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psnet.ahrq.gov/node/40430/psn-pdf
October 18, 2011 - Eliminating CLABSI: A National Patient Safety Imperative.
October 18, 2011
Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11-
0037-1-EF.
https://psnet.ahrq.gov/issue/eliminating-clabsi-national-patient-safety-imperative
This publication reports the impact hospital p…
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psnet.ahrq.gov/node/851451/psn-pdf
July 19, 2023 - Issues and complexities in safety culture assessment in
healthcare.
July 19, 2023
Ellis LA, Falkland E, Hibbert P, et al. Issues and complexities in safety culture assessment in healthcare.
Front Public Health. 2023;11:1217542. doi:10.3389/fpubh.2023.1217542.
https://psnet.ahrq.gov/issue/issues-and-complexities-sa…
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psnet.ahrq.gov/node/39161/psn-pdf
December 09, 2009 - Medication reconciliation at an academic medical center:
implementation of a comprehensive program from
admission to discharge.
December 9, 2009
Murphy EM, Oxencis CJ, Klauck JA, et al. Medication reconciliation at an academic medical center:
implementation of a comprehensive program from admission to discharge. A…
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psnet.ahrq.gov/node/39254/psn-pdf
January 27, 2010 - Practical challenges of introducing WHO surgical
checklist: UK pilot experience.
January 27, 2010
Vats A, Vincent CA, Nagpal K, et al. Practical challenges of introducing WHO surgical checklist: UK pilot
experience. BMJ. 2010;340(jan13 2). doi:10.1136/bmj.b5433.
https://psnet.ahrq.gov/issue/practical-challenges-in…
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psnet.ahrq.gov/node/39299/psn-pdf
September 27, 2016 - Development and evaluation of an observational tool for
assessing surgical flow disruptions and their impact on
surgical performance.
September 27, 2016
Parker SEH, Laviana AA, Wadhera RK, et al. Development and evaluation of an observational tool for
assessing surgical flow disruptions and their impact on surgica…
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psnet.ahrq.gov/node/35193/psn-pdf
July 10, 2008 - Diagnostic error in internal medicine.
July 10, 2008
Graber ML, Franklin N, Gordon R. Diagnostic error in internal medicine. Arch Intern Med.
2005;165(13):1493-1499.
https://psnet.ahrq.gov/issue/diagnostic-error-internal-medicine
This study identified 100 cases of diagnostic error in internal medicine and conducte…
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psnet.ahrq.gov/node/46469/psn-pdf
October 25, 2017 - RxAwareness.
October 25, 2017
Centers for Disease Control and Prevention; CDC.
https://psnet.ahrq.gov/issue/rxawareness
The opioid crisis is a persisting patient safety problem. One approach to prevent misuse of opioids is to
raise awareness of the addictive nature of the medication. This national campaign enlists…
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psnet.ahrq.gov/node/40558/psn-pdf
May 20, 2019 - Patient Safety in the Context of Perinatal, Neonatal, and
Pediatric Care.
May 20, 2019
Eunice Kennedy Shriver National Institute of Child Health and Human Development; NICHD; National
Institutes of Health; NIH.
https://psnet.ahrq.gov/issue/patient-safety-context-perinatal-neonatal-and-pediatric-care
This dual-com…
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psnet.ahrq.gov/node/46718/psn-pdf
August 08, 2018 - Workplace Violence Prevention: Implementing Strategies
for Safer Healthcare Organizations.
August 8, 2018
Joint Commission.
https://psnet.ahrq.gov/issue/workplace-violence-prevention-implementing-strategies-safer-healthcare-
organizations
Workplace violence in health care can affect the safety of both staff and p…
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psnet.ahrq.gov/node/47765/psn-pdf
February 20, 2019 - Negative behaviours in health care: prevalence and
strategies.
February 20, 2019
Layne DM, Nemeth LS, Mueller M, et al. Negative behaviours in health care: Prevalence and strategies. J
Nurs Manag. 2019;27(1):154-160. doi:10.1111/jonm.12660.
https://psnet.ahrq.gov/issue/negative-behaviours-health-care-prevalence-an…
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psnet.ahrq.gov/node/47196/psn-pdf
October 17, 2018 - Adaptive expertise in medical decision making.
October 17, 2018
Croskerry P. Adaptive expertise in medical decision making. Med Teach. 2018;40(8):803-808.
doi:10.1080/0142159X.2018.1484898.
https://psnet.ahrq.gov/issue/adaptive-expertise-medical-decision-making
Clinical reasoning is a complex process that can be i…
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psnet.ahrq.gov/node/43734/psn-pdf
January 21, 2015 - Explicit and Standardized Prescription Medicine
Instructions.
January 21, 2015
Rockville, MD: Agency for Healthcare Research and Quality; December 2014.
https://psnet.ahrq.gov/issue/explicit-and-standardized-prescription-medicine-instructions
Standardization has been embraced as a strategy to improve health litera…
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psnet.ahrq.gov/node/60569/psn-pdf
June 10, 2020 - Workplace team resilience: a systematic review and
conceptual development.
June 10, 2020
Hartwig A, Clarke S, Johnson S, et al. Workplace team resilience: s systematic review and conceptual
development. Org Psychol Rev. 2020;10(3-4):169-200. doi:10.1177/2041386620919476.
https://psnet.ahrq.gov/issue/workplace-team…
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psnet.ahrq.gov/node/48136/psn-pdf
August 07, 2019 - Safe Practices for Drug Allergies—Using CDS and Health
IT.
August 7, 2019
Partnership for Health IT Patient Safety. Plymouth Meeting, PA: ECRI Institute; 2019.
https://psnet.ahrq.gov/issue/safe-practices-drug-allergies-using-cds-and-health-it
Inconsistent checking for and consideration of drug allergy alerts can d…
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psnet.ahrq.gov/node/60024/psn-pdf
March 11, 2020 - Artificial intelligence and surgical decision-making.
March 11, 2020
Loftus TJ, Tighe PJ, Filiberto AC, et al. Artificial intelligence and surgical decision-making. JAMA Surg.
2019;155(2):148-158. doi:10.1001/jamasurg.2019.4917.
https://psnet.ahrq.gov/issue/artificial-intelligence-and-surgical-decision-making
Arti…
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psnet.ahrq.gov/node/42902/psn-pdf
January 29, 2014 - Improving Patient Safety Through Teamwork and Team
Training.
January 29, 2014
Salas E, Frush K, eds. Oxford, UK: Oxford University Press; 2013. ISBN: 9780195399097.
https://psnet.ahrq.gov/issue/improving-patient-safety-through-teamwork-and-team-training
Health care has been recently been directed toward focusing o…
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psnet.ahrq.gov/node/866696/psn-pdf
September 11, 2024 - The Impact of Complications on Surgeons.
September 11, 2024
The Impact of Complications on Surgeons. Modi PK, Singer EA, eds. Urol Oncol. 2024;42(10):295-320.
doi:10.1016/j.urolonc.2024.05.016.
https://psnet.ahrq.gov/issue/impact-complications-surgeons
Complications and medical errors can result in psychological d…
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psnet.ahrq.gov/node/72514/psn-pdf
November 25, 2020 - AI is wrestling with a replication crisis.
November 25, 2020
Heaven WD. MIT Technology Review. November 12, 2020.
https://psnet.ahrq.gov/issue/ai-wrestling-replication-crisis
Lack of transparency of research and development processes are thought to undermine the value of
artificial intelligence (AI) and trust in i…
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psnet.ahrq.gov/node/38213/psn-pdf
November 12, 2008 - AHRQ announces interest in research on diagnostic
errors in ambulatory care settings.
November 12, 2008
Rockville, MD: Agency for Healthcare Research and Quality. Special Emphasis Notice. October 25, 2007.
Publication No. NOT-HS-08-002.
https://psnet.ahrq.gov/issue/ahrq-announces-interest-research-diagnostic-error…
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psnet.ahrq.gov/node/45835/psn-pdf
February 01, 2017 - Deploying and measuring a risk and patient safety
program.
February 1, 2017
Orel H, McGroarty M, Marchegiani H. Deploying and measuring a risk and patient safety program. J
Healthc Risk Manag. 2017;36(3):26-33. doi:10.1002/jhrm.21266.
https://psnet.ahrq.gov/issue/deploying-and-measuring-risk-and-patient-safety-pro…