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psnet.ahrq.gov/node/42568/psn-pdf
December 29, 2014 - Hospital readmission and parent perceptions of their
child's hospital discharge.
December 29, 2014
Berry JG, Ziniel SI, Freeman L, et al. Hospital readmission and parent perceptions of their child's hospital
discharge. Int J Qual Health Care. 2013;25(5):573-81. doi:10.1093/intqhc/mzt051.
https://psnet.ahrq.gov/iss…
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psnet.ahrq.gov/node/41847/psn-pdf
November 28, 2012 - Improving organizational climate for quality and quality of
care: does membership in a collaborative help?
November 28, 2012
Nembhard IM, Northrup V, Shaller D, et al. Improving organizational climate for quality and quality of care:
does membership in a collaborative help? Med Care. 2012;50 Suppl:S74-82.
doi:10.1…
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psnet.ahrq.gov/node/42710/psn-pdf
December 29, 2014 - Impact of electronic chemotherapy order forms on
prescribing errors at an urban medical center: results
from an interrupted time-series analysis.
December 29, 2014
Elsaid K, Truong T, Monckeberg M, et al. Impact of electronic chemotherapy order forms on prescribing
errors at an urban medical center: results from a…
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psnet.ahrq.gov/node/73364/psn-pdf
January 01, 2022 - Impact of opioid administration in the intensive care unit
and subsequent use in opioid-naïve patients.
June 9, 2021
Krancevich NM, Belfer JJ, Draper HM, et al. Impact of opioid administration in the intensive care unit and
subsequent use in opioid-naïve patients. Ann Pharmacother. 2022;56(1):52-59.
doi:10.1177/10…
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psnet.ahrq.gov/node/42047/psn-pdf
March 18, 2013 - Do you have to re-examine to reconsider your diagnosis?
Checklists and cardiac exam.
March 18, 2013
Sibbald M, de Bruin A, Cavalcanti RB, et al. Do you have to re-examine to reconsider your diagnosis?
Checklists and cardiac exam. BMJ Qual Saf. 2013;22(4):333-8. doi:10.1136/bmjqs-2012-001537.
https://psnet.ahrq.gov…
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psnet.ahrq.gov/node/47900/psn-pdf
January 01, 2021 - Is physician mentorship associated with the occurrence
of adverse patient safety events?
April 10, 2019
Harrison R, Sharma A, Lawton R, et al. Is Physician Mentorship Associated With the Occurrence of
Adverse Patient Safety Events? J Patient Saf. 2021;17(8):e1633-e1637.
doi:10.1097/PTS.0000000000000592.
https://p…
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psnet.ahrq.gov/node/866908/psn-pdf
October 09, 2024 - Risk factors for wrong-site surgery: a study of 1,166
reports of informed consent and schedule errors.
October 9, 2024
Taylor MA, Yonash RA. Risk factors for wrong-site surgery: a study of 1,166 reports of informed consent
and schedule errors. Patient Safety. 2024;6(1):1-11. doi:10.33940/001c.117084.
https://psnet…
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psnet.ahrq.gov/node/47247/psn-pdf
December 19, 2018 - Preventing central line–associated bloodstream
infections in the intensive care unit: application of high-
reliability principles.
December 19, 2018
McCraw B, Crutcher T, Polancich S, et al. Preventing Central Line-Associated Bloodstream Infections in
the Intensive Care Unit: Application of High-Reliability Princi…
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psnet.ahrq.gov/node/38891/psn-pdf
January 04, 2010 - Do calculation errors by nurses cause medication errors
in clinical practice? A literature review.
January 4, 2010
Wright K. Do calculation errors by nurses cause medication errors in clinical practice? A literature review.
Nurse Educ Today. 2010;30(1):85-97. doi:10.1016/j.nedt.2009.06.009.
https://psnet.ahrq.gov/…
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psnet.ahrq.gov/node/44609/psn-pdf
June 21, 2016 - The missing evidence: a systematic review of patients'
experiences of adverse events in health care.
June 21, 2016
Harrison R, Walton M, Manias E, et al. The missing evidence: a systematic review of patients' experiences
of adverse events in health care. Int J Qual Health Care. 2015;27(6):424-42. doi:10.1093/intqhc…
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psnet.ahrq.gov/node/857444/psn-pdf
December 06, 2023 - The relationship between nursing home staffing and
resident safety outcomes: a systematic review of reviews.
December 6, 2023
Blatter C, Osi?ska M, Simon M, et al. The relationship between nursing home staffing and resident safety
outcomes: a systematic review of reviews. Int J Nurs Stud. 2023;150:104641.
doi:10.1…
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psnet.ahrq.gov/node/38047/psn-pdf
January 31, 2011 - Single-patient rooms for safe patient-centered hospitals.
January 31, 2011
Detsky ME. Single-Patient Rooms for Safe Patient-Centered Hospitals. JAMA. 2008;300(8).
doi:10.1001/jama.300.8.954.
https://psnet.ahrq.gov/issue/single-patient-rooms-safe-patient-centered-hospitals
Providing patient-centered care continues …
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psnet.ahrq.gov/node/44103/psn-pdf
July 08, 2015 - Results of survey on pediatric medication safety—part 1
and part 2.
July 8, 2015
ISMP Medication Safety Alert! Acute Care Edition. June 4, 2015;20:1-6. July 2, 2015;20:1-5.
https://psnet.ahrq.gov/issue/results-survey-pediatric-medication-safety-part-1-and-part-2
Hospitalized children are susceptible to medication …
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psnet.ahrq.gov/issue/patient-safety-group
March 27, 2024 - Multi-use Website
The Patient Safety Group.
Save
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August 9, 2006
Development of The Patient Safety Group was motivated by the death of…
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psnet.ahrq.gov/node/45575/psn-pdf
November 09, 2016 - Developing a high value care programme from the bottom
up: a programme of faculty-resident improvement
projects targeting harmful or unnecessary care.
November 9, 2016
Stinnett-Donnelly JM, Stevens PG, Hood VL. Developing a high value care programme from the bottom up:
a programme of faculty-resident improvement p…
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psnet.ahrq.gov/node/39123/psn-pdf
April 30, 2014 - Incorrect surgical procedures within and outside of the
operating room.
April 30, 2014
Neily J, Mills PD, Eldridge N, et al. Incorrect surgical procedures within and outside of the operating room.
Arch Surg. 2009;144(11):1028-34. doi:10.1001/archsurg.2009.126.
https://psnet.ahrq.gov/issue/incorrect-surgical-proced…
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psnet.ahrq.gov/node/850931/psn-pdf
June 21, 2023 - What US hospitals are doing to prevent common device-
associated infections during the coronavirus disease
2019 (COVID-19) pandemic: results from a national survey
in the United States.
June 21, 2023
Saint S, Greene MT, Krein SL, et al. What US hospitals are doing to prevent common device-associated
infections du…
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psnet.ahrq.gov/node/46565/psn-pdf
January 23, 2019 - Closing the Loop: A Guide to Safer Ambulatory Referrals
in the EHR Era.
January 23, 2019
Institute for Healthcare Improvement, National Patient Safety Foundation. Cambridge, MA: Institute for
Healthcare Improvement; 2017.
https://psnet.ahrq.gov/issue/closing-loop-guide-safer-ambulatory-referrals-ehr-era
Missed an…
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psnet.ahrq.gov/node/42588/psn-pdf
September 18, 2013 - Cognitive debiasing; part 1 and part 2.
September 18, 2013
Croskerry P, Singhal G, Mamede S. Cognitive debiasing 1: origins of bias and theory of debiasing. BMJ
Qual Saf. 2013;22 Suppl 2:ii58-ii64. doi:10.1136/bmjqs-2012-001712.
https://psnet.ahrq.gov/issue/cognitive-debiasing-part-1-and-part-2
Experienced diagnos…
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psnet.ahrq.gov/node/72566/psn-pdf
January 01, 2021 - Incidence, nature and causes of avoidable significant
harm in primary care in England: retrospective case note
review.
December 16, 2020
Avery AJ, Sheehan C, Bell BG, et al. Incidence, nature and causes of avoidable significant harm in primary
care in England: retrospective case note review. BMJ Qual Saf. 2021;30(…