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psnet.ahrq.gov/node/855421/psn-pdf
November 15, 2023 - Informatics tools in deprescribing and medication
optimization in older adults: development and
dissemination of VIONE methodology in a high reliability
organization.
November 15, 2023
Winter SG, Sedgwick C, Wallace-Lacey A, et al. Informatics tools in deprescribing and medication
optimization in older adults: de…
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psnet.ahrq.gov/node/60528/psn-pdf
May 27, 2020 - The prevalence and impact of potentially inappropriate
prescribing among older persons in primary care
settings: multilevel meta-analysis.
May 27, 2020
Liew TM, Lee CS, Goh SKL, et al. The prevalence and impact of potentially inappropriate prescribing
among older persons in primary care settings: multilevel meta-a…
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psnet.ahrq.gov/node/50933/psn-pdf
February 26, 2020 - Medication-related harm in older adults following hospital
discharge: development and validation of a prediction
tool.
February 26, 2020
Parekh N, Ali K, Davies JG, et al. Medication-related harm in older adults following hospital discharge:
development and validation of a prediction tool. BMJ Qual Saf. 2020;29(2)…
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psnet.ahrq.gov/node/46618/psn-pdf
June 25, 2018 - Identifying quality markers of a safe surgical ward: an
interview study of patients, clinical staff, and
administrators.
June 25, 2018
Hassen Y, Singh P, Pucher PH, et al. Identifying quality markers of a safe surgical ward: An interview study
of patients, clinical staff, and administrators. Surgery. 2018;163(6):1…
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psnet.ahrq.gov/node/837027/psn-pdf
May 04, 2022 - Association of measured quality with financial health
among U.S. hospitals.
May 4, 2022
Enumah SJ, Resnick AS, Chang DC. Association of measured quality with financial health among U.S.
hospitals. PLOS ONE. 2022;17(4):e0266696. doi:10.1371/journal.pone.0266696.
https://psnet.ahrq.gov/issue/association-measured-qua…
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psnet.ahrq.gov/node/45655/psn-pdf
November 23, 2016 - Effect of US Drug Enforcement Administration's
rescheduling of hydrocodone combination analgesic
products on opioid analgesic prescribing.
November 23, 2016
Jones CM, Lurie PG, Throckmorton DC. Effect of US Drug Enforcement Administration's Rescheduling of
Hydrocodone Combination Analgesic Products on Opioid Analg…
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psnet.ahrq.gov/node/837903/psn-pdf
August 24, 2022 - The impact of drug error reduction software on
preventing harmful adverse drug events in England: a
retrospective database study.
August 24, 2022
Sutherland A, Gerrard WS, Patel A, et al. The impact of drug error reduction software on preventing
harmful adverse drug events in England: a retrospective database stud…
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psnet.ahrq.gov/node/60898/psn-pdf
September 09, 2020 - Sequential implementation of the EQUIPPED geriatric
medication safety program as a learning health system.
September 9, 2020
Vandenberg AE, Kegler M, Hastings SN, et al. Sequential implementation of the EQUIPPED geriatric
medication safety program as a learning health system. Int J Qual Health Care. 2020;32(7):470-…
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psnet.ahrq.gov/node/837632/psn-pdf
July 06, 2022 - Serious experience events: applying patient safety
concepts to improve patient experience.
July 6, 2022
Donnelly LF, Uhlhorn E, Bargmann-Losche J, et al. Serious experience events: applying patient safety
concepts to improve patient experience. J Patient Exp. 2022;9:237437352211026.
doi:10.1177/23743735221102670.
…
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psnet.ahrq.gov/node/40079/psn-pdf
December 18, 2014 - Adverse events from cough and cold medications after a
market withdrawal of products labeled for infants.
December 18, 2014
Shehab N, Schaefer MK, Kegler SR, et al. Adverse events from cough and cold medications after a market
withdrawal of products labeled for infants. Pediatrics. 2010;126(6):1100-7. doi:10.1542/p…
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psnet.ahrq.gov/node/74719/psn-pdf
February 02, 2022 - Failure to rescue following emergency surgery: a FRAM
analysis of the management of the deteriorating patient.
February 2, 2022
Sujan M, Bilbro N, Ross A, et al. Failure to rescue following emergency surgery: A FRAM analysis of the
management of the deteriorating patient. Appl Ergon. 2022;98:103608. doi:10.1016/j.a…
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psnet.ahrq.gov/node/47194/psn-pdf
August 22, 2018 - Labeling morphine milligram equivalents on opioid
packaging: a potential patient safety intervention.
August 22, 2018
Stone AB, Urman RD, Kaye AD, et al. Labeling Morphine Milligram Equivalents on Opioid Packaging: a
Potential Patient Safety Intervention. Curr Pain Headache Rep. 2018;22(7):46. doi:10.1007/s11916-01…
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psnet.ahrq.gov/node/853242/psn-pdf
September 06, 2023 - Protocolization of analgesia and sedation through smart
technology in intensive care: improving patient safety.
September 6, 2023
Ojeda IM, Sánchez-Cuervo M, Candela-Toha Á, et al. Protocolization of Analgesia and Sedation Through
Smart Technology in Intensive Care: Improving Patient Safety. Crit Care Nurs. 2023;43…
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psnet.ahrq.gov/node/867040/psn-pdf
October 30, 2024 - Preoperative multidisciplinary team huddle improves
communication and safety for unscheduled cesarean
deliveries: a system redesign using improvement science.
October 30, 2024
Girnius A, Snyder C, Czarny H, et al. Preoperative multidisciplinary team huddle improves communication
and safety for unscheduled cesarean…
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psnet.ahrq.gov/node/72790/psn-pdf
March 03, 2021 - Parent engagement in perinatal mortality reviews: an
online survey of clinicians from six high-income
countries.
March 3, 2021
Boyle FM, Horey D, Siassakos D, et al. Parent engagement in perinatal mortality reviews: an online survey
of clinicians from six high?income countries. BJOG. 2020;128(4):696-703. doi:10.11…
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psnet.ahrq.gov/node/60636/psn-pdf
July 01, 2020 - Measuring the impact of medication-related interventions
on 30-day readmission rates in a skilled nursing facility.
July 1, 2020
Amin PB, Bradford CD, Rizos AL, et al. Measuring the Impact of Medication-Related Interventions on 30-
Day Readmission Rates in a Skilled Nursing Facility. J Pharm Pract. 2020;33(3):306-3…
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psnet.ahrq.gov/node/866637/psn-pdf
September 04, 2024 - Impact of rounding checklists on the outcomes of
patients admitted to ICUs: a systematic review and meta-
analysis.
September 4, 2024
MacKinnon KM, Seshadri S, Mailman JF, et al. Impact of rounding checklists on the outcomes of patients
admitted to ICUs: a systematic review and meta-analysis. Crit Care Explor. 202…
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psnet.ahrq.gov/issue/states-targeting-reduction-infections-engagement-strive
June 12, 2024 - Special or Theme Issue
States Targeting Reduction in Infections via Engagement (STRIVE).
Citation Text:
States Targeting Reduction in Infections via Engagement (STRIVE). Ann Intern Med. 2019;171(7_Suppl):s1-s82.
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psnet.ahrq.gov/node/49541/psn-pdf
August 21, 2007 - Mark My Tooth
August 21, 2007
Smith RA. Mark My Tooth. PSNet [internet]. 2007.
https://psnet.ahrq.gov/web-mm/mark-my-tooth
The Case
A 45-year-old healthy man was scheduled to have two teeth extracted for progressive dental caries. The
patient underwent the extractions, awoke from the anesthesia, and then realized…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.398_slideshow.ppt
February 01, 2017 - PowerPoint Presentation
Spotlight
The Hazards of Distraction: Ticking All the EHR Boxes
*
Source and Credits
This presentation is based on the February 2017
AHRQ WebM&M Spotlight Case
See the full article at https://psnet.ahrq.gov/webmm
CME credit is available
Commentary by: Anthony C. Easty, PhD, Adjunct Pr…