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psnet.ahrq.gov/node/35367/psn-pdf
July 20, 2009 - Reducing adverse events in blood transfusion.
July 20, 2009
Stainsby D, Russell J, Cohen H, et al. Reducing adverse events in blood transfusion. Br J Haematol.
2005;131(1). doi:10.1111/j.1365-2141.2005.05702.x.
https://psnet.ahrq.gov/issue/reducing-adverse-events-blood-transfusion
The authors discuss how errors ca…
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psnet.ahrq.gov/node/35787/psn-pdf
July 01, 2009 - Hospital Bed System Dimensional and Assessment
Guidance to Reduce Entrapment.
July 1, 2009
Rockville MD: Center for Devices and Radiological Health, Food and Drug Administration; 2006.
https://psnet.ahrq.gov/issue/hospital-bed-system-dimensional-and-assessment-guidance-reduce-
entrapment
This document provides ba…
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psnet.ahrq.gov/node/41883/psn-pdf
June 10, 2018 - Reduce readmissions with pharmacy programs that focus
on transitions from the hospital to the community.
June 10, 2018
ISMP Medication Safety Alert! Acute care edition. November 15, 2012;17:1-3.
https://psnet.ahrq.gov/issue/reduce-readmissions-pharmacy-programs-focus-transitions-hospital-
community
This article d…
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psnet.ahrq.gov/node/40420/psn-pdf
July 08, 2013 - Health Care Leaders Action Guide: Hospital Strategies for
Reducing Preventable Mortality.
July 8, 2013
Chicago, IL: Health Research & Educational Trust; March 2011.
https://psnet.ahrq.gov/issue/health-care-leaders-action-guide-hospital-strategies-reducing-preventable-
mortality
This report discusses steps hospita…
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psnet.ahrq.gov/node/867225/psn-pdf
December 04, 2024 - Characterization of interventions to reduce the frequency
of critical medication doses missed or delayed during
perioperative and unit-to-unit patient transfers.
December 4, 2024
Cole E, Duncan R, Grucz T, et al. Characterization of interventions to reduce the frequency of critical
medication doses missed or delay…
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psnet.ahrq.gov/node/836916/psn-pdf
April 13, 2022 - Implementing a robust process improvement program in
the neonatal intensive care unit to reduce harm.
April 13, 2022
Nether KG, Thomas EJ, Khan A, et al. Implementing a robust process improvement program in the
neonatal intensive care unit to reduce harm. J Healthc Qual. 2022;44(1):23-30.
doi:10.1097/jhq.000000000…
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psnet.ahrq.gov/node/45954/psn-pdf
December 22, 2017 - Effectiveness of a 'Do not interrupt' bundled intervention
to reduce interruptions during medication administration:
a cluster randomised controlled feasibility study.
December 22, 2017
Westbrook JI, Li L, Hooper TD, et al. Effectiveness of a 'Do not interrupt' bundled intervention to reduce
interruptions during m…
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psnet.ahrq.gov/node/47415/psn-pdf
December 05, 2018 - Blinding or information control in diagnosis: could it
reduce errors in clinical decision-making?
December 5, 2018
Lockhart JJ, Satya-Murti S. Blinding or information control in diagnosis: could it reduce errors in clinical
decision-making? Diagnosis (Berl). 2018;5(4):179-189. doi:10.1515/dx-2018-0030.
https://psn…
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psnet.ahrq.gov/node/842417/psn-pdf
January 11, 2023 - Scaling-up a pharmacist-led information technology
intervention (PINCER) to reduce hazardous prescribing in
general practices: multiple interrupted time series study.
January 11, 2023
Rodgers S, Taylor AC, Roberts SA, et al. Scaling-up a pharmacist-led information technology intervention
(PINCER) to reduce hazardo…
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psnet.ahrq.gov/node/37655/psn-pdf
September 24, 2010 - Reducing anticoagulant medication adverse events and
avoidable patient harm.
September 24, 2010
Jennings HR, Miller EC, Williams TS, et al. Reducing anticoagulant medication adverse vents and
avoidable patient harm. Jt Comm J Qual Patient Saf. 2008;34(4):196-200.
https://psnet.ahrq.gov/issue/reducing-anticoagulant…
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psnet.ahrq.gov/node/855084/psn-pdf
November 08, 2023 - Validation of a reduced set of high-performance triggers
for identifying patient safety incidents with harm in
primary care.
November 8, 2023
Garzón González G, Alonso Safont T, Conejos Míquel D, et al. Validation of a reduced set of high-
performance triggers for identifying patient safety incidents with harm in …
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psnet.ahrq.gov/node/45137/psn-pdf
May 18, 2016 - Less is more: a project to reduce the number of PIMs
(potentially inappropriate medications) on an elderly care
ward.
May 18, 2016
Aung TH, Beck AJ, Siese T, et al. Less is more: a project to reduce the number of PIMs (potentially
inappropriate medications) on an elderly care ward. BMJ Qual Improv Rep. 2016;5(1).
…
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psnet.ahrq.gov/node/45313/psn-pdf
September 27, 2016 - An acetaminophen icon helps reduce medication decision
errors in an experimental setting.
September 27, 2016
Shiffman S, Cotton H, Jessurun C, et al. An acetaminophen icon helps reduce medication decision errors in
an experimental setting. J Am Pharm Assoc (2003). 2016;56(5):495-503.e4.
doi:10.1016/j.japh.2016.04.…
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psnet.ahrq.gov/node/39637/psn-pdf
September 27, 2016 - Medication safety initiative in reducing medication errors.
September 27, 2016
Nguyen EE, Connolly PM, Wong V. Medication safety initiative in reducing medication errors. J Nurs Care
Qual. 2010;25(3):224-230.
https://psnet.ahrq.gov/issue/medication-safety-initiative-reducing-medication-errors
This study found that…
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psnet.ahrq.gov/node/41854/psn-pdf
September 24, 2016 - Reducing interruptions to improve medication safety.
September 24, 2016
Freeman R, McKee S, Lee-Lehner B, et al. Reducing interruptions to improve medication safety. J Nurs
Care Qual. 2013;28(2):176-85. doi:10.1097/NCQ.0b013e318275ac3e.
https://psnet.ahrq.gov/issue/reducing-interruptions-improve-medication-safety
…
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psnet.ahrq.gov/node/42496/psn-pdf
September 18, 2013 - Use of health information technology to reduce
diagnostic errors.
September 18, 2013
El-Kareh R, Hasan O, Schiff G. Use of health information technology to reduce diagnostic errors. BMJ Qual
Saf. 2013;22 Suppl 2:ii40-ii51. doi:10.1136/bmjqs-2013-001884.
https://psnet.ahrq.gov/issue/use-health-information-technolog…
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psnet.ahrq.gov/node/47977/psn-pdf
August 14, 2019 - Reducing Diagnostic Error: Measurement Considerations.
August 14, 2019
National Quality Forum
https://psnet.ahrq.gov/issue/reducing-diagnostic-error-measurement-considerations
This website tracks the progress of a project focused on the development and review of measures to
enhance viability, reporting, accountabi…
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psnet.ahrq.gov/node/36022/psn-pdf
July 10, 2008 - Reducing warfarin medication interactions: an interrupted
time series evaluation.
July 10, 2008
Feldstein AC, Smith DH, Perrin N, et al. Reducing warfarin medication interactions: an interrupted time
series evaluation. Arch Intern Med. 2006;166(9):1009-15.
https://psnet.ahrq.gov/issue/reducing-warfarin-medication-…
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psnet.ahrq.gov/node/40384/psn-pdf
April 20, 2011 - A "back to basics" approach to reduce ED medication
errors.
April 20, 2011
Blank FSJ, Tobin J, Macomber S, et al. A "back to basics" approach to reduce ED medication errors.
Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association.
2011;37(2):141-7. doi:10.1016/j.jen.…
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psnet.ahrq.gov/node/41294/psn-pdf
June 01, 2012 - Reducing specimen identification errors.
June 1, 2012
Rees S, Stevens L, Mikelsons D, et al. Reducing specimen identification errors. J Nurs Care Qual.
2012;27(3):253-7. doi:10.1097/NCQ.0b013e3182510303.
https://psnet.ahrq.gov/issue/reducing-specimen-identification-errors
This commentary describes a hospital safet…