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psnet.ahrq.gov/node/41617/psn-pdf
August 22, 2012 - Medical devices and patient safety.
August 22, 2012
Mattox E. Medical devices and patient safety. Crit Care Nurse. 2012;32(4):60-8. doi:10.4037/ccn2012925.
https://psnet.ahrq.gov/issue/medical-devices-and-patient-safety
This commentary discusses errors associated with medical device use in intensive care environmen…
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psnet.ahrq.gov/node/41691/psn-pdf
September 19, 2012 - Events associated with the prescribing, dispensing, and
administering of medication loading doses.
September 19, 2012
Carson SL, Gaunt MJ. PA-PSRS Patient Saf Advis. 2012;9:82-88.
https://psnet.ahrq.gov/issue/events-associated-prescribing-dispensing-and-administering-medication-
loading-doses
This article discuss…
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psnet.ahrq.gov/node/35954/psn-pdf
August 02, 2010 - Decreasing errors in pediatric continuous intravenous
infusions.
August 2, 2010
Lehmann CU, Kim G, Gujral R, et al. Decreasing errors in pediatric continuous intravenous infusions.
Pediatr Crit Care Med. 2006;7(3):225-30.
https://psnet.ahrq.gov/issue/decreasing-errors-pediatric-continuous-intravenous-infusions
Th…
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psnet.ahrq.gov/training-catalog/niosh-training-nurses-shift-work-and-long-work-hours
June 23, 2025 - NIOSH Training for Nurses on Shift Work and Long Work Hours
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Organization:
Organization
National Institute for Occupational Safety and Health (…
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psnet.ahrq.gov/node/42959/psn-pdf
February 19, 2014 - A mislabeling event with batched drugs: the unintended
consequences of practice changes.
February 19, 2014
ISMP Medication Safety Alert! Acute Care Edition. 2014;19:1-3.
https://psnet.ahrq.gov/issue/mislabeling-event-batched-drugs-unintended-consequences-practice-changes
This newsletter article describes how…
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psnet.ahrq.gov/node/40813/psn-pdf
July 19, 2017 - How to develop an effective obstetric checklist.
July 19, 2017
Fausett B, Propst A, Van Doren K, et al. How to develop an effective obstetric checklist. Am J Obstet
Gynecol. 2011;205(3):165-70. doi:10.1016/j.ajog.2011.06.003.
https://psnet.ahrq.gov/issue/how-develop-effective-obstetric-checklist
This commentary di…
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psnet.ahrq.gov/node/42176/psn-pdf
April 17, 2013 - Checklists improve experts' diagnostic decisions.
April 17, 2013
Sibbald M, de Bruin A, van Merrienboer JJG. Checklists improve experts' diagnostic decisions. Med Educ.
2013;47(3):301-8. doi:10.1111/medu.12080.
https://psnet.ahrq.gov/issue/checklists-improve-experts-diagnostic-decisions
Checklists have recently be…
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psnet.ahrq.gov/node/37565/psn-pdf
February 27, 2008 - Effect of pharmacists on medication errors in an
emergency department.
February 27, 2008
Brown JN, Barnes CL, Beasley B, et al. Effect of pharmacists on medication errors in an emergency
department. Am J Health Syst Pharm. 2008;65(4):330-3. doi:10.2146/ajhp070391.
https://psnet.ahrq.gov/issue/effect-pharmacists-me…
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psnet.ahrq.gov/node/40521/psn-pdf
June 14, 2011 - Johns Hopkins receives $10 million to open patient safety
institute.
June 14, 2011
Cohn M. Baltimore Sun. May 27, 2011:A1.
https://psnet.ahrq.gov/issue/johns-hopkins-receives-10-million-open-patient-safety-institute
This newspaper article reports on plans to develop the Armstrong Institute for Patient Safety…
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psnet.ahrq.gov/node/39693/psn-pdf
July 21, 2010 - Learning accountability for patient outcomes.
July 21, 2010
Pronovost P. Learning accountability for patient outcomes. JAMA. 2010;304(2):204-5.
doi:10.1001/jama.2010.979.
https://psnet.ahrq.gov/issue/learning-accountability-patient-outcomes
This commentary discusses efforts to reduce central line blood stream infe…
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psnet.ahrq.gov/node/39272/psn-pdf
February 03, 2010 - Patient safety and diagnostic error: tips for your next
shift.
February 3, 2010
Sinclair D, Croskerry P. Patient safety and diagnostic error: tips for your next shift. Can Fam Physician.
2010;56(1):28-30.
https://psnet.ahrq.gov/issue/patient-safety-and-diagnostic-error-tips-your-next-shift
Through case examples, …
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psnet.ahrq.gov/node/34621/psn-pdf
September 27, 2017 - Human Factors and Medical Devices.
September 27, 2017
Center for Devices and Radiological Health, US Food and Drug Administration.
https://psnet.ahrq.gov/issue/human-factors-and-medical-devices
Human factors engineering (HFE) helps improve human performance and reduce the risks associated with
use error. The U.S. …
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psnet.ahrq.gov/node/36146/psn-pdf
February 05, 2019 - Guidelines for Design and Construction.
February 5, 2019
St Louis, Missouri; Facilities Guidelines Institute; 2018.
https://psnet.ahrq.gov/issue/guidelines-design-and-construction
These updated guidelines include design changes, such as the adoption of private rooms to reduce
medical error, interruptions, and hosp…
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psnet.ahrq.gov/node/37173/psn-pdf
January 02, 2017 - Eliminating adverse drug events at Ascension Health.
January 2, 2017
Butler K, Mollo P, Gale JL, et al. Eliminating adverse drug events at Ascension Health. Jt Comm J Qual
Patient Saf. 2007;33(9):527-36.
https://psnet.ahrq.gov/issue/eliminating-adverse-drug-events-ascension-health
The authors describe an initiativ…
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psnet.ahrq.gov/node/36312/psn-pdf
October 26, 2010 - The intensive care unit, patient safety, and the Agency for
Healthcare Research and Quality.
October 26, 2010
Clancy CM. The intensive care unit, patient safety, and the Agency for Healthcare Research and Quality.
Am J Med Qual. 2006;21(5):348-51.
https://psnet.ahrq.gov/issue/intensive-care-unit-patient-safety-and…
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psnet.ahrq.gov/node/42600/psn-pdf
September 18, 2013 - Oral medications inadvertently given via the intravenous
route.
September 18, 2013
Shah-Mohammadi AR, Gaunt MJ. PA-PSRS Patient Saf Advis. September 2013;10:85-91.
https://psnet.ahrq.gov/issue/oral-medications-inadvertently-given-intravenous-route
Analyzing data submitted to the Pennsylvania Patient Safety Reporti…
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digital.ahrq.gov/principal-investigator/pak-theodore-r
January 01, 2023 - Pak, Theodore R.
Identifying Sepsis Phenotypes Associated with Antibiotic-Resistant Pathogens Using Large Language Models and Machine Learning
Description
This research uses large language models and machine learning to retrospectively analyze electronic health records of pat…
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digital.ahrq.gov/principal-investigator/wang-hsin-hsiao-scott
January 01, 2023 - Wang, Hsin-Hsiao Scott
Machine-Learning Prediction Model for Personalized Urinary Tract Infection Care in Children
Description
The study will develop and implement a validated machine learning model to optimize voiding cystourethrogram timing and use for diagnosing vesicourete…
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digital.ahrq.gov/program/national-center-excellence-primary-care-research-center-evidence-and-practice-improvement
January 01, 2023 - National Center for Excellence in Primary Care Research, Center for Evidence and Practice Improvement
Program Link: https://www.ahrq.gov/ncepcr/index.html
Assessing the Effects of EHR Optimization Interventions in Primary Care
Description
This research…
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effectivehealthcare.ahrq.gov/sites/default/files/diabetes-horizon-scan-high-impact-1506.pdf
June 01, 2015 - In LAGB, a surgeon
reversibly reduces stomach size by placing a band around the upper part of the stomach … “The preliminary data
show that the MiniMed 530G with Enlite system improves glycemic control and reduces