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psnet.ahrq.gov/issue/partnership-patients-pfp-hospital-engagement-network-hen-20-final-report
May 06, 2015 - Book/Report
Partnership for Patients (PfP) Hospital Engagement Network (HEN) 2.0 Final Report.
Citation Text:
Partnership for Patients (PfP) Hospital Engagement Network (HEN) 2.0 Final Report. Chicago, IL: American Hospital Association and Health Research & Educational Trust; September 2…
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psnet.ahrq.gov/issue/medication-safety-reducing-anesthesia-medication-errors-and-adverse-drug-events-dentistry
June 14, 2006 - Commentary
Medication safety: reducing anesthesia medication errors and adverse drug events in dentistry part I and II.
Citation Text:
Medication safety: reducing anesthesia medication errors and adverse drug events in dentistry part I and II. Sarasin DS, Brady JW, Stevens RL. Anesth Pro…
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psnet.ahrq.gov/node/38411/psn-pdf
December 16, 2014 - A reengineered hospital discharge program to decrease
rehospitalization: a randomized trial.
December 16, 2014
Jack BW, Chetty VK, Anthony D, et al. A reengineered hospital discharge program to decrease
rehospitalization: a randomized trial. Ann Intern Med. 2009;150(3):178-87.
https://psnet.ahrq.gov/issue/reengine…
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psnet.ahrq.gov/node/844537/psn-pdf
February 15, 2023 - Intended and unintended consequences: changes in
opioid prescribing practices for postsurgical, acute, and
chronic pain indications following two policies in North
Carolina, 2012-2018 - controlled and single-series
interrupted time series analyses.
February 15, 2023
Maierhofer CN, Ranapurwala SI, DiPrete BL, et a…
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psnet.ahrq.gov/node/46986/psn-pdf
June 27, 2018 - A multi-hospital before–after observational study using a
point-prevalence approach with an infusion safety
intervention bundle to reduce intravenous medication
administration errors.
June 27, 2018
Schnock KO, Dykes PC, Albert J, et al. A Multi-hospital Before-After Observational Study Using a Point-
Prevalence A…
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psnet.ahrq.gov/node/40766/psn-pdf
September 14, 2011 - Medicines reconciliation using a shared electronic health
care record.
September 14, 2011
Moore P, Armitage G, Wright J, et al. Medicines reconciliation using a shared electronic health care record.
J Patient Saf. 2011;7(3):148-154. doi:10.1097/PTS.0b013e31822c5bf9.
https://psnet.ahrq.gov/issue/medicines-reconcili…
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psnet.ahrq.gov/node/866055/psn-pdf
May 29, 2024 - Reducing Preventable Patient Harm Due to Retained
Surgical Items: The RSI Bundle
May 29, 2024
https://psnet.ahrq.gov/innovation/reducing-preventable-patient-harm-due-retained-surgical-items-rsi-bundle
Summary
Retained surgical items (RSIs) cause severe yet preventable patient harm. RSIs are the most common
catego…
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psnet.ahrq.gov/issue/improved-policies-and-oversight-needed-reviewing-and-reporting-providers-quality-and-safety
November 22, 2017 - Book/Report
Improved Policies and Oversight Needed for Reviewing and Reporting Providers for Quality and Safety Concerns.
Citation Text:
Improved Policies and Oversight Needed for Reviewing and Reporting Providers for Quality and Safety Concerns. Washington, DC: United States Government …
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psnet.ahrq.gov/issue/design-and-conduct-project-redde-cluster-randomized-trial-reduce-diagnostic-errors-pediatric
April 08, 2018 - Study
The design and conduct of Project RedDE: a cluster-randomized trial to reduce diagnostic errors in pediatric primary care.
Citation Text:
Bundy DG, Singh H, Stein RE, et al. The design and conduct of Project RedDE: A cluster-randomized trial to reduce diagnostic errors in pediatric…
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psnet.ahrq.gov/issue/interruptions-during-nurses-work-state-science-review
October 21, 2009 - Review
Interruptions during nurses' work: a state-of-the-science review.
Citation Text:
Hopkinson SG, Jennings BM. Interruptions during nurses' work: A state-of-the-science review. Res Nurs Health. 2013;36(1):38-53. doi:10.1002/nur.21515.
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DOI Google Sc…
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psnet.ahrq.gov/issue/health-care-associated-infections-hospitals-overview-state-reporting-programs-and-individual
June 07, 2008 - Book/Report
Health-Care-Associated Infections in Hospitals: An Overview of State Reporting Programs and Individual Hospital Initiatives to Reduce Certain Infections.
Citation Text:
Health-Care-Associated Infections in Hospitals: An Overview of State Reporting Programs and Individual Ho…
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psnet.ahrq.gov/issue/debriefing-medical-teams-12-evidence-based-best-practices-and-tips
February 15, 2011 - Commentary
Debriefing medical teams: 12 evidence-based best practices and tips.
Citation Text:
Salas E, Klein C, King HB, et al. Debriefing medical teams: 12 evidence-based best practices and tips. Jt Comm J Qual Patient Saf. 2008;34(9):518-527.
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Format:
Google…
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psnet.ahrq.gov/issue/missed-breast-cancers-us-guided-core-needle-biopsy-how-reduce-them
March 25, 2020 - Review
Missed breast cancers at US-guided core needle biopsy: how to reduce them.
Citation Text:
Youk JH, Kim E-K, Kim MJ, et al. Missed breast cancers at US-guided core needle biopsy: how to reduce them. Radiographics. 2007;27(1):79-94.
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psnet.ahrq.gov/issue/strategies-improve-patient-safety-outcome-indicator-preventing-or-reducing-falls
March 24, 2021 - Commentary
Strategies to improve the patient safety outcome indicator: preventing or reducing falls.
Citation Text:
Bright L. Strategies to improve the patient safety outcome indicator: preventing or reducing falls. Home Healthc Nurse. 2005;23(1):29-36.
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…
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psnet.ahrq.gov/issue/decreasing-errors-pediatric-continuous-intravenous-infusions
January 06, 2017 - Study
Decreasing errors in pediatric continuous intravenous infusions.
Citation Text:
Lehmann CU, Kim G, Gujral R, et al. Decreasing errors in pediatric continuous intravenous infusions. Pediatr Crit Care Med. 2006;7(3):225-30.
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psnet.ahrq.gov/issue/diagnostic-errors-pediatric-radiology
November 16, 2022 - Study
Diagnostic errors in pediatric radiology.
Citation Text:
Taylor GA, Voss SD, Melvin PR, et al. Diagnostic errors in pediatric radiology. Pediatr Radiol. 2011;41(3):327-34. doi:10.1007/s00247-010-1812-6.
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psnet.ahrq.gov/issue/story-behind-story-physician-skepticism-about-relying-clinical-information-technologies
July 14, 2010 - Study
The story behind the story: physician skepticism about relying on clinical information technologies to reduce medical errors.
Citation Text:
McAlearney AS, Chisolm DJ, Schweikhart S, et al. The story behind the story: physician skepticism about relying on clinical information tec…
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psnet.ahrq.gov/issue/nurses-behaviors-and-visual-scanning-patterns-may-reduce-patient-identification-errors
December 12, 2012 - Study
Nurses' behaviors and visual scanning patterns may reduce patient identification errors.
Citation Text:
Marquard J, Henneman PL, He Z, et al. Nurses' behaviors and visual scanning patterns may reduce patient identification errors. J Exp Psychol Appl. 2011;17(3):247-56. doi:10.1037/…
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psnet.ahrq.gov/issue/better-understanding-downsides-low-value-healthcare-could-reduce-harm
August 11, 2021 - Commentary
Better understanding the downsides of low value healthcare could reduce harm.
Citation Text:
Brownlee SM, Korenstein D. Better understanding the downsides of low value healthcare could reduce harm. BMJ. 2021;372:n117. doi:10.1136/bmj.n117.
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psnet.ahrq.gov/issue/managing-alarms-acute-care-across-life-span-electrocardiography-and-pulse-oximetry
April 01, 2019 - Organizational Policy/Guidelines
Managing Alarms in Acute Care Across the Life Span: Electrocardiography and Pulse Oximetry.
Citation Text:
Managing Alarms in Acute Care Across the Life Span: Electrocardiography and Pulse Oximetry. Crit Care Nurse. 2018;38(2):e16-e20. doi:10.4037/ccn2018…