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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47367/psn-pdf
    October 15, 2018 - Themed Issue on Innovations in Medication Safety. October 15, 2018 Kane-Gill SL. Innovations in Medication Safety: Services and Technologies to Enhance the Understanding and Prevention of Adverse Drug Reactions. Pharmacotherapy. 2018;38(8):782-784. doi:10.1002/phar.2154. https://psnet.ahrq.gov/issue/themed-issue-i…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47279/psn-pdf
    July 23, 2018 - No Place Like Home: Advancing the Safety of Care in the Home. July 23, 2018 Boston, MA: Institute for Healthcare Improvement; 2018. https://psnet.ahrq.gov/issue/no-place-home-advancing-safety-care-home The home care setting harbors unique challenges to patient safety. This report builds on a previous evidence ass…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46861/psn-pdf
    February 28, 2018 - Special K with no license to kill: accidental ketamine overdose on induction of general anesthesia. February 28, 2018 Warner LL, Smischney N. Accidental Ketamine Overdose on Induction of General Anesthesia. Am J Case Rep. 2018;19:10-12. https://psnet.ahrq.gov/issue/special-k-no-license-kill-accidental-ketamine-ove…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44664/psn-pdf
    May 30, 2016 - Ventilator-related adverse events: a taxonomy and findings from 3 incident reporting systems. May 30, 2016 Pham JC, Williams TL, Sparnon EM, et al. Ventilator-Related Adverse Events: A Taxonomy and Findings From 3 Incident Reporting Systems. Respir Care. 2016;61(5):621-31. doi:10.4187/respcare.04151. https://psnet…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47924/psn-pdf
    June 05, 2019 - Effect of a central call center on employee perceptions of safety culture within community pharmacies in an academic health system. June 5, 2019 Bowden A, Mullin S, Tak C, et al. Effect of a central call center on employee perceptions of safety culture within community pharmacies in an academic health system. Am J…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44422/psn-pdf
    November 17, 2017 - Stop the noise: a quality improvement project to decrease electrocardiographic nuisance alarms. November 17, 2017 Sendelbach S, Wahl S, Anthony A, et al. Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms. Crit Care Nurse. 2015;35(4):15-22; quiz 1p following 22. doi:10.4…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44536/psn-pdf
    November 11, 2015 - Healthcare system intervention for safer use of medicines in elderly patients in primary care—a qualitative study of the participants' perceptions of self-assessment, peer review, feedback and agreement for change. November 11, 2015 Lenander C, Bondesson Å, Midlöv P, et al. Healthcare system intervention for safer…
  8. psnet.ahrq.gov/innovations
    February 26, 2025 - Innovations The PSNet Innovations page highlights pioneering advances that can improve patient safety. PSNet innovations are defined as “new or updated interventions, approaches, systems, tools, policies, organizational structures or business models implemented to improve or enhance quality of care and reduce harm.” …
  9. psnet.ahrq.gov/primer/covid-19-team-and-human-factors-improve-safety
    September 15, 2024 - COVID-19: Team and Human Factors to Improve Safety Citation Text: Zipperer L. COVID-19: Team and Human Factors to Improve Safety. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2020. Copy Citation Format: Google Scholar…
  10. psnet.ahrq.gov/primer/deprescribing-patient-safety-strategy
    December 15, 2024 - Deprescribing as a Patient Safety Strategy Citation Text: Takhar S, Nelson N. Deprescribing as a Patient Safety Strategy. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2021. Copy Citation Format: Google Scholar BibTeX …
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/845652/psn-pdf
    March 14, 2023 - Controlled substance drug diversion by healthcare workers as a threat to patient safety. March 14, 2023 ISMP Medication Safety Alert! Acute care edition. February 23, 2023;28(4):1-4; March 9, 2023:28(5):1-4. https://psnet.ahrq.gov/issue/controlled-substance-drug-diversion-healthcare-workers-threat-patient-safety D…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73471/psn-pdf
    July 07, 2021 - Rapid response teams as a patient safety practice for failure to rescue. July 7, 2021 Fischer CP, Bilimoria KY, Ghaferi AA. Rapid Response Teams as a Patient Safety Practice for Failure to Rescue. JAMA. 2021;326(2):179-180. doi:10.1001/jama.2021.7510. https://psnet.ahrq.gov/issue/rapid-response-teams-patient-safet…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47331/psn-pdf
    October 17, 2018 - Description and factors associated with missed nursing care in an acute care community hospital. October 17, 2018 Duffy JR, Culp S, Padrutt T. Description and factors associated with missed nursing care in an acute care community hospital. J Nurs Adm. 2018;48(7-8):361-367. doi:10.1097/NNA.0000000000000630. https:/…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/851065/psn-pdf
    June 28, 2023 - Patient safety of perioperative medication through the lens of digital health and artificial intelligence. June 28, 2023 Ye J. Patient safety of perioperative medication through the lens of digital health and artificial intelligence. JMIR Periop Med. 2023;6:e34453. doi:10.2196/34453. https://psnet.ahrq.gov/issue/p…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47148/psn-pdf
    June 25, 2018 - Necessity for a pathway for "high-alert" patients. June 25, 2018 Shane R, Amer K, Noh L, et al. Necessity for a pathway for "high-alert" patients. Am J Health Syst Pharm. 2018;75(13):993-997. doi:10.2146/ajhp170397. https://psnet.ahrq.gov/issue/necessity-pathway-high-alert-patients Medication errors can contribute…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/838081/psn-pdf
    September 14, 2022 - Medication dosage calculation among nursing students: does digital technology make a difference? A literature review. September 14, 2022 Stake-Nilsson K, Almstedt M, Fransson G, et al. Medication dosage calculation among nursing students: does digital technology make a difference? A literature review. BMC Nurs. 20…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45650/psn-pdf
    December 14, 2016 - Are physicians safely prescribing opioids for chronic noncancer pain? A systematic review of current evidence. December 14, 2016 Tournebize J, Gibaja V, Muszczak A, et al. Are Physicians Safely Prescribing Opioids for Chronic Noncancer Pain? A Systematic Review of Current Evidence. Pain Pract. 2016;16(3):370-83. d…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73566/psn-pdf
    August 04, 2021 - Personal formularies of primary care physicians across 4 health care systems. August 4, 2021 Galanter W, Eguale T, Gellad WF, et al. Personal formularies of primary care physicians across 4 health care systems. JAMA Netw Open. 2021;4(7):e2117038. doi:10.1001/jamanetworkopen.2021.17038. https://psnet.ahrq.gov/issue…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47783/psn-pdf
    April 10, 2019 - An IDEA: safety training to improve critical thinking by individuals and teams. April 10, 2019 Browne AM, Deutsch ES, Corwin K, et al. An IDEA: Safety Training to Improve Critical Thinking by Individuals and Teams. Am J Med Qual. 2019;34(6):569-576. doi:10.1177/1062860618820687. https://psnet.ahrq.gov/issue/idea-s…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47542/psn-pdf
    January 16, 2019 - Utilizing a Systems and Design Thinking Approach for Improving Well-Being Within Health Professional Education and Health Care. January 16, 2019 Kreitzer MJ, Carter K, Coffey DS, et al. NAM Perspectives. Washington, DC: National Academy of Medicine; 2019. https://psnet.ahrq.gov/issue/utilizing-systems-and-design-…

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