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psnet.ahrq.gov/node/846453/psn-pdf
March 02, 2021 - The dollar or disease burden: caps on healthcare
spending may save money, but at what "cost" to
patients?
March 2, 2021
Ciarametaro M, Houghton K, Wamble D, et al. The dollar or disease burden: caps on healthcare spending
may save money, but at what "cost" to patients? Value Health. 2021;24(3):388-396.
doi:10.101…
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psnet.ahrq.gov/node/837338/psn-pdf
June 08, 2022 - Healthcare-related infections within nursing homes
(NHS): a qualitative study of care practices based on a
systemic approach.
June 8, 2022
Lefosse G, Rasero L, Bellandi T, et al. Healthcare-related infections within nursing homes (NHS): A
qualitative study of care practices based on a systemic approach. J Patient …
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psnet.ahrq.gov/node/44799/psn-pdf
July 11, 2017 - Unintended Consequences: New Problems and New
Solutions.
July 11, 2017
Lehmann CU, Sroussi B, Jaulent MC, eds. Yearb Med Inform. 2016;1:1-271.
https://psnet.ahrq.gov/issue/unintended-consequences-new-problems-and-new-solutions
Unexpected effects associated with implementation and use of health information technolo…
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psnet.ahrq.gov/node/45795/psn-pdf
May 24, 2017 - Patient Hand-Off iNitiation and Evaluation (PHONE) study:
a randomized trial of patient handoff methods.
May 24, 2017
Clanton J, Gardner A, Subichin M, et al. Patient Hand-Off iNitiation and Evaluation (PHONE) study: A
randomized trial of patient handoff methods. Am J Surg. 2017;213(2):299-306.
doi:10.1016/j.amjsu…
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psnet.ahrq.gov/node/47729/psn-pdf
April 10, 2019 - Reclaiming the systems approach to paediatric safety.
April 10, 2019
Cheung R, Roland D, Lachman P. Reclaiming the systems approach to paediatric safety. Arch Dis Child.
2019;104(12):1130-1133. doi:10.1136/archdischild-2018-316401.
https://psnet.ahrq.gov/issue/reclaiming-systems-approach-paediatric-safety
Children…
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psnet.ahrq.gov/node/44742/psn-pdf
January 06, 2016 - A piece of my mind. From shame to guilt to love.
January 6, 2016
Pronovost P, Bienvenu J. A piece of my mind. From shame to guilt to love. JAMA. 2015;314(23):2507-
2508. doi:10.1001/jama.2015.11521.
https://psnet.ahrq.gov/issue/piece-my-mind-shame-guilt-love
While numerous studies have examined the psychological i…
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psnet.ahrq.gov/node/837805/psn-pdf
August 10, 2022 - Adverse events in infants less than 6 months of age after
ambulatory surgery and diagnostic imaging requiring
anesthesia.
August 10, 2022
Uffman JC, Kim SS, Quan LN, et al. Adverse events in infants less than 6 months of age after ambulatory
surgery and diagnostic imaging requiring anesthesia. Pediatr Qual Saf. 20…
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psnet.ahrq.gov/node/60532/psn-pdf
May 27, 2020 - Improving timely recognition and treatment of sepsis in
the pediatric ICU.
May 27, 2020
Vidrine R, Zackoff M, Paff Z, et al. Improving timely recognition and treatment of sepsis in the pediatric ICU.
Jt Comm J Qual Patient Saf. 2020;46(5):299-307. doi:10.1016/j.jcjq.2020.02.005.
https://psnet.ahrq.gov/issue/improv…
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psnet.ahrq.gov/node/46575/psn-pdf
December 13, 2017 - Economic evaluation of pharmacist-led medication
reviews in residential aged care facilities.
December 13, 2017
Hasan SS, Thiruchelvam K, Kow CS, et al. Economic evaluation of pharmacist-led medication reviews in
residential aged care facilities. Expert Rev Pharmacoecon Outcomes Res. 2017;17(5):431-439.
doi:10.108…
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psnet.ahrq.gov/node/866244/psn-pdf
July 10, 2024 - Optimizing the use of dose error reduction software on
intravenous infusion pumps.
July 10, 2024
Hughes K, Cole M, Tims D, et al. Optimizing the use of dose error reduction software on intravenous
infusion pumps. Hosp Pediatr. 2024;14(6):448-454. doi:10.1542/hpeds.2023-007385.
https://psnet.ahrq.gov/issue/optimizi…
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psnet.ahrq.gov/node/837303/psn-pdf
June 01, 2022 - What is the medication iatrogenic risk in elderly
outpatients for chronic pain?
June 1, 2022
Jambon J, Choukroun C, Roux-Marson C, et al. What is the medication iatrogenic risk in elderly outpatients
for chronic pain? Clin Neuropharmacol. 2022;45(3):65-71. doi:10.1097/wnf.0000000000000505.
https://psnet.ahrq.gov/i…
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psnet.ahrq.gov/node/852451/psn-pdf
August 16, 2023 - The impact of transition to a digital hospital on
medication errors (TIME study).
August 16, 2023
Engstrom T, McCourt E, Canning M, et al. The impact of transition to a digital hospital on medication errors
(TIME study). NPJ Digit Med. 2023;6(1):133. doi:10.1038/s41746-023-00877-w.
https://psnet.ahrq.gov/issue/imp…
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psnet.ahrq.gov/node/43325/psn-pdf
September 27, 2016 - Quiet please! Drug round tabards: are they effective and
accepted? A mixed method study.
September 27, 2016
Verweij L, Smeulers M, Maaskant JM, et al. Quiet please! Drug round tabards: are they effective and
accepted? A mixed method study. J Nurs Scholarsh. 2014;46(5):340-8. doi:10.1111/jnu.12092.
https://psnet.ah…
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psnet.ahrq.gov/node/854635/psn-pdf
January 01, 2024 - CheckPOINT: a simple tool to measure Surgical Safety
Checklist implementation fidelity.
October 18, 2023
Moyal-Smith R, Etheridge JC, Turley N, et al. CheckPOINT: a simple tool to measure Surgical Safety
Checklist implementation fidelity. BMJ Qual Saf. 2024;33(4):223-231. doi:10.1136/bmjqs-2023-016030.
https://psn…
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psnet.ahrq.gov/node/837853/psn-pdf
August 17, 2022 - RaDonda Vaught, medication safety, and the profession
of pharmacy: steps to improve safety and ensure justice.
August 17, 2022
Lambert BL, Schiff GD. RaDonda Vaught, medication safety, and the profession of pharmacy: steps to
improve safety and ensure justice. J Am Coll Clin Pharm. 2022;5(9):981-987. doi:10.1002/ja…
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psnet.ahrq.gov/node/47858/psn-pdf
July 10, 2019 - Modification of potentially inappropriate prescribing
following fall-related hospitalizations in older adults.
July 10, 2019
Walsh ME, Boland F, Moriarty F, et al. Modification of potentially inappropriate prescribing following fall-
related hospitalizations in older adults. Drugs Aging. 2019;36(5):461-470. doi:10.…
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psnet.ahrq.gov/node/43472/psn-pdf
September 03, 2014 - Nighttime cross-coverage is associated with decreased
intensive care unit mortality. A single-center study.
September 3, 2014
Amaral ACK-B, Barros BS, Barros CCPP, et al. Nighttime cross-coverage is associated with decreased
intensive care unit mortality. A single-center study. Am J Respir Crit Care Med. 2014;189(1…
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psnet.ahrq.gov/node/41571/psn-pdf
October 29, 2012 - Adverse drug events caused by serious medication
administration errors.
October 29, 2012
Kale A, Keohane C, Maviglia SM, et al. Adverse drug events caused by serious medication administration
errors. BMJ Qual Saf. 2012;21(11):933-8. doi:10.1136/bmjqs-2012-000946.
https://psnet.ahrq.gov/issue/adverse-drug-events-ca…
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psnet.ahrq.gov/node/72482/psn-pdf
November 18, 2020 - Real-time debriefing after critical events: exploring the
gap between principle and reality.
November 18, 2020
Arriaga AF, Szyld D, Pian-Smith MCM. Real-time debriefing after critical events: exploring the gap between
principle and reality. Anesthesiol Clin. 2020;38(4):801-820. doi:10.1016/j.anclin.2020.08.003.
ht…
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psnet.ahrq.gov/node/844545/psn-pdf
February 15, 2023 - Providers' and patients' perspectives on diagnostic errors
in the acute care setting.
February 15, 2023
Schnock KO, Garber A, Fraser H, et al. Providers' and patients' perspectives on diagnostic errors in the
acute care setting. Jt Comm J Qual Patient Saf. 2023;49(2):89-97. doi:10.1016/j.jcjq.2022.11.009.
https://…