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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46079/psn-pdf
    June 28, 2017 - Death due to pharmacy compounding error reinforces need for safety focus. June 28, 2017 ISMP Medication Safety Alert! Acute Care Edition. June 15, 2017;22:1-4. https://psnet.ahrq.gov/issue/death-due-pharmacy-compounding-error-reinforces-need-safety-focus Compounding pharmacies prepare medicines for patients that a…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45371/psn-pdf
    April 24, 2017 - Patient safety and workplace bullying: an integrative review. April 24, 2017 Houck NM, Colbert AM. Patient Safety and Workplace Bullying: An Integrative Review. J Nurs Care Qual. 2017;32(2):164-171. doi:10.1097/NCQ.0000000000000209. https://psnet.ahrq.gov/issue/patient-safety-and-workplace-bullying-integrative-rev…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47581/psn-pdf
    January 09, 2019 - Patient safety in inpatient psychiatry: a remaining frontier for health policy. January 9, 2019 Shields MC, Stewart MT, Delaney KR. Patient Safety In Inpatient Psychiatry: A Remaining Frontier For Health Policy. Health Aff (Millwood). 2018;37(11):1853-1861. doi:10.1377/hlthaff.2018.0718. https://psnet.ahrq.gov/iss…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46447/psn-pdf
    September 27, 2017 - Creating highly reliable accountable care organizations. September 27, 2017 Vogus TJ, Singer SJ. Creating Highly Reliable Accountable Care Organizations. Med Care Res Rev. 2016;73(6):660-672. https://psnet.ahrq.gov/issue/creating-highly-reliable-accountable-care-organizations High reliability is a goal throughout …
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/854255/psn-pdf
    October 04, 2023 - Empowering telemetry technicians and enhancing communication to improve in-hospital cardiac arrest survival. October 4, 2023 McCoy C, Keshvani N, Warsi M, et al. Empowering telemetry technicians and enhancing communication to improve in-hospital cardiac arrest survival. BMJ Open Qual. 2023;12(3):e002220. doi:10.11…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34777/psn-pdf
    February 16, 2011 - Systems errors versus physicians' errors: finding the balance in medical education. February 16, 2011 Casarett D, Helms C. Systems errors versus physicians' errors: finding the balance in medical education. Acad Med. 1999;74(1):19-22. https://psnet.ahrq.gov/issue/systems-errors-versus-physicians-errors-finding-bal…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46129/psn-pdf
    September 28, 2017 - Missed diagnosis of cardiovascular disease in outpatient general medicine: insights from malpractice claims data. September 28, 2017 Quinn GR, Ranum D, Song E, et al. Missed Diagnosis of Cardiovascular Disease in Outpatient General Medicine: Insights from Malpractice Claims Data. Jt Comm J Qual Patient Saf. 2017;43…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/854826/psn-pdf
    October 25, 2023 - Observing sources of system resilience using in situ alarm simulations. October 25, 2023 McLoone M, McNamara M, Jennings MA, et al. Observing sources of system resilience using in situ alarm simulations. J Hosp Med. 2023;18(11):994-998. doi:10.1002/jhm.13217. https://psnet.ahrq.gov/issue/observing-sources-system-r…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46815/psn-pdf
    April 29, 2018 - Designing and evaluating an automated system for real- time medication administration error detection in a neonatal intensive care unit. April 29, 2018 Ni Y, Lingren T, Hall ES, et al. Designing and evaluating an automated system for real-time medication administration error detection in a neonatal intensive care …
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45745/psn-pdf
    August 02, 2017 - Emergency diagnosis of cancer and previous general practice consultations: insights from linked patient survey data. August 2, 2017 Abel GA, Mendonca SC, McPhail S, et al. Emergency diagnosis of cancer and previous general practice consultations: insights from linked patient survey data. Br J Gen Pract. 2017;67(65…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/854821/psn-pdf
    October 25, 2023 - Factors determining safety culture in hospitals: a scoping review. October 25, 2023 Carvalho REFL de, Bates DW, Syrowatka A, et al. Factors determining safety culture in hospitals: a scoping review. BMJ Open Qual. 2023;12(4):e002310. doi:10.1136/bmjoq-2023-002310. https://psnet.ahrq.gov/issue/factors-determining-s…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866955/psn-pdf
    October 16, 2024 - Adverse diagnostic events in hospitalised patients: a single-centre, retrospective cohort study. October 16, 2024 Dalal AK, Plombon S, Konieczny K, et al. Adverse diagnostic events in hospitalised patients: a single- centre, retrospective cohort study. BMJ Qual Saf. 2024;Epub Oct 1. doi:10.1136/bmjqs-2024-017183. …
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46474/psn-pdf
    November 08, 2017 - Clearing the Error: Using Public Deliberation to Define Patient Roles as Partners in the Diagnostic Process. November 8, 2017 St. Paul, MN: Society to Improve Diagnosis in Medicine, Maxwell School of Citizenship and Public Affairs at Syracuse University, and Jefferson Center; 2017. https://psnet.ahrq.gov/issue/cle…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45845/psn-pdf
    December 19, 2017 - You can't blame the wreck on the train. December 19, 2017 Potts JR. You can't blame the wreck on the train. Am J Surg. 2017;214(5):974-978. doi:10.1016/j.amjsurg.2016.11.046. https://psnet.ahrq.gov/issue/you-cant-blame-wreck-train Insufficient supervision can limit resident education, which may increase risks to p…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50569/psn-pdf
    October 23, 2019 - Design and implementation of a tool for pharmacists to register potential errors in prescribed medication. October 23, 2019 Frid S, Zapico V, Mansilla A, et al. Design and Implementation of a Tool for Pharmacists to Register Potential Errors in Prescribed Medication. Stud Health Technol Inform. 2019;264:581-585. d…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46811/psn-pdf
    May 17, 2018 - A surgical procedure grid for safety and operating room communication in multisite surgery. May 17, 2018 Insalaco LF, Spiegel JH. A Surgical Procedure Grid for Safety and Operating Room Communication in Multisite Surgery. JAMA Facial Plast Surg. 2018;20(3):185-186. doi:10.1001/jamafacial.2017.2049. https://psnet.a…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836825/psn-pdf
    March 30, 2022 - Antibiotic prescribing errors in patients discharged from the pediatric emergency department. March 30, 2022 LaScala EC, Monroe AK, Hall GA, et al. Antibiotic prescribing errors in patients discharged from the pediatric emergency department. Pediatr Emerg Care. 2022;38(1):e387-e392. doi:10.1097/pec.000000000000229…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35762/psn-pdf
    January 02, 2017 - Using Failure Mode and Effects Analysis for safe administration of chemotherapy to hospitalized children with cancer. January 2, 2017 Robinson DL, Heigham M, Clark J. Using Failure Mode and Effects Analysis for safe administration of chemotherapy to hospitalized children with cancer. Jt Comm J Qual Patient Saf. 20…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35332/psn-pdf
    September 21, 2005 - Are language barriers associated with serious medical events in hospitalized pediatric patients? September 21, 2005 Cohen AL. Are Language Barriers Associated With Serious Medical Events in Hospitalized Pediatric Patients? Pediatrics. 2005;116(3):575-579. doi:10.1542/peds.2005-0521. https://psnet.ahrq.gov/issue/ar…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866728/psn-pdf
    September 18, 2024 - ROI for a fall prevention intervention: invest a little, save a lot. September 18, 2024 Cooper AS. ROI for a fall prevention intervention: invest a little, save a lot. Nurs Adm Q. 2024;48(3):248- 252. doi:10.1097/naq.0000000000000647. https://psnet.ahrq.gov/issue/roi-fall-prevention-intervention-invest-little-save…

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