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psnet.ahrq.gov/node/866900/psn-pdf
October 09, 2024 - Defects in value associated with hospital-acquired
conditions: how improving quality could save U.S.
healthcare $50 billion.
October 9, 2024
Padula WV, Pronovost PJ. Defects in value associated with hospital-acquired conditions: how improving
quality could save U.S. healthcare $50 billion. J Patient Saf. 2024;20(7…
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psnet.ahrq.gov/node/45662/psn-pdf
January 23, 2017 - National trends in hospitalizations for opioid poisonings
among children and adolescents, 1997 to 2012.
January 23, 2017
Gaither JR, Leventhal JM, Ryan SA, et al. National Trends in Hospitalizations for Opioid Poisonings Among
Children and Adolescents, 1997 to 2012. JAMA Peds. 2016;170(12):1195-1201.
doi:10.1001/j…
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psnet.ahrq.gov/node/37837/psn-pdf
June 11, 2008 - Testing process errors and their harms and
consequences reported from family medicine practices: a
study of the American Academy of Family Physicians
National Research Network.
June 11, 2008
Hickner J, Graham DG, Elder NC, et al. Testing process errors and their harms and consequences
reported from family medicin…
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psnet.ahrq.gov/node/858164/psn-pdf
December 13, 2023 - Risk-adjusted cumulative sum for early detection of
hospitals with excess perioperative mortality.
December 13, 2023
Chen VW, Chidi AP, Dong Y, et al. Risk-adjusted cumulative sum for early detection of hospitals with
excess perioperative mortality. JAMA Surg. 2023;158(11):1176. doi:10.1001/jamasurg.2023.3673.
htt…
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psnet.ahrq.gov/node/60180/psn-pdf
April 01, 2020 - Incidence of wrong-site surgery list errors for a 2-year
period in a single national health service board.
April 1, 2020
Geraghty A, Ferguson L, McIlhenny C, et al. Incidence of wrong-site surgery list errors for a 2-year period
in a single national health service board. J Patient Saf. 2020;16(1):79-83.
doi:10.109…
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psnet.ahrq.gov/node/35467/psn-pdf
March 11, 2011 - The impact of electronic health records on time efficiency
of physicians and nurses: a systematic review.
March 11, 2011
Poissant L, Pereira J, Tamblyn R, et al. The impact of electronic health records on time efficiency of
physicians and nurses: a systematic review. J Am Med Inform Assoc. 2005;12(5):505-16.
https…
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psnet.ahrq.gov/node/842421/psn-pdf
January 11, 2023 - Weight and size descriptors for drug dosing: too many
options and too many errors.
January 11, 2023
Erstad BL, Romero AV, Barletta JF. Weight and size descriptors for drug dosing: Too many options and too
many errors. Am J Health Syst Pharm. 2023;80(2):87-91. doi:10.1093/ajhp/zxac283.
https://psnet.ahrq.gov/issue/…
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psnet.ahrq.gov/node/60048/psn-pdf
March 18, 2020 - 'Immunising' physicians against availability bias in
diagnostic reasoning: a randomised controlled
experiment.
March 18, 2020
Mamede S, de Carvalho-Filho MA, de Faria RMD, et al. ‘Immunising’ physicians against availability bias in
diagnostic reasoning: a randomised controlled experiment. BMJ Qual Saf. 2020;29(7):…
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psnet.ahrq.gov/node/36524/psn-pdf
May 31, 2011 - A human factors engineering paradigm for patient safety:
designing to support the performance of the healthcare
professional.
May 31, 2011
Karsh B-T, Holden RJ, Alper SJ, et al. A human factors engineering paradigm for patient safety: designing
to support the performance of the healthcare professional. Qual Saf He…
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psnet.ahrq.gov/node/846161/psn-pdf
March 15, 2023 - Ten years of online incident reporting and learning using
CPiRLS: implications for improved patient safety.
March 15, 2023
Thomas M, Swait G, Finch R. Ten years of online incident reporting and learning using CPiRLS:
implications for improved patient safety. Chiropr Man Therap. 2023;31(1):9. doi:10.1186/s12998-023-…
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psnet.ahrq.gov/node/43655/psn-pdf
December 19, 2014 - Systematic biases in group decision-making: implications
for patient safety.
December 19, 2014
Mannion R, Thompson C. Systematic biases in group decision-making: implications for patient safety. Int J
Qual Health Care. 2014;26(6):606-12. doi:10.1093/intqhc/mzu083.
https://psnet.ahrq.gov/issue/systematic-biases-gro…
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psnet.ahrq.gov/node/40128/psn-pdf
January 12, 2011 - Impact of a comprehensive safety initiative on patient-
controlled analgesia errors.
January 12, 2011
Paul JE, Bertram B, Antoni K, et al. Impact of a comprehensive safety initiative on patient-controlled
analgesia errors. Anesthesiology. 2010;113(6):1427-32. doi:10.1097/ALN.0b013e3181fcb427.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/74179/psn-pdf
January 01, 2022 - Establishing a multidisciplinary taskforce to improve
anticoagulation safety at a large health system.
December 12, 2021
Attia E, Fuentes A, Vassallo M, et al. Establishing a multidisciplinary taskforce to improve anticoagulation
safety at a large health system. Am J Health Syst Pharm. 2022;79(4):297-305. doi:10.10…
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psnet.ahrq.gov/node/50443/psn-pdf
October 09, 2019 - Medicare's Hospital-Acquired Condition Reduction
Program and community diversity in the United States:
the need to account for racial and ethnic segregation.
October 9, 2019
Hamadi H, Tafili A, Apatu E, et al. Medicare' Hospital-Acquired Condition Reduction Program and
Community Diversity in the United States: The…
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psnet.ahrq.gov/node/61092/psn-pdf
November 04, 2020 - Patient race and opioid misuse history influence provider
risk perceptions for future opioid-related problems.
November 4, 2020
Hirsh AT, Anastas TM, Miller MM, et al. Patient race and opioid misuse history influence provider risk
perceptions for future opioid-related problems. Am Psychol. 2020;75(6):784-795.
doi:…
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psnet.ahrq.gov/node/851919/psn-pdf
August 02, 2023 - A data-driven approach to evaluate barcode-assisted
medication preparation alerts at a large academic medical
center.
August 2, 2023
Joshi RN, Kalaminsky S, Feemster A-A, et al. A data-driven approach to evaluate barcode-assisted
medication preparation alerts at a large academic medical center. Jt Comm J Qual Pati…
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psnet.ahrq.gov/node/46894/psn-pdf
June 20, 2018 - Smart pump custom concentrations without hard "low
concentration" alerts can lead to patient harm.
June 20, 2018
ISMP Medication Safety Alert! Acute Care Edition. May 31, 2018;23:1-4.
https://psnet.ahrq.gov/issue/smart-pump-custom-concentrations-without-hard-low-concentration-alerts-can-
lead-patient-harm
Smart p…
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psnet.ahrq.gov/node/73159/psn-pdf
April 21, 2021 - Drug-drug interactions and prescription appropriateness
at hospital discharge: experience with COVID-19 patients.
April 21, 2021
Cattaneo D, Pasina L, Maggioni AP, et al. Drug-drug interactions and prescription appropriateness at
hospital discharge: experience with COVID-19 patients. Drugs Aging. 2021;38(4):341-346…
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psnet.ahrq.gov/node/865969/psn-pdf
May 29, 2024 - Impact of pharmacist-led interventions on medication-
related problems among patients treated for cancer: a
systematic review and meta-analysis of randomized
control trials.
May 29, 2024
Fentie AM, Huluka SA, Gebremariam GT, et al. Impact of pharmacist-led interventions on medication-
related problems among patie…
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psnet.ahrq.gov/node/42283/psn-pdf
February 27, 2014 - Finding and fixing mistakes: do checklists work for
clinicians with different levels of experience?
February 27, 2014
Sibbald M, de Bruin A, van Merrienboer JJG. Finding and fixing mistakes: do checklists work for clinicians
with different levels of experience? Adv Health Sci Educ Theory Pract. 2014;19(1):43-51.
d…