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psnet.ahrq.gov/issue/residents-intentions-and-actions-after-patient-safety-education
June 08, 2011 - Study
Residents' intentions and actions after patient safety education.
Citation Text:
Jansma JD, Wagner C, Bijnen AB. Residents' intentions and actions after patient safety education. BMC Health Serv Res. 2010;10:350. doi:10.1186/1472-6963-10-350.
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psnet.ahrq.gov/issue/creating-distraction-simulation-safe-medication-administration
May 27, 2011 - Commentary
Creating a distraction simulation for safe medication administration.
Citation Text:
Thomas CM, McIntosh CE, Allen R. Creating a Distraction Simulation for Safe Medication Administration. Clin Simul Nurs. 2014;10(8). doi:10.1016/j.ecns.2014.03.004.
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psnet.ahrq.gov/issue/harm-caused-adverse-events-primary-care-clinical-observational-study
July 23, 2008 - Study
Harm caused by adverse events in primary care: a clinical observational study.
Citation Text:
Wetzels R, Wolters R, van Weel C, et al. Harm caused by adverse events in primary care: a clinical observational study. J Eval Clin Pract. 2009;15(2):323-7. doi:10.1111/j.1365-2753.2008.…
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psnet.ahrq.gov/issue/frequency-medication-errors-intravenous-acetylcysteine-acetaminophen-overdose
March 03, 2010 - Study
Frequency of medication errors with intravenous acetylcysteine for acetaminophen overdose.
Citation Text:
Hayes BD, Klein-Schwartz W, Doyon S. Frequency of medication errors with intravenous acetylcysteine for acetaminophen overdose. Ann Pharmacother. 2008;42(6):766-70. doi:10.13…
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psnet.ahrq.gov/issue/experiences-lean-six-sigma-improvement-strategy-reduce-parenteral-medication-administration
October 13, 2021 - Commentary
Experiences with Lean Six Sigma as improvement strategy to reduce parenteral medication administration errors and associated potential risk of harm.
Citation Text:
van de Plas A, Slikkerveer M, Hoen S, et al. Experiences with Lean Six Sigma as improvement strategy to reduce pa…
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psnet.ahrq.gov/issue/understanding-medical-errors-and-adverse-events-icu-patients
March 20, 2015 - Commentary
Understanding medical errors and adverse events in ICU patients.
Citation Text:
Garrouste-Orgeas M, Flaatten H, Moreno R. Understanding medical errors and adverse events in ICU patients. Intensive Care Med. 2016;42(1):107-9. doi:10.1007/s00134-015-3968-x.
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psnet.ahrq.gov/issue/when-should-multicampus-hospital-be-considered-single-entity-public-reporting-patient-safety
June 28, 2011 - Commentary
When should a multicampus hospital be considered a single entity for public reporting on patient safety issues?
Citation Text:
Naessens JM, Culbertson R, Lefante JJ, et al. When should a multicampus hospital be considered a single entity for public reporting on patient safet…
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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…
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psnet.ahrq.gov/issue/mentorship-newly-appointed-physicians-strategy-enhancing-patient-safety
April 22, 2012 - Study
Mentorship for newly appointed physicians: a strategy for enhancing patient safety?
Citation Text:
Harrison R, McClean S, Lawton R, et al. Mentorship for newly appointed physicians: a strategy for enhancing patient safety? J Patient Saf. 2014;10(3):159-67. doi:10.1097/PTS.0b013e318…
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psnet.ahrq.gov/issue/work-arounds-and-artifacts-during-transition-computer-physician-order-entry-what-they-are-and
January 12, 2022 - Study
Work-arounds and artifacts during transition to a computer physician order entry: what they are and what they mean.
Citation Text:
Schoville RR. Work-arounds and artifacts during transition to a computer physician order entry: what they are and what they mean. J Nurs Care Qual. 2…
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psnet.ahrq.gov/issue/extraneous-tissue-potential-source-diagnostic-error-surgical-pathology
October 27, 2010 - Study
Extraneous tissue a potential source for diagnostic error in surgical pathology.
Citation Text:
Layfield LJ, Witt BL, Metzger KG, et al. Extraneous tissue: a potential source for diagnostic error in surgical pathology. Am J Clin Pathol. 2011;136(5):767-72. doi:10.1309/AJCP4FFSBPHA…
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psnet.ahrq.gov/issue/deploying-six-sigma-health-care-system-work-progress
March 04, 2011 - Study
Deploying Six Sigma in a health care system as a work in progress.
Citation Text:
Christianson JB, Warrick LH, Howard R, et al. Deploying Six Sigma in a health care system as a work in progress. Jt Comm J Qual Patient Saf. 2005;31(11):603-13.
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psnet.ahrq.gov/issue/hospital-inpatient-nutrition-service-errors-and-patient-safety-interventions-scoping-review
January 01, 2000 - Review
Hospital inpatient nutrition service errors and patient safety interventions: a scoping review.
Citation Text:
Austria D, McConnell C, Pope C. Hospital inpatient nutrition service errors and patient safety interventions: a scoping review. J Patient Saf. 2024;20(4):272-278. doi:10.…
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psnet.ahrq.gov/issue/human-factors-focused-reporting-system-improving-care-quality-and-safety-hospital-wards
February 17, 2010 - Study
Human factors–focused reporting system for improving care quality and safety in hospital wards.
Citation Text:
Morag I, Gopher D, Spillinger A, et al. Human Factors–Focused Reporting System for Improving Care Quality and Safety in Hospital Wards. Hum Factors. 2012;54(2):195-213. …
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psnet.ahrq.gov/issue/recognizing-and-responding-toxic-work-environment-worker-safety-patient-safety-and
July 02, 2019 - Study
Recognizing and responding to the "toxic" work environment: worker safety, patient safety, and abuse/neglect in nursing homes.
Citation Text:
Pickering CEZ, Nurenberg K, Schiamberg L. Recognizing and Responding to the "Toxic" Work Environment: Worker Safety, Patient Safety, and Abu…
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psnet.ahrq.gov/issue/patient-risk-factors-medical-injury-case-control-study
April 12, 2011 - Study
Patient risk factors for medical injury: a case–control study.
Citation Text:
Marbella AM, Laud PW, Brasel KJ, et al. Patient risk factors for medical injury: a case-control study. BMJ Qual Saf. 2011;20(2):187-93. doi:10.1136/bmjqs.2009.032664.
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psnet.ahrq.gov/issue/systematic-review-antimicrobial-urinary-catheters-prevent-catheter-associated-urinary-tract
October 19, 2022 - Review
Systematic review: antimicrobial urinary catheters to prevent catheter-associated urinary tract infection in hospitalized patients.
Citation Text:
Johnson JR, Kuskowski MA, Wilt TJ. Systematic review: antimicrobial urinary catheters to prevent catheter-associated urinary tract i…
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psnet.ahrq.gov/issue/reporting-and-classification-patient-safety-events-cardiothoracic-intensive-care-unit-and
August 02, 2011 - Study
Reporting and classification of patient safety events in a cardiothoracic intensive care unit and cardiothoracic postoperative care unit.
Citation Text:
Nast PA, Avidan M, Harris CB, et al. Reporting and classification of patient safety events in a cardiothoracic intensive care uni…
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psnet.ahrq.gov/issue/reducing-health-care-hazards-lessons-commercial-aviation-safety-team
September 17, 2010 - Commentary
Reducing health care hazards: lessons from the Commercial Aviation Safety Team.
Citation Text:
Pronovost P, Goeschel CA, Olsen KL, et al. Reducing health care hazards: lessons from the commercial aviation safety team. Health Aff (Millwood). 2009;28(3):w479-89. doi:10.1377/hl…
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psnet.ahrq.gov/issue/failure-medication-delivery-system-how-disclosure-and-systems-investigation-improve-patient
April 03, 2005 - Commentary
A failure in the medication delivery system-how disclosure and systems investigation improve patient safety.
Citation Text:
Lucas SR, Pollak E, Makowski C. A failure in the medication delivery system—how disclosure and systems investigation improve patient safety. J Healthc Ri…