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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43790/psn-pdf
    October 23, 2023 - Complaints to the Parliamentary and Health Service Ombudsman. October 23, 2023 Manchester, UK: Parliamentary and Health Service Ombudsman. https://psnet.ahrq.gov/issue/complaints-about-acute-trusts-2016-2017 The National Health Service broadly reports the results of system-level analyses and investigations into t…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/838144/psn-pdf
    September 21, 2022 - Eliminating Unintentionally Retained Surgical Items - Special Report. September 21, 2022 Saver C. AORN J. 2022;116(2):111-132. https://psnet.ahrq.gov/issue/eliminating-unintentionally-retained-surgical-items-special-report Retained surgical items (RSI) are regarded as “never events” but are a persistent cause of p…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33916/psn-pdf
    December 22, 2014 - Training of Hospital Staff To Respond to a Mass Casualty Incident. Summary, Evidence Report/Technology Assessment. December 22, 2014 Hsu EB, Jenckes MW, Catlett CL, et al. In: AHRQ Evidence Report Summaries. Rockville, MD: Agency for Healthcare Research and Quality; 1998-2005. 95. AHRQ Publication No. 04-E015-1 h…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45899/psn-pdf
    March 15, 2017 - Patient Safety: Investigating and Reporting Serious Clinical Incidents. March 15, 2017 Kelsey R. CRC Press: Boca Raton, FL; 2017. ISBN: 9781498781169. https://psnet.ahrq.gov/issue/patient-safety-investigating-and-reporting-serious-clinical-incidents Research is increasingly focusing on patient safety in primary ca…

  5. Emerging from EHR purgatory—moving from process to outcomes. | PSNet

    psnet.ahrq.gov/issue/emerging-ehr-purgatory-moving-process-outcomes
    July 22, 2020 - Commentary Emerging from EHR purgatory—moving from process to outcomes. Citation Text: Goroll AH. Emerging from EHR Purgatory - Moving from Process to Outcomes. N Engl J Med. 2017;376(21):2004-2006. doi:10.1056/NEJMp1700601. Copy Citation Format: DOI Google Scholar PubMed B…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49419/psn-pdf
    October 01, 2003 - The Other Side October 1, 2003 Vincent CA. The Other Side. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/other-side Case Objectives List the factors contributing to wrong site surgery. Understand the key components of the Universal Protocol for eliminating wrong site, wrong procedure, wrong person surger…

  7. Health Literacy | PSNet

    psnet.ahrq.gov/primer/health-literacy
    September 07, 2019 - Health Literacy Save Save to your library Print Share Facebook Twitter Linkedin Copy URL September 7, 2019 Background Health literacy is defined as an individual's ability to find, process, and comprehend the basic health information necessary…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49692/psn-pdf
    September 01, 2013 - A Picture Speaks 1000 Words September 1, 2013 Hemphill RR. A Picture Speaks 1000 Words. PSNet [internet]. 2013. https://psnet.ahrq.gov/web-mm/picture-speaks-1000-words The Case A 62-year-old man with a past medical history of hypertension, hyperlipidemia, and type A aortic dissection repair presented with chest p…

  9. Insulin dosing error in a patient with severe hyperkalemia. | PSNet

    psnet.ahrq.gov/issue/insulin-dosing-error-patient-severe-hyperkalemia
    May 06, 2020 - Commentary Insulin dosing error in a patient with severe hyperkalemia. Citation Text: Hewitt B, Barnard C, Bilimoria KY. Insulin Dosing Error in a Patient With Severe Hyperkalemia. JAMA. 2017;318(24):2485-2486. doi:10.1001/jama.2017.7964. Copy Citation Format: DOI Google Sc…

  10. Caution: coloured medication and the colour blind. | PSNet

    psnet.ahrq.gov/issue/caution-coloured-medication-and-colour-blind
    April 24, 2018 - Image/Poster Caution: coloured medication and the colour blind. Citation Text: Cole BL, Harris RW. Caution: coloured medication and the colour blind. Lancet. 2009;374(9691):720. doi:10.1016/S0140-6736(09)60313-5. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNo…

  11. A systemic methodology for risk management in healthcare sector. | PSNet

    psnet.ahrq.gov/issue/systemic-methodology-risk-management-healthcare-sector
    December 23, 2020 - Commentary A systemic methodology for risk management in healthcare sector. Citation Text: Cagliano AC, Grimaldi S, Rafele C. A systemic methodology for risk management in healthcare sector. Saf Sci. 2011;49(5). doi:10.1016/j.ssci.2011.01.006. Copy Citation Format: DOI Go…

  12. Get a clue: it can be all too easy to make assessment errors in the field; here's some tips to prevent you from making mistakes. | PSNet

    psnet.ahrq.gov/issue/get-clue-it-can-be-all-too-easy-make-assessment-errors-field-heres-some-tips-prevent-you
    May 01, 2024 - Newspaper/Magazine Article Get a clue: it can be all too easy to make assessment errors in the field; here's some tips to prevent you from making mistakes. Citation Text: Rubin M. Get a clue: It can be all too easy to make assessment errors in the field; here's some tips to prevent you …

  13. Clinical drug interactions in outpatients of a university hospital in Thailand. | PSNet

    psnet.ahrq.gov/issue/clinical-drug-interactions-outpatients-university-hospital-thailand
    September 20, 2011 - Study Clinical drug interactions in outpatients of a university hospital in Thailand. Citation Text: Janchawee B, Owatranporn T, Mahatthanatrakul W, et al. Clinical drug interactions in outpatients of a university hospital in Thailand. J Clin Pharm Ther. 2005;30(6):583-90. Copy Citat…

  14. The iatrogenic-harm cost equation and new technology. | PSNet

    psnet.ahrq.gov/issue/iatrogenic-harm-cost-equation-and-new-technology
    January 24, 2024 - Commentary The iatrogenic-harm cost equation and new technology. Citation Text: Webster CS. The iatrogenic-harm cost equation and new technology. Anaesthesia. 2005;60(9). doi:10.1111/j.1365-2044.2005.04331.x. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML …

  15. Tubing safety in the obstetric setting: preventing medication errors. | PSNet

    psnet.ahrq.gov/issue/tubing-safety-obstetric-setting-preventing-medication-errors
    November 04, 2020 - Commentary Tubing safety in the obstetric setting: preventing medication errors. Citation Text: Broussard BS. Tubing safety in the obstetric setting: preventing medication errors. Nurs Womens Health. 2009;13(2):155-158. doi:10.1111/j.1751-486X.2009.01407.x. Copy Citation Format: …

  16. Enhancing a culture of safety through disclosure of adverse events. | PSNet

    psnet.ahrq.gov/issue/enhancing-culture-safety-through-disclosure-adverse-events
    October 26, 2022 - Newspaper/Magazine Article Enhancing a culture of safety through disclosure of adverse events. Citation Text: Enhancing a culture of safety through disclosure of adverse events. Cornelissen C, Call RC, Harbell MW, et al. APSF Newsletter. February 202136(1);25-27 Copy Citati…

  17. Learning, Candour and Accountability. A Review of the Way NHS Trusts Review and Investigate the Deaths of Patients in England. | PSNet

    psnet.ahrq.gov/issue/learning-candour-and-accountability-review-way-nhs-trusts-review-and-investigate-deaths
    January 23, 2019 - Book/Report Learning, Candour and Accountability. A Review of the Way NHS Trusts Review and Investigate the Deaths of Patients in England. Citation Text: Learning, Candour and Accountability. A Review of the Way NHS Trusts Review and Investigate the Deaths of Patients in England. Newcast…

  18. Creating safe spaces in organizations to talk about safety. | PSNet

    psnet.ahrq.gov/issue/creating-safe-spaces-organizations-talk-about-safety
    March 18, 2019 - Study Creating safe spaces in organizations to talk about safety. Citation Text: Morath J, Leary M. Creating safe spaces in organizations to talk about safety. Nurs Econ. 2004;22(6):344-51, 354. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 X…

  19. Retained lumbar catheter tip. | PSNet

    psnet.ahrq.gov/issue/retained-lumbar-catheter-tip
    June 07, 2017 - Commentary Retained lumbar catheter tip. Citation Text: DeLancey JO, Barnard C, Bilimoria KY. Retained Lumbar Catheter Tip. JAMA. 2017;317(12):1269-1270. doi:10.1001/jama.2017.1713. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote …

  20. Underreporting of patient safety incidents reduces health care's ability to quantify and accurately measure harm reduction. | PSNet

    psnet.ahrq.gov/issue/underreporting-patient-safety-incidents-reduces-health-cares-ability-quantify-and-accurately
    June 08, 2011 - Commentary Underreporting of patient safety incidents reduces health care's ability to quantify and accurately measure harm reduction. Citation Text: Noble DJ, Pronovost P. Underreporting of patient safety incidents reduces health care's ability to quantify and accurately measure harm …
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