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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60766/psn-pdf
    August 05, 2020 - Dermatology faces a reckoning: lack of darker skin in textbooks and journals harms care for patients of color. August 5, 2020 McFarling UL. Stat. July 21, 2020. https://psnet.ahrq.gov/issue/dermatology-faces-reckoning-lack-darker-skin-textbooks-and-journals-harms- care-patients-color Dermatologists rely on v…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35019/psn-pdf
    June 22, 2009 - Improving patient safety in critical care: big challenge, exciting opportunity/L'amelioration de la securite des patients a l'unite des soins intensifs : un grand defi, une occasion stimulante. June 22, 2009 Dodek P. Improving patient safety in critical care: big challenge, exciting opportunity. Can J Anaesth. 20…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74064/psn-pdf
    May 27, 2021 - Achieving zero inequity: lessons learned from patient safety. May 27, 2021 Gandhi TK. NEJM Catalyst. May 27, 2021. https://psnet.ahrq.gov/issue/achieving-zero-inequity-lessons-learned-patient-safety The COVID-19 pandemic has shown a spotlight on bias, disparities, and inequity in the healthcare system. The author…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43677/psn-pdf
    November 19, 2014 - Reporting and Learning Systems for Medication Errors: The Role of Pharmacovigilance Centres. November 19, 2014 Bencheikh SR, Cousins D, Benabdallah G, et al. Geneva, Switzerland: World Health Organization; October 2014. ISBN: 9789241507943. https://psnet.ahrq.gov/issue/reporting-and-learning-systems-medication-err…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46483/psn-pdf
    October 04, 2017 - Fall Prevention in Hospitals Training Program. October 4, 2017 Rockville, MD: Agency for Healthcare Research and Quality; 2017. https://psnet.ahrq.gov/issue/fall-prevention-hospitals-training-program Falls are a primary focus of quality and patient safety improvement efforts in hospitals. This training program pro…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40188/psn-pdf
    February 02, 2011 - Decreasing mislabeled laboratory specimens using barcode technology and bedside printers. February 2, 2011 Brown JE, Smith N, Sherfy BR. Decreasing mislabeled laboratory specimens using barcode technology and bedside printers. J Nurs Care Qual. 2011;26(1):13-21. doi:10.1097/NCQ.0b013e3181e4e6dd. https://psnet.ahrq…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44782/psn-pdf
    January 13, 2016 - The Swiss cheese model of adverse event occurrence—closing the holes. January 13, 2016 Stein JE, Heiss K. The Swiss cheese model of adverse event occurrence--Closing the holes. Semin Pediatr Surg. 2015;24(6):278-82. doi:10.1053/j.sempedsurg.2015.08.003. https://psnet.ahrq.gov/issue/swiss-cheese-model-adverse-event…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45987/psn-pdf
    April 26, 2017 - Using simulation to prepare nursing staff for the move to a new building. April 26, 2017 Knippa S, Senecal P-A. Using Simulation to Prepare Nursing Staff for the Move to a New Building. J Nurses Prof Dev. 2017;33(2):E1-E5. doi:10.1097/NND.0000000000000329. https://psnet.ahrq.gov/issue/using-simulation-prepare-nurs…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42961/psn-pdf
    February 19, 2014 - Healthcare-associated infections: a national patient safety problem and the coordinated response. February 19, 2014 Jeeva RR, Wright D. Healthcare-associated infections: a national patient safety problem and the coordinated response. Med Care. 2014;52(2 Suppl 1):S4-8. doi:10.1097/MLR.0b013e3182a54581. https://psne…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41633/psn-pdf
    January 01, 2013 - Determinants of success of quality improvement collaboratives: what does the literature show? December 31, 2012 Hulscher M, Schouten LMT, Grol R, et al. Determinants of success of quality improvement collaboratives: what does the literature show? BMJ Qual Saf. 2013;22(1):19-31. doi:10.1136/bmjqs-2011-000651. https…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41911/psn-pdf
    December 12, 2012 - Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial. December 12, 2012 Shorr RI, Chandler M, Mion LC, et al. Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial. Ann Intern …
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50575/psn-pdf
    October 23, 2019 - Dynamic pocket card for implementing ISBAR in shift handover communication. October 23, 2019 Schmidt T, Kocher DR, Mahendran P, et al. Dynamic Pocket Card for Implementing ISBAR in Shift Handover Communication. Stud Health Technol Inform. 2019;267:224-229. doi:10.3233/SHTI190831. https://psnet.ahrq.gov/issue/dynam…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46742/psn-pdf
    March 14, 2018 - Evidence-based guidelines for fatigue risk management in emergency medical services. March 14, 2018 Patterson D, Higgins S, Van Dongen HPA, et al. Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services. Prehosp Emerg Care. 2018;22(sup1):89-101. doi:10.1080/10903127.2017.1376137. https…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44843/psn-pdf
    September 06, 2016 - Addressing the Global Shortages of Medicines, and the Safety and Accessibility of Children's Medication. September 6, 2016 Geneva, Switzerland: World Health Organization; 2015. https://psnet.ahrq.gov/issue/addressing-global-shortages-medicines-and-safety-and-accessibility-childrens- medication Drug shortages have…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43888/psn-pdf
    August 02, 2015 - Diagnostic performance by medical students working individually or in teams. August 2, 2015 Hautz WE, Kämmer JE, Schauber SK, et al. Diagnostic performance by medical students working individually or in teams. JAMA. 2015;313(3):303-4. doi:10.1001/jama.2014.15770. https://psnet.ahrq.gov/issue/diagnostic-performance…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/855440/psn-pdf
    November 15, 2023 - NPSD Data Spotlight: Patterns of Fall Interventions. November 15, 2023 Rockville, MD: Agency for Healthcare Research and Quality; September 2023. AHRQ Publication no. 23- 0055. https://psnet.ahrq.gov/issue/npsd-data-spotlight-patterns-fall-interventions Falls are a frequently reported sentinel event. This Data Spo…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/48001/psn-pdf
    May 22, 2019 - Medicines safety in anaesthetic practice. May 22, 2019 Mackay E, Jennings J, Webber S. Medicines safety in anaesthetic practice. BJA Edu. 2019;19(5):151-157. doi:10.1016/j.bjae.2019.01.001. https://psnet.ahrq.gov/issue/medicines-safety-anaesthetic-practice Human factors affect medication delivery in the operating …
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74118/psn-pdf
    January 01, 2022 - From HRO to HERO: making health equity a core system capability. November 24, 2021 Moy E, Hausmann LRM, Clancy CM. From HRO to HERO: making health equity a core system capability. Am J Med Qual. 2022;37(1):81-83. doi:10.1097/jmq.0000000000000020. https://psnet.ahrq.gov/issue/hro-hero-making-health-equity-core-syst…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37469/psn-pdf
    January 16, 2008 - Towards the reduction of medication errors in orthopedics and spinal surgery: outcomes using a pharmacist-led approach. January 16, 2008 Weiner BK, Venarske J, Yu M, et al. Towards the reduction of medication errors in orthopedics and spinal surgery: outcomes using a pharmacist-led approach. Spine (Phila Pa 1976).…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38068/psn-pdf
    March 10, 2011 - The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. March 10, 2011 Ammenwerth E, Schnell-Inderst P, Machan C, et al. The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. J Am Med Inform Assoc. 2008;15(5):585-600. …

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