positioning injuries in the nonoperating room setting. | PSNet

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November 21, 2012 - Commentary Preventing patient positioning injuries in the nonoperating room setting. Citation Text: Moody A, Chacin B, Chang C. Preventing patient positioning injuries in the nonoperating room setting. Curr Opin Anaesthesiol. 2022;35(4):465-471. doi:10.1097/aco.0000000000001153. Copy C…

Medication errors in intravenous drug preparation and administration: a multicentre audit in the UK, Germany and France. | PSNet

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December 04, 2015 - Study Medication errors in intravenous drug preparation and administration: a multicentre audit in the UK, Germany and France. Citation Text: Cousins DH, Sabatier B, Begue D, et al. Medication errors in intravenous drug preparation and administration: a multicentre audit in the UK, Ger…

Use of failure mode and effects analysis for proactive identification of communication and handoff failures from organ procurement to transplantation. | PSNet

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August 04, 2021 - Study Use of failure mode and effects analysis for proactive identification of communication and handoff failures from organ procurement to transplantation. Citation Text: Steinberger DM, Douglas S, Kirschbaum MS. Use of failure mode and effects analysis for proactive identification of…

Handoffs and communication: the underappreciated roles of situational awareness and inattentional blindness. | PSNet

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February 01, 2003 - Commentary Handoffs and communication: the underappreciated roles of situational awareness and inattentional blindness. Citation Text: Gosbee JW. Handoffs and communication: the underappreciated roles of situational awareness and inattentional blindness. Clin Obstet Gynecol. 2010;53(3)…

The power of collaboration with patient safety programs: building safe passage for patients, nurses, and clinical staff. | PSNet

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April 21, 2021 - Commentary The power of collaboration with patient safety programs: building safe passage for patients, nurses, and clinical staff. Citation Text: Kerfoot KM, Rapala K, Ebright PR, et al. The power of collaboration with patient safety programs: building safe passage for patients, nurse…

Responsible e-prescribing needs e-discontinuation. | PSNet

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July 10, 2017 - Commentary Responsible e-prescribing needs e-discontinuation. Citation Text: Fischer SH, Rose AJ. Responsible e-Prescribing Needs e-Discontinuation. JAMA. 2017;317(5):469-470. doi:10.1001/jama.2016.19908. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML…

Simulation techniques for teaching time-outs: a controlled trial. | PSNet

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June 22, 2016 - Study Simulation techniques for teaching time-outs: a controlled trial. Citation Text: Simulation techniques for teaching time-outs: a controlled trial. Paull DE, Williams L, Sine DM. Patient Saf Qual Healthc. March/April 2016;13:28-37. Copy Citation Save Save to …

How do community pharmacies recover from e-prescription errors? | PSNet

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November 04, 2014 - Study How do community pharmacies recover from e-prescription errors? Citation Text: Odukoya OK, Stone JA, Chui MA. How do community pharmacies recover from e-prescription errors? Res Social Adm Pharm. 2014;10(6):837-852. doi:10.1016/j.sapharm.2013.11.009. Copy Citation Format: …

Safety-I, Safety-II and burnout: how complexity science can help clinician wellness. | PSNet

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December 20, 2017 - Review Safety-I, Safety-II and burnout: how complexity science can help clinician wellness. Citation Text: Smaggus A. Safety-I, Safety-II and burnout: how complexity science can help clinician wellness. BMJ Qual Saf. 2019;28(8):667-671. doi:10.1136/bmjqs-2018-009147. Copy Citation …

Underreporting of robotic surgery complications. | PSNet

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November 21, 2017 - Study Underreporting of robotic surgery complications. Citation Text: Cooper M, Ibrahim AM, Lyu H, et al. Underreporting of robotic surgery complications. J Healthc Qual. 2015;37(2):133-8. doi:10.1111/jhq.12036. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote…

A model for developing high-reliability teams. | PSNet

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September 01, 2018 - Commentary A model for developing high-reliability teams. Citation Text: Riley W, Davis SE, Miller KK, et al. A model for developing high-reliability teams. J Nurs Manag. 2010;18(5):556-63. doi:10.1111/j.1365-2834.2010.01121.x. Copy Citation Format: DOI Google Scholar Pub…

A prospective, multicenter study of pharmacist activities resulting in medication error interception in the emergency department. | PSNet

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December 14, 2011 - Study A prospective, multicenter study of pharmacist activities resulting in medication error interception in the emergency department. Citation Text: Patanwala AE, Sanders AB, Thomas MC, et al. A prospective, multicenter study of pharmacist activities resulting in medication error int…

Seeking high reliability in primary care: leadership, tools, and organization. | PSNet

psnet.ahrq.gov/issue/seeking-high-reliability-primary-care-leadership-tools-and-organization

October 13, 2018 - Study Seeking high reliability in primary care: leadership, tools, and organization. Citation Text: Weaver RR. Seeking high reliability in primary care: Leadership, tools, and organization. Health Care Manage Rev. 2015;40(3):183-92. doi:10.1097/HMR.0000000000000022. Copy Citation F…

Medical errors education: a prospective study of a new educational tool. | PSNet

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March 20, 2024 - Study Medical errors education: a prospective study of a new educational tool. Citation Text: Paxton JH, Rubinfeld IS. Medical errors education: A prospective study of a new educational tool. Am J Med Qual. 2010;25(2):135-42. doi:10.1177/1062860609353345. Copy Citation Format: …

Enhancing communication in surgery through team training interventions: a systematic literature review. | PSNet

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August 11, 2021 - Review Enhancing communication in surgery through team training interventions: a systematic literature review. Citation Text: Gillespie BM, Chaboyer W, Murray P. Enhancing communication in surgery through team training interventions: a systematic literature review. AORN J. 2010;92(6):6…

A roadmap to advance patient safety in ambulatory care. | PSNet

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June 09, 2021 - Commentary A roadmap to advance patient safety in ambulatory care. Citation Text: 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. Copy Citation Format: DOI Google Scholar BibTeX EndNote X…

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