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6841. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/37601/psn-pdf
      March 19, 2008 - Patient Safety Education Project. March 19, 2008 Buehler Center on Aging, Health & Society; Northwestern University. https://psnet.ahrq.gov/issue/patient-safety-education-project This Web site provides information on the Patient Safety Education Project (PSEP), an initiative to build a core patient safety curricul…

6842. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/41987/psn-pdf
      January 23, 2013 - When Doctors Don't Listen. January 23, 2013 Wen L, Kosowsky J. New York, NY: St. Martin's Press; 2013. ISBN: 9780312594916. https://psnet.ahrq.gov/issue/when-doctors-dont-listen Drawing on two physicians' experiences, this publication provides recommendations to improve patient–physician interactions to prevent di…

6843. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/41471/psn-pdf
      June 20, 2012 - Patients taking their own medications while in the hospital. June 20, 2012 PA-PSRS Patient Saf Advis. June 2012;9:50-57.  https://psnet.ahrq.gov/issue/patients-taking-their-own-medications-while-hospital Discussing errors related to hospital patients' use of personal medications, this newsletter article provi…

6844. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/42718/psn-pdf
      September 17, 2018 - A Culture of Safety in EMS Systems. September 17, 2018 Irving, TX: American College of Emergency Physicians; 2014. https://psnet.ahrq.gov/issue/culture-safety-ems-systems This guidance recognizes risks associated with emergency medical services and provides recommendations to support the implementation of a safety…

6845. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/36347/psn-pdf
      March 18, 2010 - Skin tears: the clinical challenge. March 18, 2010 PA PSRS Patient Saf Advis 2006 Sep;3(3):1,5-10. https://psnet.ahrq.gov/issue/skin-tears-clinical-challenge This article discusses the Pennsylvania Patient Safety Reporting System (PA-PSRS) reports of skin tears and provides suggestions to help keep patients safe f…

6846. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/36970/psn-pdf
      March 17, 2011 - Connecticut Center for Patient Safety. March 17, 2011 Connecticut Center for Patient Safety https://psnet.ahrq.gov/issue/connecticut-center-patient-safety The Connecticut Center for Patient Safety works to improve patient safety in Connecticut hospitals and protect the rights of injured patients. This Web site sha…

6847. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/36647/psn-pdf
      February 14, 2007 - Patient safety: the patient's role. February 14, 2007 Ford D. Patient safety: the patient's role. . World Hosp Health Serv. 2006;42(3):45-48. https://psnet.ahrq.gov/issue/patient-safety-patients-role The author shares his family's experience with medical error and provides recommendations for how patients and fami…

6848. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/35372/psn-pdf
      June 06, 2018 - Paralyzed by mistakes: preventing errors with neuromuscular blocking agents. June 6, 2018 ISMP Medication Safety Alert! Acute Care Edition. September 22, 2005;10:1-3. https://psnet.ahrq.gov/issue/paralyzed-mistakes-preventing-errors-neuromuscular-blocking-agents This article provides examples of incidents involvin…

6849. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39359/psn-pdf
      May 25, 2015 - Patient Safety in the Intensive Care Unit. May 25, 2015 Oak Brook, IL: Joint Commission Resources; 2010. ISBN: 9781599403144. https://psnet.ahrq.gov/issue/patient-safety-intensive-care-unit This guide offers tools and strategies to ensure that intensive care units provide safe care, in the context of evidence-base…

6850. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/36271/psn-pdf
      September 20, 2006 - Safe Foundations: Junior Doctors and Patient Safety. September 20, 2006 National Patient Safety Agency. https://psnet.ahrq.gov/issue/safe-foundations-junior-doctors-and-patient-safety This Web site has educational modules for doctors-in-training and provides slides, trainer's notes, and relevant case studies on hu…

6851. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/40300/psn-pdf
      March 16, 2011 - Informed Patient Institute. March 16, 2011 Annapolis, MD. https://psnet.ahrq.gov/issue/informed-patient-institute Transparency is an important tool to support patient decision making. This organization rates online health care report cards and provides tips for reporting quality concerns. They emphasize informatio…

6852. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/38230/psn-pdf
      August 11, 2010 - The Patient Safety Leadership WalkRounds Guide. August 11, 2010 Frankel AS, Grillo S, Pittman MA. Chicago, IL: Health Research and Educational Trust; 2006. https://psnet.ahrq.gov/issue/patient-safety-leadership-walkrounds-guide This booklet provides information on the implementation of a WalkRounds program as a cul…

6853. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/37539/psn-pdf
      June 16, 2019 - ISMP medication error report analysis. June 16, 2019 Cohen MR; Smetzer JL. https://psnet.ahrq.gov/issue/ismp-medication-error-report-analysis-21 This monthly selection of medication error reports provides examples of intravenous amphotericin mix-ups, cardiac catheterization lab set-up problems, and sound-alike dru…

6854. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/40303/psn-pdf
      May 16, 2019 - Safer Hospital Care: Strategies for Continuous Innovation, Second Edition. May 16, 2019 Raheja D. New York, NY: Productivity Press; 2019. ISBN: 9780367178482 https://psnet.ahrq.gov/issue/safer-hospital-care-strategies-continuous-innovation This publication provides various strategies to drive innovation in patient…

6855. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/40190/psn-pdf
      May 21, 2011 - Perinatal high reliability. May 21, 2011 Knox E, Simpson KR. Perinatal high reliability. Am J Obstet Gynecol. 2011;204(5):373-377. doi:10.1016/j.ajog.2010.10.900. https://psnet.ahrq.gov/issue/perinatal-high-reliability This review provides background on high-reliability organizations and discusses how these concep…

6856. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/35578/psn-pdf
      June 21, 2010 - Patient safety: latex allergy. June 21, 2010 Reines D, Seifert PC. Patient safety: latex allergy. Surg Clin North Am. 2005;85(6):1329-40, xiv. https://psnet.ahrq.gov/issue/patient-safety-latex-allergy The authors provide a brief history of latex allergies and several recommendations for minimizing the risk of alle…

6857. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39066/psn-pdf
      October 28, 2021 - Hospital Performance Report. October 28, 2021 Trenton, NJ: New Jersey Department of Health and Senior Services. https://psnet.ahrq.gov/issue/hospital-performance-report Detailing results of an error reporting initiative in New Jersey, these reports explain how consumers can use this information and provides tips f…

6858. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/35920/psn-pdf
      March 17, 2011 - North Carolina Center for Hospital Quality and Patient Safety. March 17, 2011 North Carolina Center for Hospital Quality and Patient Safety. https://psnet.ahrq.gov/issue/north-carolina-center-hospital-quality-and-patient-safety The center was created by the North Carolina Hospital Association to provide education …

6859. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/34768/psn-pdf
      March 07, 2005 - Man-Made Disasters. 2nd ed. March 7, 2005 Turner BA, Pidgeon NF. Oxford, UK: Butterworth-Heinemann; 1997. https://psnet.ahrq.gov/issue/man-made-disasters-2nd-ed For those interested in potential lessons drawn from analyses of major accidents in other industries, this book, originally published in 1978, still provi…

6860. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/35081/psn-pdf
      March 29, 2007 - Achieving Safe and Reliable Healthcare: Strategies and Solutions. March 29, 2007 Leonard MS, Frankel A, Simmonds T, Vega KB. Chicago, IL: Health Administration Press; 2004. https://psnet.ahrq.gov/issue/achieving-safe-and-reliable-healthcare-strategies-and-solutions The authors provide examples of tools and methods…