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  1. Causes of near misses: perceptions of perioperative nurses. | PSNet

    psnet.ahrq.gov/issue/causes-near-misses-perceptions-perioperative-nurses
    October 07, 2020 - Study Causes of near misses: perceptions of perioperative nurses. Citation Text: Cohoon B. Causes of near misses: perceptions of perioperative nurses. AORN J. 2011;93(5):551-65. doi:10.1016/j.aorn.2010.02.017. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote…

  2. Unintended exposure in radiotherapy: identification of prominent causes. | PSNet

    psnet.ahrq.gov/issue/unintended-exposure-radiotherapy-identification-prominent-causes
    May 01, 2003 - Study Unintended exposure in radiotherapy: identification of prominent causes. Citation Text: Boadu M, Rehani MM. Unintended exposure in radiotherapy: identification of prominent causes. Radiother Oncol. 2009;93(3):609-17. doi:10.1016/j.radonc.2009.08.044. Copy Citation Format: …

  3. Assessing residents' communication skills: disclosure of an adverse event to a standardized patient. | PSNet

    psnet.ahrq.gov/issue/assessing-residents-communication-skills-disclosure-adverse-event-standardized-patient
    December 21, 2016 - Study Assessing residents' communication skills: disclosure of an adverse event to a standardized patient. Citation Text: Posner G, Nakajima A. Assessing residents' communication skills: disclosure of an adverse event to a standardized patient. J Obstet Gynaecol Can. 2011;33(3):262-26…

  4. Handoffs: transitions of care for children in the emergency department. | PSNet

    psnet.ahrq.gov/issue/handoffs-transitions-care-children-emergency-department
    July 03, 2016 - Organizational Policy/Guidelines Handoffs: transitions of care for children in the emergency department. Citation Text: Handoffs: transitions of care for children in the emergency department. American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Em…

  5. In harm's way. | PSNet

    psnet.ahrq.gov/issue/harms-way
    July 08, 2009 - Commentary In harm's way. Citation Text: Donaldson LJ, Lemer C, Titcombe J. In harm's way. BMJ. 2019;365:l2037. doi:10.1136/bmj.l2037. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Download Citation…

  6. Many people of color worry good health care is tied to their appearance. | PSNet

    psnet.ahrq.gov/issue/many-people-color-worry-good-health-care-tied-their-appearance
    September 20, 2023 - Newspaper/Magazine Article Many people of color worry good health care is tied to their appearance. Citation Text: Many people of color worry good health care is tied to their appearance. DeGuzman C. KFF Health News. December 5, 2023 Copy Citation Save Save to y…

  7. Incidence of Adverse Events in Indian Health Service Hospitals. | PSNet

    psnet.ahrq.gov/issue/incidence-adverse-events-indian-health-service-hospitals
    May 20, 2020 - Book/Report Incidence of Adverse Events in Indian Health Service Hospitals. Citation Text: Incidence of Adverse Events in Indian Health Service Hospitals. Office of the Inspector General: Washington DC; December 2020. OIG report OEI-06-17-00530. Copy Citation Sav…

  8. Clearing the Error: Using Public Deliberation to Define Patient Roles as Partners in the Diagnostic Process. | PSNet

    psnet.ahrq.gov/issue/clearing-error-using-public-deliberation-define-patient-roles-partners-diagnostic-process
    September 13, 2016 - Book/Report Clearing the Error: Using Public Deliberation to Define Patient Roles as Partners in the Diagnostic Process. Citation Text: Clearing the Error: Using Public Deliberation to Define Patient Roles as Partners in the Diagnostic Process. St. Paul, MN: Society to Improve Diagnosis …

  9. Public reporting of surgical outcomes: surgeons, hospitals, or both? | PSNet

    psnet.ahrq.gov/issue/public-reporting-surgical-outcomes-surgeons-hospitals-or-both
    April 05, 2013 - Commentary Public reporting of surgical outcomes: surgeons, hospitals, or both? Citation Text: Jha AK. Public Reporting of Surgical Outcomes: Surgeons, Hospitals, or Both? JAMA. 2017;318(15):1429-1430. doi:10.1001/jama.2017.13815. Copy Citation Format: DOI Google Scholar Pu…

  10. New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings. | PSNet

    psnet.ahrq.gov/issue/new-hhs-data-shows-major-strides-made-patient-safety-leading-improved-care-and-savings
    October 31, 2014 - Book/Report New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings. Citation Text: New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings. Washington, DC: US Department of Health and Human Services; May 7, 2014…

  11. The frustrating case of incident-reporting systems. | PSNet

    psnet.ahrq.gov/issue/frustrating-case-incident-reporting-systems
    June 22, 2022 - Commentary The frustrating case of incident-reporting systems. Citation Text: Shojania KG. The frustrating case of incident-reporting systems. Qual Saf Health Care. 2008;17(6):400-2. doi:10.1136/qshc.2008.029496. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndN…

  12. FDA public health notification: unretrieved device fragments. | PSNet

    psnet.ahrq.gov/issue/fda-public-health-notification-unretrieved-device-fragments
    June 02, 2021 - Press Release/Announcement FDA public health notification: unretrieved device fragments. Citation Text: FDA public health notification: unretrieved device fragments. Silver Spring MD, Center for Devices and Radiological Health, US Food and Drug Administration; January 15, 2008. Copy Ci…

  13. Human reliability analysis: a critique and review for managers. | PSNet

    psnet.ahrq.gov/issue/human-reliability-analysis-critique-and-review-managers
    November 21, 2021 - Review Human reliability analysis: a critique and review for managers. Citation Text: French S, Bedford T, Pollard SJT, et al. Human reliability analysis: A critique and review for managers. Saf Sci. 2011;49(6). doi:10.1016/j.ssci.2011.02.008. Copy Citation Format: DOI Go…

  14. Increasing demands for quality measurement. | PSNet

    psnet.ahrq.gov/issue/increasing-demands-quality-measurement
    November 16, 2022 - Commentary Increasing demands for quality measurement. Citation Text: Panzer RJ, Gitomer RS, Greene WH, et al. Increasing demands for quality measurement. JAMA. 2013;310(18):1971-80. doi:10.1001/jama.2013.282047. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNo…

  15. Assessment of the AHRQ Patient Safety Initiative: Final Report Evaluation Report IV. | PSNet

    psnet.ahrq.gov/issue/assessment-ahrq-patient-safety-initiative-final-report-evaluation-report-iv
    May 21, 2014 - Book/Report Assessment of the AHRQ Patient Safety Initiative: Final Report Evaluation Report IV. Citation Text: Assessment of the AHRQ Patient Safety Initiative: Final Report Evaluation Report IV. Farley DO, Damberg CL, Ridgely MS, et al. Santa Monica, CA: RAND Corporation; 2008. ISBN: 9…

  16. Patient Safety 2030. | PSNet

    psnet.ahrq.gov/issue/patient-safety-2030
    April 13, 2016 - Book/Report Patient Safety 2030. Citation Text: Patient Safety 2030. Yu A, Flott K, Chainani N, Fontana G, Darzi A. London, UK: NIHR Imperial Patient Safety Translational Research Centre; 2016. Copy Citation Save Save to your library Print Download PDF …

  17. Patient safety in obstetrics and gynecology: an agenda for the future. | PSNet

    psnet.ahrq.gov/issue/patient-safety-obstetrics-and-gynecology-agenda-future
    January 12, 2011 - Commentary Patient safety in obstetrics and gynecology: an agenda for the future. Citation Text: Pearlman MD. Patient safety in obstetrics and gynecology: an agenda for the future. Obstet Gynecol. 2006;108(5):1266-71. Copy Citation Format: Google Scholar PubMed BibTeX End…

  18. Back to basics: preventing surgical site infections. | PSNet

    psnet.ahrq.gov/issue/back-basics-preventing-surgical-site-infections
    March 17, 2021 - Commentary Back to basics: preventing surgical site infections. Citation Text: Spruce L. Back to basics: preventing surgical site infections. AORN J. 2014;99(5):600-8; quiz 609-11. doi:10.1016/j.aorn.2014.02.002. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNot…

  19. Total systems safety supports practitioners in partnering with families to protect patients. | PSNet

    psnet.ahrq.gov/issue/total-systems-safety-supports-practitioners-partnering-families-protect-patients
    April 17, 2024 - Newspaper/Magazine Article Total systems safety supports practitioners in partnering with families to protect patients. Citation Text: Total systems safety supports practitioners in partnering with families to protect patients. ISMP Medication Safety Alert! Acute Care. 2024;29(13):1-4. …

  20. Adverse Events in Hospitals: Methods for Identifying Events. | PSNet

    psnet.ahrq.gov/issue/adverse-events-hospitals-methods-identifying-events
    February 18, 2009 - Book/Report Adverse Events in Hospitals: Methods for Identifying Events. Citation Text: Adverse Events in Hospitals: Methods for Identifying Events. Levinson DR. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; March 2010. Report No. OEI-06…
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