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psnet.ahrq.gov/node/866348/psn-pdf
July 24, 2024 - How can interventions more directly address drivers of
unprofessional behaviour between healthcare staff?
July 24, 2024
Aunger JA, Abrams R, Mannion R, et al. How can interventions more directly address drivers of
unprofessional behaviour between healthcare staff? BMJ Open Qual. 2024;13(3):e002830.
doi:10.1136/bmj…
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psnet.ahrq.gov/node/852275/psn-pdf
January 01, 2024 - Improving emergency medicine clinician awareness of
prehospital-administered medications.
August 9, 2023
Kamta J, Fregoso B, Lee A, et al. Improving emergency medicine clinician awareness of prehospital-
administered medications. Prehosp Emerg Care. 2024;28(3):506-512.
doi:10.1080/10903127.2023.2238815.
https://p…
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psnet.ahrq.gov/node/73317/psn-pdf
May 26, 2021 - Clinical and economic impacts of explicit tools detecting
prescribing errors: a systematic review.
May 26, 2021
Farhat A, Al?Hajje A, Csajka C, et al. Clinical and economic impacts of explicit tools detecting prescribing
errors: A systematic review. J Clin Pharm Ther. 2021;46(4):877-886. doi:10.1111/jcpt.13408.
ht…
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psnet.ahrq.gov/node/45674/psn-pdf
September 29, 2017 - Pain Management and Prescription Opioid-related Harms:
Exploring the State of the Evidence: Proceedings of a
Workshop—in Brief.
September 29, 2017
Forstag EH; Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid
Abuse; Health and Medicine Division. Washington, DC: National Academy …
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psnet.ahrq.gov/node/60679/psn-pdf
July 15, 2020 - Effect on patient safety of a resident physician schedule
without 24-hour shifts.
July 15, 2020
Landrigan CP, Rahman SA, Sullivan JP, et al. Effect on patient safety of a resident physician schedule
without 24-hour shifts. N Engl J Med. 2020;382(26):2514-2523. doi:10.1056/nejmoa1900669.
https://psnet.ahrq.gov/issu…
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psnet.ahrq.gov/node/850910/psn-pdf
June 21, 2023 - Developing electronic clinical quality measures to assess
the cancer diagnostic process.
June 21, 2023
Murphy DR, Zimolzak AJ, Upadhyay DK, et al. Developing electronic clinical quality measures to assess
the cancer diagnostic process. J Am Med Inform Assoc. 2023;30(9):1526-1531.
doi:10.1093/jamia/ocad089.
https:…
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psnet.ahrq.gov/node/847534/psn-pdf
April 12, 2023 - Prevalence and causes of diagnostic errors in
hospitalized patients under investigation for COVID-19.
April 12, 2023
Auerbach AD, Astik GJ, O’Leary KJ, et al. Prevalence and causes of diagnostic errors in hospitalized
patients under investigation for COVID-19. J Gen Intern Med. 2023;38(8):1902-1910. doi:10.1007/s11…
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psnet.ahrq.gov/node/72532/psn-pdf
December 02, 2020 - Association of display of patient photographs in the
electronic health record with wrong-patient order entry
errors.
December 2, 2020
Salmasian H, Blanchfield BB, Joyce K, et al. Association of display of patient photographs in the electronic
health record with wrong-patient order entry errors. JAMA Netw Open. 202…
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psnet.ahrq.gov/node/867192/psn-pdf
November 20, 2024 - 2024 Network of Patient Safety Databases Chartbook:
Medication and Other Substance Events.
November 20, 2024
2024 Network Of Patient Safety Databases Chartbook: Medication And Other Substance Events. Rockville,
MD: Agency for Healthcare Research and Quality; 2024. AHRQ Pub. No. 24-0088
https://psnet.ahrq.gov/issue…
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psnet.ahrq.gov/node/44837/psn-pdf
February 03, 2016 - Impact of pharmacist involvement in the transitional care
of high-risk patients through medication reconciliation,
medication education, and postdischarge call-backs
(IPITCH Study).
February 3, 2016
Phatak A, Prusi R, Ward B, et al. Impact of pharmacist involvement in the transitional care of high-risk
patients t…
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psnet.ahrq.gov/node/46000/psn-pdf
April 26, 2017 - Diagnostic error in the emergency department: follow up
of patients with minor trauma in the outpatient clinic.
April 26, 2017
Moonen P-J, Mercelina L, Boer W, et al. Diagnostic error in the Emergency Department: follow up of
patients with minor trauma in the outpatient clinic. Scand J Trauma Resusc Emerg Med. 2017…
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psnet.ahrq.gov/node/845634/psn-pdf
March 08, 2023 - Compliance with and barriers to implementing the
surgical safety checklist: a mixed-methods study.
March 8, 2023
Aydin Akbuga G, Sürme Y, Esenkaya D. Compliance with and barriers to implementing the surgical safety
checklist: a mixed-methods study. AORN J. 2023;117(2):e1-e10. doi:10.1002/aorn.13861.
https://psnet.…
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psnet.ahrq.gov/node/73291/psn-pdf
May 19, 2021 - How can never event data be used to reflect or improve
hospital safety performance?
May 19, 2021
Olivarius?McAllister J, Pandit M, Sykes A, et al. How can never event data be used to reflect or improve
hospital safety performance? Anaesthesia. 2021;76(12):1616-1624. doi:10.1111/anae.15476.
https://psnet.ahrq.gov/i…
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psnet.ahrq.gov/node/851057/psn-pdf
June 28, 2023 - The burden of peri-operative work at night as perceived
by anaesthesiologists: an international survey.
June 28, 2023
Cortegiani A, Ippolito M, Lakbar I, et al. The burden of peri-operative work at night as perceived by
anaesthesiologists: an international survey. Eur J Anaesthesiol. 2023;40(5):326-333.
doi:10.109…
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psnet.ahrq.gov/node/44322/psn-pdf
June 21, 2016 - Emotional harm from disrespect: the neglected
preventable harm.
June 21, 2016
Sokol-Hessner L, Folcarelli P, Sands KEF. Emotional harm from disrespect: the neglected preventable
harm. BMJ Qual Saf. 2015;24(9):550-3. doi:10.1136/bmjqs-2015-004034.
https://psnet.ahrq.gov/issue/emotional-harm-disrespect-neglected-pre…
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psnet.ahrq.gov/node/844555/psn-pdf
February 15, 2023 - AHRQ-Funded Patient Safety Project Highlights:
Improving Healthcare Safety by Engaging Patients and
Families.
February 15, 2023
Rockville, MD: Agency for Healthcare Research and Quality; January 2023. AHRQ Pub. No.22(23)-0065-1.
https://psnet.ahrq.gov/issue/ahrq-funded-patient-safety-project-highlights-improving-h…
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psnet.ahrq.gov/node/46101/psn-pdf
January 01, 2018 - Factors associated with barcode medication
administration technology that contribute to patient
safety: an integrative review.
December 19, 2017
Strudwick G, Reisdorfer E, Warnock C, et al. Factors Associated With Barcode Medication Administration
Technology That Contribute to Patient Safety: An Integrative Review…
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psnet.ahrq.gov/node/849610/psn-pdf
May 31, 2023 - Implementation of ED I-PASS as a standardized handoff
tool in the pediatric emergency department.
May 31, 2023
Yanni E, Calaman S, Wiener E, et al. Implementation of ED I-PASS as a standardized handoff tool in the
pediatric emergency department. J Healthc Qual. 2023;45(3):140-147.
doi:10.1097/jhq.0000000000000374.…
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psnet.ahrq.gov/node/866272/psn-pdf
July 10, 2024 - Infection control measure performance in long-term care
hospitals and their relationship to Joint Commission
accreditation.
July 10, 2024
Schmaltz SP, Longo BA, Williams SC. Infection control measure performance in long-term care hospitals
and their relationship to Joint Commission accreditation. Jt Comm J Qual Pa…
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psnet.ahrq.gov/node/46739/psn-pdf
January 24, 2019 - Symptom–Disease Pair Analysis of Diagnostic Error
(SPADE): a conceptual framework and methodological
approach for unearthing misdiagnosis-related harms
using big data.
January 24, 2019
Liberman AL, Newman-Toker DE. Symptom-Disease Pair Analysis of Diagnostic Error (SPADE): a
conceptual framework and methodologica…