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psnet.ahrq.gov/node/46155/psn-pdf
December 21, 2017 - A national implementation project to prevent catheter-
associated urinary tract infection in nursing home
residents.
December 21, 2017
Mody L, Greene T, Meddings J, et al. A National Implementation Project to Prevent Catheter-Associated
Urinary Tract Infection in Nursing Home Residents. JAMA Intern Med. 2017;177(8…
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psnet.ahrq.gov/issue/society-improve-diagnosis-medicine
March 27, 2019 - Multi-use Website
Society to Improve Diagnosis in Medicine.
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August 1, 2024
The Society to Improve Diagnosis in Medicine (SIDM) was…
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psnet.ahrq.gov/node/47547/psn-pdf
February 13, 2019 - Prevention of prescription opioid misuse and projected
overdose deaths in the United States.
February 13, 2019
Chen Q, Larochelle MR, Weaver DT, et al. Prevention of Prescription Opioid Misuse and Projected
Overdose Deaths in the United States. JAMA Netw Open. 2019;2(2):e187621.
doi:10.1001/jamanetworkopen.2018.76…
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psnet.ahrq.gov/issue/african-partnerships-patient-safety
April 30, 2024 - Multi-use Website
African Partnerships for Patient Safety.
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November 11, 2009
This Web site establishes a forum for hospitals in E…
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psnet.ahrq.gov/node/38118/psn-pdf
October 01, 2019 - Preventing errors relating to commonly used
anticoagulants.
December 23, 2016
Preventing errors relating to commonly used anticoagulants. Sentinel Event Alert. 2008;41(41):1-4.
https://psnet.ahrq.gov/issue/preventing-errors-relating-commonly-used-anticoagulants
Anticoagulant therapies such as heparin and warfarin …
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psnet.ahrq.gov/node/73156/psn-pdf
April 21, 2021 - Increasing naloxone prescribing in the emergency
department through education and electronic medical
record work-aids.
April 21, 2021
Funke M, Kaplan MC, Glover H, et al. Increasing naloxone prescribing in the emergency department
through education and electronic medical record work-aids. Jt Comm J Qual Patient Sa…
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psnet.ahrq.gov/node/74178/psn-pdf
December 15, 2021 - Strategies to Improve Patient Safety: Final Report to
Congress Required by the Patient Safety and Quality
Improvement Act of 2005.
December 15, 2021
Rockville, MD: Agency for Healthcare Research and Quality; December 2021. AHRQ Publication No. 22-
0009.
https://psnet.ahrq.gov/issue/strategies-improve-patient-safe…
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psnet.ahrq.gov/node/45488/psn-pdf
April 24, 2018 - National trends in safety performance of electronic health
record systems in children's hospitals.
April 24, 2018
Chaparro JD, Classen D, Danforth M, et al. National trends in safety performance of electronic health
record systems in children's hospitals. J Am Med Inform Assoc. 2017;24(2):268-274.
doi:10.1093/jami…
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psnet.ahrq.gov/node/47092/psn-pdf
October 13, 2018 - Organizational response to known medical errors: does
peer review protection impede improvement?
October 13, 2018
Wenner WJ, Choi SW. Organizational Response to Known Medical Errors: Does Peer Review Protection
Impede Improvement? Am J Med Qual. 2018;33(5):552-553. doi:10.1177/1062860618769429.
https://psnet.ahrq.…
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psnet.ahrq.gov/node/46615/psn-pdf
January 23, 2019 - The surgical safety checklist and patient outcomes after
surgery: a prospective observational cohort study,
systematic review and meta-analysis.
January 23, 2019
Abbott TEF, Ahmad T, Phull MK, et al. The surgical safety checklist and patient outcomes after surgery: a
prospective observational cohort study, systema…
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psnet.ahrq.gov/node/41010/psn-pdf
November 26, 2014 - Preventing hospital-acquired infections: a national survey
of practices reported by U.S. hospitals in 2005 and 2009.
November 26, 2014
Krein SL, Kowalski CP, Hofer TP, et al. Preventing hospital-acquired infections: a national survey of
practices reported by U.S. hospitals in 2005 and 2009. J Gen Intern Med. 2012;2…
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psnet.ahrq.gov/node/43766/psn-pdf
September 26, 2016 - Driven to distraction: a prospective controlled study of a
simulated ward round experience to improve patient
safety teaching for medical students.
September 26, 2016
Thomas I, Nicol L, Regan L, et al. Driven to distraction: a prospective controlled study of a simulated ward
round experience to improve patient saf…
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psnet.ahrq.gov/node/46484/psn-pdf
August 20, 2018 - Defining and measuring diagnostic uncertainty in
medicine: a systematic review.
August 20, 2018
Bhise V, Rajan SS, Sittig DF, et al. Defining and Measuring Diagnostic Uncertainty in Medicine: A
Systematic Review. J Gen Intern Med. 2018;33(1):103-115. doi:10.1007/s11606-017-4164-1.
https://psnet.ahrq.gov/issue/defi…
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psnet.ahrq.gov/node/47579/psn-pdf
December 12, 2018 - A prescription for enhancing electronic prescribing
safety.
December 12, 2018
Schiff G, Mirica MM, Dhavle AA, et al. A Prescription For Enhancing Electronic Prescribing Safety. Health
Aff (Millwood). 2018;37(11):1877-1883. doi:10.1377/hlthaff.2018.0725.
https://psnet.ahrq.gov/issue/prescription-enhancing-electroni…
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psnet.ahrq.gov/node/39210/psn-pdf
January 12, 2010 - Can aviation-based team training elicit sustainable
behavioral change?
January 12, 2010
Sax HC, Browne P, Mayewski RJ, et al. Can aviation-based team training elicit sustainable behavioral
change? Arch Surg. 2009;144(12):1133-1137. doi:10.1001/archsurg.2009.207.
https://psnet.ahrq.gov/issue/can-aviation-based-team…
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psnet.ahrq.gov/node/41924/psn-pdf
April 05, 2013 - Disclosure-and-resolution programs that include
generous compensation offers may prompt a complex
patient response.
April 5, 2013
Murtagh L, Gallagher TH, Andrew P, et al. Disclosure-and-resolution programs that include generous
compensation offers may prompt a complex patient response. Health Aff (Millwood). 2012…
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psnet.ahrq.gov/node/37791/psn-pdf
September 29, 2017 - Controversy and quality improvement: lingering
questions about ethics, oversight, and patient safety
research.
September 29, 2017
Kass N, Pronovost P, Sugarman J, et al. Controversy and quality improvement: lingering questions about
ethics, oversight, and patient safety research. Jt Comm J Qual Patient Saf. 2008;3…
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psnet.ahrq.gov/node/43002/psn-pdf
March 12, 2014 - Exposure to media information about a disease can cause
doctors to misdiagnose similar-looking clinical cases.
March 12, 2014
Schmidt HG, Mamede S, Van den Berge K, et al. Exposure to media information about a disease can
cause doctors to misdiagnose similar-looking clinical cases. Acad Med. 2014;89(2):285-91.
doi…
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psnet.ahrq.gov/node/60229/psn-pdf
April 15, 2020 - Factors associated with mental health outcomes among
health care workers exposed to coronavirus disease 2019.
April 15, 2020
Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers
exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976.
doi:10.1001/jaman…
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psnet.ahrq.gov/node/42816/psn-pdf
October 31, 2014 - Rates of medical errors and preventable adverse events
among hospitalized children following implementation of
a resident handoff bundle.
October 31, 2014
Starmer AJ, Sectish TC, Simon DW, et al. Rates of medical errors and preventable adverse events among
hospitalized children following implementation of a reside…