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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47466/psn-pdf
    October 17, 2018 - ASHP guidelines on preventing medication errors in hospitals. October 17, 2018 Billstein-Leber M, Carrillo CJD, Cassano AT, et al. ASHP Guidelines on Preventing Medication Errors in Hospitals. Am J Health-Syst Pharm. 2018;75(19):1493-1517. doi:10.2146/ajhp170811. https://psnet.ahrq.gov/issue/ashp-guidelines-preven…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42974/psn-pdf
    September 07, 2016 - Chemotherapy drug shortages in pediatric oncology: a consensus statement. September 7, 2016 Decamp M, Joffe S, Fernandez C, et al. Chemotherapy drug shortages in pediatric oncology: a consensus statement. Pediatrics. 2014;133(3):e716-24. doi:10.1542/peds.2013-2946. https://psnet.ahrq.gov/issue/chemotherapy-drug-sh…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44472/psn-pdf
    January 22, 2016 - Understanding medical errors and adverse events in ICU patients. January 22, 2016 Garrouste-Orgeas M, Flaatten H, Moreno R. Understanding medical errors and adverse events in ICU patients. Intensive Care Med. 2016;42(1):107-9. doi:10.1007/s00134-015-3968-x. https://psnet.ahrq.gov/issue/understanding-medical-errors…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41450/psn-pdf
    May 30, 2012 - Hospira Carpuject pre-filled cartridges—drug alert: products may contain more than the intended fill volume. May 30, 2012 MedWatch Safety Alert. Silver Spring, MD: US Food and Drug Administration; May 23, 2012. https://psnet.ahrq.gov/issue/hospira-carpuject-pre-filled-cartridges-drug-alert-products-may-contain-more…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36736/psn-pdf
    March 21, 2012 - FDA preliminary public health notification: unpredictable events in medical equipment due to new daylight savings time change. March 21, 2012 Silver Spring MD; Center for Devices and Radiological Health, Food and Drug Administration; March1, 2007. https://psnet.ahrq.gov/issue/fda-preliminary-public-health-notific…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35995/psn-pdf
    October 28, 2010 - FDA Guidance Document: Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment. October 28, 2010 Rockville MD: Center for Devices and Radiological Health, Food and Drug Administration: March 10, 2006. https://psnet.ahrq.gov/issue/fda-guidance-document-hospital-bed-system-dimensional-and-assess…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/48128/psn-pdf
    August 28, 2019 - Burnout in healthcare: the case for organisational change. August 28, 2019 Montgomery A, Panagopoulou E, Esmail A, et al. Burnout in healthcare: the case for organisational change. BMJ. 2019;366:l4774. doi:10.1136/bmj.l4774. https://psnet.ahrq.gov/issue/burnout-healthcare-case-organisational-change Burnout has be…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42028/psn-pdf
    February 18, 2014 - Warning! Severe burns and permanent scarring after glacial acetic acid (?99.5%) mistakenly applied topically. February 18, 2014 National Alert Network for Serious Medication Errors. Bethesda, MD: American Society of Health-System Pharmacists and Institute for Safe Medication Practices; January 23, 2013. https://ps…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45370/psn-pdf
    July 27, 2016 - Correct use of inhalers: help patients breathe easier. July 27, 2016 ISMP Medication Safety Alert! Acute Care Edition. July 14, 2016;21:1-6. https://psnet.ahrq.gov/issue/correct-use-inhalers-help-patients-breathe-easier Patients and clinicians can make medication administration mistakes when new drug delivery mecha…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60850/psn-pdf
    August 26, 2020 - Beyond the corrective action hierarchy: a systems approach to organizational change. August 26, 2020 Wood LJ, Wiegmann DA. Beyond the corrective action hierarchy: a systems approach to organizational change. Int J Qual Health Care. 2020;32(7):438-444. doi:10.1093/intqhc/mzaa068. https://psnet.ahrq.gov/issue/beyond…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43156/psn-pdf
    December 12, 2014 - National patterns of codeine prescriptions for children in the emergency department. December 12, 2014 Kaiser S, Asteria-Peñaloza R, Vittinghoff E, et al. National patterns of codeine prescriptions for children in the emergency department. Pediatrics. 2014;133(5):e1139-47. doi:10.1542/peds.2013-3171. https://psnet…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/841145/psn-pdf
    December 07, 2022 - Guidelines in Practice: prevention of unintentionally retained surgical items. December 7, 2022 Cochran K. Guidelines in Practice: prevention of unintentionally retained surgical items. AORN J. 2022;116(5):427-440. doi:10.1002/aorn.13804. https://psnet.ahrq.gov/issue/guidelines-practice-prevention-unintentionally-…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/48090/psn-pdf
    August 28, 2019 - Preventing errors with high-risk medications. August 28, 2019 Wiley F. Drug Topics. August 2019;1633:16-18. https://psnet.ahrq.gov/issue/preventing-errors-high-risk-medications High-alert medications have the potential to cause serious patient harm if not administered correctly. Reporting on challenges to medicati…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39964/psn-pdf
    January 04, 2011 - Fatal consequences of a simple mistake: how can a patient be saved from inadvertent intrathecal vincristine? January 4, 2011 Reddy K, Brown B, Nanda A. Fatal consequences of a simple mistake: how can a patient be saved from inadvertent intrathecal vincristine? Clin Neurol Neurosurg. 2011;113(1):68-71. doi:10.1016/…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45777/psn-pdf
    January 11, 2017 - Disclosure of adverse events in pediatrics. January 11, 2017 McDonnell WM; Altman RL; Bondi SA et al for the Committee on Medical Liability and Risk Management; Council on Quality Improvement and Patient Safety. Pediatrics. 2016;138(6);e20163215. https://psnet.ahrq.gov/issue/disclosure-adverse-events-pediatrics Op…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40713/psn-pdf
    August 24, 2011 - Medication reconciliation: barriers and facilitators from the perspectives of resident physicians and pharmacists. August 24, 2011 Boockvar KS, Santos SL, Kushniruk AW, et al. Medication reconciliation: Barriers and facilitators from the perspectives of resident physicians and pharmacists. J Hosp Med. 2011;6(6). do…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39616/psn-pdf
    February 02, 2011 - Infection control assessment of ambulatory surgical centers. February 2, 2011 Schaefer MK, Jhung M, Dahl M, et al. Infection control assessment of ambulatory surgical centers. JAMA. 2010;303(22):2273-9. doi:10.1001/jama.2010.744. https://psnet.ahrq.gov/issue/infection-control-assessment-ambulatory-surgical-centers…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74105/psn-pdf
    November 24, 2021 - Abdominal pain in the emergency department: missed diagnoses. November 24, 2021 Halsey-Nichols M, McCoin N. Abdominal pain in the emergency department: missed diagnoses. Emerg Med Clin North Am. 2021;39(4):703-717. doi:10.1016/j.emc.2021.07.005. https://psnet.ahrq.gov/issue/abdominal-pain-emergency-department-miss…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40821/psn-pdf
    October 31, 2011 - Educational interventions to improve handover in health care: a systematic review. October 31, 2011 Gordon M, Findley R. Educational interventions to improve handover in health care: a systematic review. Med Educ. 2011;45(11):1081-9. doi:10.1111/j.1365-2923.2011.04049.x. https://psnet.ahrq.gov/issue/educational-in…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46997/psn-pdf
    July 25, 2018 - Gross Negligence Manslaughter in Healthcare: The Report of a Rapid Policy Review. July 25, 2018 Williams N. Department of Health and Social Care. London, England: Crown Copyright; 2018. https://psnet.ahrq.gov/issue/gross-negligence-manslaughter-healthcare-report-rapid-policy-review Accountability for errors and or…
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