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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38600/psn-pdf
    October 03, 2017 - Assessment of transparency of cost estimates in economic evaluations of patient safety programmes. October 3, 2017 Fukuda H, Imanaka Y. Assessment of transparency of cost estimates in economic evaluations of patient safety programmes. J Eval Clin Pract. 2009;15(3):451-9. doi:10.1111/j.1365-2753.2008.01033.x. https…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837057/psn-pdf
    May 11, 2022 - Presenting complaint: use of language that disempowers patients. May 11, 2022 doi:10.1136/bmj-2021-066720. https://psnet.ahrq.gov/issue/presenting-complaint-use-language-disempowers-patients As more patients are gaining access to their electronic health records, including clinician notes, the language clinicians …

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72583/psn-pdf
    December 16, 2020 - Wear face masks with no metal during MRI exams. December 16, 2020 FDA Safety Communication. MedWatch Safety Alert. Silver Spring, MD: US Food and Drug Administration; December 7, 2020. https://psnet.ahrq.gov/issue/wear-face-masks-no-metal-during-mri-exams Magnetic resonance imaging (MRI) requires patient prep…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47709/psn-pdf
    August 07, 2019 - Medication histories in critically ill patients completed by pharmacy personnel. August 7, 2019 Kram BL, Trammel MA, Kram SJ, et al. Medication histories in critically ill patients completed by pharmacy personnel. Ann Pharmacother. 2019;53(6):596-602. doi:10.1177/1060028018825483. https://psnet.ahrq.gov/issue/medi…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74248/psn-pdf
    January 12, 2022 - Safety, Equity and Engagement in Maternity Services. January 12, 2022 Newcastle upon Tyne, UK: Care Quality Commission; September 2021. https://psnet.ahrq.gov/issue/safety-equity-and-engagement-maternity-services The safety of maternity care is threatened by inequity. This report analyzes a set of United Kingdom i…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47485/psn-pdf
    January 09, 2019 - System-related and cognitive errors in laboratory medicine. January 9, 2019 Plebani M. System-related and cognitive errors in laboratory medicine. Diagnosis (Berl). 2018;5(4):191- 196. doi:10.1515/dx-2018-0085. https://psnet.ahrq.gov/issue/system-related-and-cognitive-errors-laboratory-medicine Problems managing …

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36132/psn-pdf
    May 27, 2011 - Motion study in surgery. May 27, 2011 Gilbreth FB. Can J Med Surg. 1916:22-31. https://psnet.ahrq.gov/issue/motion-study-surgery This study was one of the first "time-motion" studies of physicians, and pioneered the application of human factors engineering and industrial principles to medical practice. The authors…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46630/psn-pdf
    November 15, 2017 - Patient Safety in the Office-Based Practice Setting. November 15, 2017 Philadelphia, PA: American College of Physicians; 2017. https://psnet.ahrq.gov/issue/patient-safety-office-based-practice-setting Patient safety in the ambulatory setting is gaining traction as a focus for research, intervention, and policy. Th…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/865932/psn-pdf
    May 22, 2024 - Cognitive Load Theory and its Impact on Diagnostic Accuracy. May 22, 2024 Knees M, Raffel KE, Kissler M, et al. Rockville, MD: Agency for Healthcare Research and Quality; May 2024. Publication No. 24-0010-2-EF. https://psnet.ahrq.gov/issue/cognitive-load-theory-and-its-impact-diagnostic-accuracy Cognition plays a…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42102/psn-pdf
    April 03, 2013 - Enhancing electronic health record usability in pediatric patient care: a scenario-based approach. April 3, 2013 Patterson ES, Zhang J, Abbott P, et al. Enhancing electronic health record usability in pediatric patient care: a scenario-based approach. Jt Comm J Qual Patient Saf. 2013;39(3):129-135. https://psnet.a…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47803/psn-pdf
    October 07, 2021 - Letter to Health Care Providers: Safe Use of Surgical Staplers and Staples. October 7, 2021 US Food and Drug Administration. October 7, 2021. https://psnet.ahrq.gov/issue/letter-health-care-providers-safe-use-surgical-staplers-and-staples Errors of commission during complex procedures can contribute to patient har…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38925/psn-pdf
    September 16, 2009 - A literature review of the individual and systems factors that contribute to medication errors in nursing practice. September 16, 2009 Brady A-M, Malone A-M, Fleming S. A literature review of the individual and systems factors that contribute to medication errors in nursing practice. J Nurs Manag. 2009;17(6):679-97…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42415/psn-pdf
    July 24, 2013 - Strategies for improving communication in the emergency department: mediums and messages in a noisy environment. July 24, 2013 Welch SJ, Cheung DS, Apker J, et al. Strategies for improving communication in the emergency department: mediums and messages in a noisy environment. Jt Comm J Qual Patient Saf. 2013;39(6)…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43826/psn-pdf
    June 01, 2015 - Radiation Oncology Incident Learning System. June 1, 2015 American Society for Radiation Oncology and American Association of Physicists in Medicine. https://psnet.ahrq.gov/issue/radiation-oncology-incident-learning-system Reporting of near misses and adverse events can provide a foundation for learning from error.…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/863003/psn-pdf
    February 21, 2024 - Positive Patient Identification. February 21, 2024 Healthcare Safety Investigation Branch (HSIB), Dorset, UK:  Health Services Safety Investigations Body; February 2024. https://psnet.ahrq.gov/issue/positive-patient-identification Patient misidentification can result in medication administration errors, …

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42212/psn-pdf
    April 17, 2013 - Reducing the risk of adverse drug events in older adults. April 17, 2013 Pretorius RW, Gataric G, Swedlund SK, et al. Reducing the risk of adverse drug events in older adults. Am Fam Physician. 2013;87(5):331-6. https://psnet.ahrq.gov/issue/reducing-risk-adverse-drug-events-older-adults This commentary outlines ty…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43763/psn-pdf
    April 22, 2015 - The nurse's role in medication safety. April 22, 2015 Durham B. The nurse's role in medication safety. Nursing (Brux). 2015;45(4). doi:10.1097/01.NURSE.0000461850.24153.8b. https://psnet.ahrq.gov/issue/nurses-role-medication-safety-0 Nurses perform a critical role in preventing medication errors. This commentary e…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43574/psn-pdf
    October 08, 2014 - The mixed blessings of smart infusion devices and health care IT. October 8, 2014 Nemeth CP, Brown J, Crandall B, et al. The mixed blessings of smart infusion devices and health care IT. Mil Med. 2014;179(8 Suppl):4-10. doi:10.7205/MILMED-D-13-00505. https://psnet.ahrq.gov/issue/mixed-blessings-smart-infusion-devi…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41738/psn-pdf
    June 10, 2018 - Inappropriate use of pharmacy bulk packages of IV contrast media increases risk of infections. June 10, 2018 ISMP Medication Safety Alert! Acute Care Edition. September 20, 2012;17:1,3-4. https://psnet.ahrq.gov/issue/inappropriate-use-pharmacy-bulk-packages-iv-contrast-media-increases-risk- infections This articl…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35043/psn-pdf
    June 22, 2009 - Human factors engineering: a tool for medical device evaluation in hospital procurement decision-making. June 22, 2009 Ginsburg G. Human factors engineering: a tool for medical device evaluation in hospital procurement decision-making. J Biomed Inform. 2005;38(3):213-9. https://psnet.ahrq.gov/issue/human-factors-e…
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