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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38697/psn-pdf
    June 10, 2009 - A report card system using error profile analysis and concurrent morbidity and mortality review: surgical outcome analysis, part II. June 10, 2009 Antonacci AC, Lam S, Lavarias V, et al. A report card system using error profile analysis and concurrent morbidity and mortality review: surgical outcome analysis, part…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44616/psn-pdf
    November 04, 2015 - Development of "SWARM" as a model for high reliability, rapid problem solving, and institutional learning. November 4, 2015 Williams EA, Nikolai DA, Ladwig L, et al. Development of "SWARM" as a Model for High Reliability, Rapid Problem Solving, and Institutional Learning. Jt Comm J Qual Patient Saf. 2015;41(11):508…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60816/psn-pdf
    August 19, 2020 - Workplace verbal abuse, nurse-reported quality of care, and patient safety outcomes among early-career hospital nurses. August 19, 2020 Cho H, Pavek K, Steege LM. Workplace verbal abuse, nurse?reported quality of care and patient safety outcomes among early?career hospital nurses. J Nurs Manag. 2020;28(6):1250-125…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867390/psn-pdf
    December 18, 2024 - Quality of care and quality of life: balancing patient safety and physician burnout. December 18, 2024 Minkoff H, O'Brien J, Berkowitz R. Quality of care and quality of life: balancing patient safety and physician burnout. Obstet Gynecol. 2024;144(3):e50-e55. doi:10.1097/aog.0000000000005681. https://psnet.ahrq.go…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73444/psn-pdf
    June 30, 2021 - Exploring patient safety outcomes for people with learning disabilities in acute hospital settings: a scoping review. June 30, 2021 Louch G, Albutt AK, Harlow-Trigg J, et al. Exploring patient safety outcomes for people with learning disabilities in acute hospital settings: a scoping review. BMJ Open. 2021;11(5):e…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44089/psn-pdf
    April 22, 2015 - Learning from mistakes and near mistakes: using root cause analysis as a risk management tool. April 22, 2015 Cerniglia-Lowensen J. Learning From Mistakes and Near Mistakes: Using Root Cause Analysis as a Risk Management Tool. J Radiol Nurs. 2015;34(1). doi:10.1016/j.jradnu.2014.11.004. https://psnet.ahrq.gov/issu…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34843/psn-pdf
    March 02, 2011 - Hand hygiene among physicians: performance, beliefs, and perceptions. March 2, 2011 Pittet D, Simon A, Hugonnet S, et al. Hand hygiene among physicians: performance, beliefs, and perceptions. Ann Intern Med. 2004;141(1):1-8. https://psnet.ahrq.gov/issue/hand-hygiene-among-physicians-performance-beliefs-and-percept…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39872/psn-pdf
    February 25, 2013 - The Essential Guide for Patient Safety Officers, Second Edition. February 25, 2013 Leonard M, Frankel A, Federico F, et al, eds. Oakbrook Terrace, IL: Joint Commission Resources, Institute for Healthcare Improvement; 2013. ISBN: 9781599407036. https://psnet.ahrq.gov/issue/essential-guide-patient-safety-officers-se…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44047/psn-pdf
    September 09, 2015 - Linking acknowledgement to action: closing the loop on non-urgent, clinically significant test results in the electronic health record. September 9, 2015 Dalal A, Pesterev BM, Eibensteiner K, et al. Linking acknowledgement to action: closing the loop on non- urgent, clinically significant test results in the elect…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867192/psn-pdf
    November 20, 2024 - 2024 Network of Patient Safety Databases Chartbook: Medication and Other Substance Events. November 20, 2024 2024 Network Of Patient Safety Databases Chartbook: Medication And Other Substance Events. Rockville, MD: Agency for Healthcare Research and Quality; 2024. AHRQ Pub. No. 24-0088 https://psnet.ahrq.gov/issue…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60352/psn-pdf
    January 01, 2021 - Stakeholders in safety: patient reports on unsafe clinical behaviors distinguish hospital mortality rates. May 20, 2020 Reader TW, Gillespie A. Stakeholders in safety: patient reports on unsafe clinical behaviors distinguish hospital mortality rates. J Appl Psychol. 2021;106(3):439-451. doi:10.1037/apl0000507. htt…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46999/psn-pdf
    June 27, 2018 - Empowering patients and agents to help prevent errors with living wills, DNRs, and POLSTs. June 27, 2018 Hoffman RM, Mirarchi FL. PA-PSRS Patient Saf Advis. June 2018;15. https://psnet.ahrq.gov/issue/empowering-patients-and-agents-help-prevent-errors-living-wills-dnrs-and- polsts Patient harm associated with adva…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45855/psn-pdf
    March 15, 2017 - The development and implementation of cognitive aids for critical events in pediatric anesthesia: the Society for Pediatric Anesthesia Critical Events Checklists. March 15, 2017 Clebone A, Burian BK, Watkins SC, et al. The Development and Implementation of Cognitive Aids for Critical Events in Pediatric Anesthesia…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837849/psn-pdf
    August 17, 2022 - Using health information technology in residential aged care homes: an integrative review to identify service and quality outcomes. August 17, 2022 Bail K, Gibson D, Acharya P, et al. Using health information technology in residential aged care homes: an integrative review to identify service and quality outcomes.…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34767/psn-pdf
    November 28, 2018 - Why Things Bite Back: Technology and the Revenge of Unintended Consequences. November 28, 2018 Tenner E. New York, NY: Knopf; 1996. ISBN: 0679425632. https://psnet.ahrq.gov/issue/why-things-bite-back-technology-and-revenge-unintended-consequences Tenner’s discussions of medical and nonmedical examples provide an e…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44864/psn-pdf
    March 23, 2016 - Caught in the middle: a resident perspective on influences from the learning environment that perpetuate mistreatment. March 23, 2016 Bynum WE, Lindeman B. Caught in the Middle: A Resident Perspective on Influences From the Learning Environment That Perpetuate Mistreatment. Acad Med. 2016;91(3):301-4. doi:10.1097…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45074/psn-pdf
    June 01, 2016 - Post-event debriefings during neonatal care: why are we not doing them, and how can we start? June 1, 2016 Sawyer T, Loren D, Halamek LP. Post-event debriefings during neonatal care: why are we not doing them, and how can we start? J Perinatol. 2016;36(6):415-9. doi:10.1038/jp.2016.42. https://psnet.ahrq.gov/issue…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45683/psn-pdf
    January 23, 2017 - Consensus bundle on prevention of surgical site infections after major gynecologic surgery. January 23, 2017 Pellegrini JE, Toledo P, Soper DE, et al. Consensus Bundle on Prevention of Surgical Site Infections After Major Gynecologic Surgery. Obstet Gynecol. 2017;129(1):50-61. doi:10.1097/AOG.0000000000001751. htt…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837899/psn-pdf
    August 24, 2022 - Feelings of trust and of safety are related facets of the patient's experience in surgery: a descriptive qualitative study in 80 patients. August 24, 2022 Occelli P, Mougeot F, Robelet M, et al. Feelings of trust and of safety are related facets of the patient's experience in surgery: a descriptive qualitative stu…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/862987/psn-pdf
    February 21, 2024 - Use of professional interpreters for patients with limited English proficiency undergoing surgery. February 21, 2024 Cevallos J, Lee C, Bongiovanni T. Use of professional interpreters for patients with limited English proficiency undergoing surgery. JAMA Netw Open. 2024;7(2):e2355014. doi:10.1001/jamanetworkopen.2…
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