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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/849133/psn-pdf
    May 17, 2023 - The association between patient safety culture and adverse events - a scoping review. May 17, 2023 Vikan M, Haugen AS, Bjørnnes AK, et al. The association between patient safety culture and adverse events – a scoping review. BMC Health Serv Res. 2023;23(1):300. doi:10.1186/s12913-023-09332-8. https://psnet.ahrq.go…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43465/psn-pdf
    February 18, 2015 - Hospital Readmissions Reduction Program: implications for pharmacy. February 18, 2015 Boesen KAG, Leal S, Sheehan VC, et al. Hospital Readmissions Reduction Program: implications for pharmacy. Am J Health Syst Pharm. 2015;72(3):237-44. doi:10.2146/ajhp140177. https://psnet.ahrq.gov/issue/hospital-readmissions-redu…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73476/psn-pdf
    July 07, 2021 - The role of apology laws in medical malpractice. July 7, 2021 Ross NE, Newman WJ. J Am Acad Psychiatry Law. 2021;49(3):406-414. https://psnet.ahrq.gov/issue/role-apology-laws-medical-malpractice Open disclosure of errors and adverse events is increasingly encouraged in healthcare, but clinicians frequently ci…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/849336/psn-pdf
    May 24, 2023 - AI may be on its way to your doctor’s office, but it’s not ready to see patients. May 24, 2023 Tahir D. KFF Health News. May 12, 2023. https://psnet.ahrq.gov/issue/ai-may-be-its-way-your-doctors-office-its-not-ready-see-patients Real-time use of artificial intelligence (AI) in health care settings continues to cau…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/851204/psn-pdf
    July 05, 2023 - Drugmakers are abandoning cheap generics, and now US cancer patients can’t get meds. July 5, 2023 Allen A. KFF Health News. June 21, 2023. https://psnet.ahrq.gov/issue/drugmakers-are-abandoning-cheap-generics-and-now-us-cancer-patients- cant-get-meds A variety of supply-chain, quality control, and economic factor…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44940/psn-pdf
    September 20, 2016 - Dual-process cognitive interventions to enhance diagnostic reasoning: a systematic review. September 20, 2016 Lambe KA, O'Reilly G, Kelly BD, et al. Dual-process cognitive interventions to enhance diagnostic reasoning: a systematic review. BMJ Qual Saf. 2016;25(10):808-820. doi:10.1136/bmjqs-2015-004417. https://p…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43811/psn-pdf
    July 18, 2018 - 2014 Annual Benchmarking Report: Malpractice Risks in the Diagnostic Process. July 18, 2018 Hoffman J, ed. Cambridge, MA: CRICO Strategies; 2014. https://psnet.ahrq.gov/issue/2014-annual-benchmarking-report-malpractice-risks-diagnostic-process This analysis of more than 4700 diagnosis-related malpractice claims fo…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41653/psn-pdf
    December 30, 2014 - Impact of a hospital-wide hand hygiene initiative on healthcare-associated infections: results of an interrupted time series. December 30, 2014 Kirkland KB, Homa KA, Lasky RA, et al. Impact of a hospital-wide hand hygiene initiative on healthcare- associated infections: results of an interrupted time series. BMJ Q…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47459/psn-pdf
    October 10, 2018 - People, processes, health IT and accurate patient identification. October 10, 2018 Quick Safety. October 1, 2018;(45):1-2. https://psnet.ahrq.gov/issue/people-processes-health-it-and-accurate-patient-identification This newsletter article reviews common problems related to patient identification and recommends st…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43749/psn-pdf
    December 10, 2014 - Alarm management: first things first: using reliable data to eliminate unnecessary alarms. December 10, 2014 Vanderveen T. Patient Saf Qual Healthc. November/December 2014;11:38-40,42-45. https://psnet.ahrq.gov/issue/alarm-management-first-things-first-using-reliable-data-eliminate-unnecessary- alarms Spotlightin…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73077/psn-pdf
    March 24, 2021 - Well-Being Playbook 2.0. A COVID-19 Resource for Hospital and Health System Leaders. March 24, 2021 AHA Physician Alliance. Chicago, IL: American Hospital Association. February 2021.  https://psnet.ahrq.gov/issue/well-being-playbook-20-covid-19-resource-hospital-and-health-system-leaders Human factors enginee…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46020/psn-pdf
    July 21, 2017 - Towards high-reliability organising in healthcare: a strategy for building organisational capacity. July 21, 2017 Aboumatar HJ, Weaver SJ, Rees D, et al. Towards high-reliability organising in healthcare: a strategy for building organisational capacity. BMJ Qual Saf. 2017;26(8):663-670. doi:10.1136/bmjqs-2016-00624…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42539/psn-pdf
    September 27, 2016 - Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence. September 27, 2016 Keers RN, Williams SD, Cooke J, et al. Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence. Drug Saf. 2013;36(1…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43565/psn-pdf
    March 22, 2016 - The role of failure mode and effects analysis in health care. March 22, 2016 Fibuch E, Ahmed A. The role of failure mode and effects analysis in health care. Physician Exec. 2014;40(4):28-32. https://psnet.ahrq.gov/issue/role-failure-mode-and-effects-analysis-health-care Failure mode and effects analysis (FMEA) h…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/852748/psn-pdf
    August 23, 2023 - Compliance with central line maintenance bundle and infection rates. August 23, 2023 Tripathi S, McGarvey J, Lee K, et al. Compliance with central line maintenance bundle and infection rates. Pediatrics. 2023;152(3):e2022059688. doi:10.1542/peds.2022-059688. https://psnet.ahrq.gov/issue/compliance-central-line-mai…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44378/psn-pdf
    August 05, 2015 - Advancing medication safety: establishing a National Action Plan for Adverse Drug Event Prevention. August 5, 2015 Harris Y, Hu DJ, Lee C, et al. Advancing Medication Safety: Establishing a National Action Plan for Adverse Drug Event Prevention. Jt Comm J Qual Patient Saf. 2015;41(8):351-60. https://psnet.ahrq.gov…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837040/psn-pdf
    May 04, 2022 - Use duodenoscopes with innovative designs to enhance safety: FDA Safety Communication. May 4, 2022 Silver Spring, MD: US Food and Drug Administration; April 5, 2022. https://psnet.ahrq.gov/issue/use-duodenoscopes-innovative-designs-enhance-safety-fda-safety- communication The challenge of medical device steriliza…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40598/psn-pdf
    August 10, 2011 - An inpatient fall prevention initiative in a tertiary care hospital. August 10, 2011 Weinberg J, Proske D, Szerszen A, et al. An inpatient fall prevention initiative in a tertiary care hospital. Jt Comm J Qual Patient Saf. 2011;37(7):317-325. https://psnet.ahrq.gov/issue/inpatient-fall-prevention-initiative-tertia…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45782/psn-pdf
    January 18, 2017 - Standardization of inpatient handoff communication. January 18, 2017 Jewell JA. Standardization of Inpatient Handoff Communication. Pediatrics. 2016;138(5):e20162681. doi:10.1542/peds.2016-2681. https://psnet.ahrq.gov/issue/standardization-inpatient-handoff-communication Handoffs at shift changes are vulnerable to…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39731/psn-pdf
    August 04, 2010 - Comparing errors in ED computer-assisted vs conventional pediatric drug dosing and administration. August 4, 2010 Yamamoto LG, Kanemori J. Comparing errors in ED computer-assisted vs conventional pediatric drug dosing and administration. Am J Emerg Med. 2010;28(5):588-92. doi:10.1016/j.ajem.2009.02.009. https://ps…

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