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psnet.ahrq.gov/node/73683/psn-pdf
September 08, 2021 - Why and how to approach user experience in safety-
critical domains: the example of health care.
September 8, 2021
Grundgeiger T, Hurtienne J, Happel O. Why and how to approach user experience in safety-critical
domains: the example of health care. Hum Factors. 2020;63(5):821-832. doi:10.1177/0018720819887575.
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psnet.ahrq.gov/node/836963/psn-pdf
April 20, 2022 - Investigating the impact of cognitive bias in nursing
documentation on decision-making and judgement.
April 20, 2022
Martin K, Bickle K, Lok J. Investigating the impact of cognitive bias in nursing documentation on decision?
making and judgement. Int J Mental Health Nurs. 2022;31(4):897-907. doi:10.1111/inm.12997.
…
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psnet.ahrq.gov/node/845070/psn-pdf
February 22, 2023 - Registered nurses' efforts to ensure safety for home-
dwelling older patients.
February 22, 2023
Lindberg C, Fock J, Nilsen P, et al. Registered nurses' efforts to ensure safety for home?dwelling older
patients. Scand J Caring Sci. 2022. doi:10.1111/scs.13142.
https://psnet.ahrq.gov/issue/registered-nurses-efforts…
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psnet.ahrq.gov/node/36244/psn-pdf
June 13, 2012 - With Safety in Mind: Mental Health Services and Patient
Safety.
June 13, 2012
Scobie S, Minghella E, Dale C, et al. London, UK: National Patient Safety Agency; 2006.
https://psnet.ahrq.gov/issue/safety-mind-mental-health-services-and-patient-safety
This report, the second in a series from the United Kingdom's Nati…
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psnet.ahrq.gov/node/44901/psn-pdf
March 30, 2016 - Medication safety pharmacy technician in a large, tertiary
care, community hospital.
March 30, 2016
Brown KN, Bergsbaken J, Reichard JS. Medication safety pharmacy technician in a large, tertiary care,
community hospital. Am J Health Syst Pharm. 2016;73(4):188-191. doi:10.2146/ajhp150098.
https://psnet.ahrq.gov/is…
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psnet.ahrq.gov/node/46183/psn-pdf
July 12, 2017 - Medication-related Malpractice Risks. 2016 CRICO
Strategies National CBS Report.
July 12, 2017
Boston, MA: CRICO Strategies; 2017.
https://psnet.ahrq.gov/issue/medication-related-malpractice-risks-2016-crico-strategies-national-cbs-report
Medication errors are a persistent challenge in health care that can occur a…
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psnet.ahrq.gov/node/39309/psn-pdf
December 09, 2014 - Patient Safety in Emergency Medicine.
December 9, 2014
Croskerry P, Cosby KS, Schenkel SM, Wears RL, eds. Philadelphia, PA: Lippincott Williams & Wilkins;
2009. ISBN: 9780781777278.
https://psnet.ahrq.gov/issue/patient-safety-emergency-medicine
The pace, diversity, and scope of an emergency department (ED) cre…
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psnet.ahrq.gov/node/44052/psn-pdf
July 16, 2015 - Graphical display of diagnostic test results in electronic
health records: a comparison of 8 systems.
July 16, 2015
Sittig DF, Murphy DR, Smith MW, et al. Graphical display of diagnostic test results in electronic health
records: a comparison of 8 systems. J Am Med Inform Assoc. 2015;22(4):900-4. doi:10.1093/jamia/…
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psnet.ahrq.gov/node/48149/psn-pdf
July 31, 2019 - Zero Harm: How to Achieve Patient and Workforce Safety
in Healthcare.
July 31, 2019
Clapper C, Merlino J, Stockmeier C, eds. New York, NY: McGraw-Hill Education; 2019. ISBN:
9781260440928.
https://psnet.ahrq.gov/issue/zero-harm-how-achieve-patient-and-workforce-safety-healthcare
Achieving zero preventable harms h…
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psnet.ahrq.gov/node/863763/psn-pdf
March 06, 2024 - After his wife died, he joined nurses to push for new
staffing rules in hospitals.
March 6, 2024
Wells K. Health Shots. KFF News and Michigan Public. February 22, 2024.
https://psnet.ahrq.gov/issue/after-his-wife-died-he-joined-nurses-push-new-staffing-rules-hospitals
Mandatory staffing ratios are a controversial …
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psnet.ahrq.gov/node/43361/psn-pdf
July 16, 2014 - An Avoidable Death of a Three-year-old Child from
Sepsis.
July 16, 2014
London, UK: Parliamentary and Health Service Ombudsman; June 2014.
https://psnet.ahrq.gov/issue/avoidable-death-three-year-old-child-sepsis
This investigation outlines how inadequate care contributed to the death of a child who developed sepsi…
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psnet.ahrq.gov/node/46952/psn-pdf
January 01, 2019 - Perspectives on patient and family engagement with
reduction in harm: the forgotten voice.
December 21, 2018
Schenk EC, Bryant RA, Van Son CR, et al. Perspectives on Patient and Family Engagement With
Reduction in Harm: The Forgotten Voice. J Nurs Care Qual. 2019;34(1):73-79.
doi:10.1097/NCQ.0000000000000333.
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psnet.ahrq.gov/node/45053/psn-pdf
May 19, 2019 - Five topics health care simulation can address to improve
patient safety: results from a consensus process.
May 19, 2019
Sollid SJM, Dieckman P, Aase K, et al. Five Topics Health Care Simulation Can Address to Improve
Patient Safety: Results From a Consensus Process. J Patient Saf. 2019;15(2):111-120.
doi:10.1097/…
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psnet.ahrq.gov/node/60283/psn-pdf
April 29, 2020 - Understanding and addressing sources of anxiety among
health care professionals during the COVID-19 pandemic.
April 29, 2020
Shanafelt TD, Ripp JA, Trockel M. Understanding and addressing sources of anxiety among health care
professionals during the COVID-19 pandemic. JAMA. 2020;323(21):2133-2134.
doi:10.1001/jama…
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psnet.ahrq.gov/node/836917/psn-pdf
April 13, 2022 - Error and cognitive bias in diagnostic radiology.
April 13, 2022
Tee QX, Nambiar M, Stuckey S. Error and cognitive bias in diagnostic radiology. J Med Imaging Radiat
Oncol. 2022;66(2):202-207. doi:10.1111/1754-9485.13320.
https://psnet.ahrq.gov/issue/error-and-cognitive-bias-diagnostic-radiology
Diagnostic errors …
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psnet.ahrq.gov/node/60668/psn-pdf
July 08, 2020 - Preserving organizational resilience, patient safety, and
staff retention during COVID-19 requires a holistic
consideration of the psychological safety of healthcare
workers
July 8, 2020
Rangachari P, L. Woods J. Preserving organizational resilience, patient safety, and staff retention during
COVID-19 requires a …
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psnet.ahrq.gov/node/836726/psn-pdf
March 09, 2022 - OpenNotes and patient safety: a perilous voyage into
uncharted waters.
March 9, 2022
Schust G, Manning M, Weil A. OpenNotes and patient safety: a perilous voyage into uncharted waters. J
Gen Intern Med. 2022;37(8):2074-2076. doi:10.1007/s11606-021-07384-2.
https://psnet.ahrq.gov/issue/opennotes-and-patient-safety-…
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psnet.ahrq.gov/node/843094/psn-pdf
January 25, 2023 - Getting Started with a Communication and Resolution
Program (CRP) Policy or Commitment Statement to CR.
January 25, 2023
Collaborative for Accountability and Improvement Policy Committee. Seattle, WA: University of
Washington; 2022
https://psnet.ahrq.gov/issue/getting-started-communication-and-resolution-program-c…
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psnet.ahrq.gov/node/853442/psn-pdf
September 13, 2023 - Pediatric Diagnostic Safety: State of the Science and
Future Directions.
September 13, 2023
Grubenhoff JA, Cifra CL, Marshall T, et al. Rockville, MD: Agency for Healthcare Research and Quality;
September 2023. AHRQ Publication No. 23-0040-5-EF.
https://psnet.ahrq.gov/issue/pediatric-diagnostic-safety-state-scienc…
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psnet.ahrq.gov/node/45050/psn-pdf
May 03, 2016 - Digital health and patient safety.
May 3, 2016
Agboola SO, Bates DW, Kvedar JC. Digital Health and Patient Safety. JAMA. 2016;315(16):1697-1698.
doi:10.1001/jama.2016.2402.
https://psnet.ahrq.gov/issue/digital-health-and-patient-safety
Patients, clinicians, and health care systems are increasingly adopting digital…