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psnet.ahrq.gov/node/60793/psn-pdf
August 12, 2020 - Is there a link between nursing home reported quality and
COVID-19 cases? Evidence from California skilled nursing
facilities.
August 12, 2020
He M, Li Y, Fang F. Is There a link between nursing home reported quality and COVID-19 cases? Evidence
from California skilled nursing facilities. J Am Med Dir Assoc. 2020;…
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psnet.ahrq.gov/node/60053/psn-pdf
January 01, 2021 - A review of adverse event reports from emergency
departments in the Veterans Health Administration.
March 18, 2020
Gill S, Mills PD, Watts BV, et al. A Review of Adverse Event Reports From Emergency Departments in the
Veterans Health Administration. J Patient Saf. 2021;17(8):e898-e903. doi:10.1097/pts.0000000000000…
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psnet.ahrq.gov/node/60530/psn-pdf
January 01, 2022 - A systematic review of patient-report safety climate
measures in health care.
May 27, 2020
Madden C, Lydon S, O’Dowd E, et al. A systematic review of patient-report safety climate measures in
health care. J Patient Saf. 2022;18(1):e51-e60. doi:10.1097/pts.0000000000000705.
https://psnet.ahrq.gov/issue/systematic-r…
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psnet.ahrq.gov/node/48110/psn-pdf
August 14, 2019 - The courage to speak out: a study describing nurses'
attitudes to report unsafe practices in patient care.
August 14, 2019
Cole DA, Bersick E, Skarbek A, et al. The courage to speak out: A study describing nurses' attitudes to
report unsafe practices in patient care. J Nurs Manag. 2019;27(6):1176-1181. doi:10.1111/…
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psnet.ahrq.gov/node/44483/psn-pdf
September 09, 2015 - Learning Not Blaming.
September 9, 2015
Department of Health and Social Care. London, England: Crown Publishing; July 2015. ISBN:
9781474123716.
https://psnet.ahrq.gov/issue/learning-not-blaming
The National Health Service (NHS) has a history of sharing analyses of problems in its system. This
publication contain…
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psnet.ahrq.gov/node/41245/psn-pdf
March 29, 2012 - The occurrence of wrong-site surgery self-reported by
candidates for certification by the American Board of
Orthopaedic Surgery.
March 29, 2012
James MA, Seiler JG, Harrast JJ, et al. The occurrence of wrong-site surgery self-reported by candidates
for certification by the American Board of Orthopaedic Surgery. J …
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psnet.ahrq.gov/node/38697/psn-pdf
June 10, 2009 - A report card system using error profile analysis and
concurrent morbidity and mortality review: surgical
outcome analysis, part II.
June 10, 2009
Antonacci AC, Lam S, Lavarias V, et al. A report card system using error profile analysis and concurrent
morbidity and mortality review: surgical outcome analysis, part…
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psnet.ahrq.gov/node/836760/psn-pdf
March 16, 2022 - Comprehensive Healthcare Inspection Summary Report:
Evaluation of Mental Health in Veterans Health
Administration Facilities, Fiscal Year 2020.
March 16, 2022
Washington, DC: VA Office of the Inspector General; February 17, 2022. Report No. 21-01506-76.
https://psnet.ahrq.gov/issue/comprehensive-healthcare-i…
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psnet.ahrq.gov/node/60352/psn-pdf
January 01, 2021 - Stakeholders in safety: patient reports on unsafe clinical
behaviors distinguish hospital mortality rates.
May 20, 2020
Reader TW, Gillespie A. Stakeholders in safety: patient reports on unsafe clinical behaviors distinguish
hospital mortality rates. J Appl Psychol. 2021;106(3):439-451. doi:10.1037/apl0000507.
htt…
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psnet.ahrq.gov/node/858170/psn-pdf
December 13, 2023 - Unsafe care in residential settings for older adults. A
content analysis of accreditation reports.
December 13, 2023
Hibbert PD, Ash R, Molloy CJ, et al. Unsafe care in residential settings for older adults: a content analysis
of accreditation reports. Int J Qual Health Care. 2023;35(4):mzad085. doi:10.1093/intqhc/…
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psnet.ahrq.gov/node/42999/psn-pdf
December 12, 2014 - The relationships among work stress, strain and self-
reported errors in UK community pharmacy.
December 12, 2014
Johnson SJ, O'Connor EM, Jacobs S, et al. The relationships among work stress, strain and self-reported
errors in UK community pharmacy. Res Social Adm Pharm. 2014;10(6):885-895.
doi:10.1016/j.sapharm.…
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psnet.ahrq.gov/node/47476/psn-pdf
February 13, 2019 - Facilitated self-reported anaesthetic medication errors
before and after implementation of a safety bundle and
barcode-based safety system.
February 13, 2019
Bowdle TA, Jelacic S, Nair B, et al. Facilitated self-reported anaesthetic medication errors before and after
implementation of a safety bundle and barcode-b…
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psnet.ahrq.gov/node/74109/psn-pdf
November 24, 2021 - Patient and caregiver factors in ambulatory incident
reports: a mixed-methods analysis.
November 24, 2021
Sharma AE, Huang B, Del Rosario JB, et al. Patient and caregiver factors in ambulatory incident reports: a
mixed-methods analysis. BMJ Open Qual. 2021;10(3):e001421. doi:10.1136/bmjoq-2021-001421.
https://psne…
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psnet.ahrq.gov/node/74205/psn-pdf
January 01, 2022 - Communicating certainty in pathology reports:
interpretation differences among staff pathologists,
clinicians, and residents in a multicenter study.
December 22, 2021
Gibson BA, McKinnon E, Bentley RC, et al. Communicating certainty in pathology reports: interpretation
differences among staff pathologists, clinici…
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psnet.ahrq.gov/node/36972/psn-pdf
June 16, 2019 - ISMP medication error report analysis.
June 16, 2019
Cohen MR. ISMP medication error report analysis. Hosp Pharm. 2010;42(6):498-499. doi:10.1310/hpj4206-
498.
https://psnet.ahrq.gov/issue/ismp-medication-error-report-analysis-14
This monthly selection of medication error reports includes an error averted because …
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psnet.ahrq.gov/node/36582/psn-pdf
January 14, 2011 - Paramedic self-reported medication errors.
January 14, 2011
Vilke GM, Tornabene S, Stepanski B, et al. Paramedic self-reported medication errors. Prehosp Emerg
Care. 2007;11(1):80-4.
https://psnet.ahrq.gov/issue/paramedic-self-reported-medication-errors-0
This survey found that paramedics who committed medication …
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psnet.ahrq.gov/node/36048/psn-pdf
September 27, 2010 - Can technology improve intershift report? What the
research reveals.
September 27, 2010
Strople B, Ottani P. Can Technology Improve Intershift Report? What the Research Reveals. Journal of
Professional Nursing. 2006;22(3). doi:10.1016/j.profnurs.2006.03.007.
https://psnet.ahrq.gov/issue/can-technology-improve-inte…
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psnet.ahrq.gov/node/38375/psn-pdf
December 01, 2019 - ISMP QuarterWatch Reports.
April 17, 2019
Horsham, PA: Institute for Safe Medication Practices.
https://psnet.ahrq.gov/issue/ismp-quarterwatch-reports
This website provides quarterly reports that identify and analyze new risks related to medications and
adverse drug events submitted to the Food and Drug Administra…
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psnet.ahrq.gov/issue/dont-underestimate-impact-change-risk-potential
May 02, 2018 - Newspaper/Magazine Article
Don't underestimate the impact of change on risk potential.
Citation Text:
Don't underestimate the impact of change on risk potential. ISMP Medication Safety Alert! Acute Care Edition. September 11, 2008;13:1-3.
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psnet.ahrq.gov/issue/good-you-good-us-good-everybody
October 20, 2021 - Book/Report
Good for You, Good for Us, Good for Everybody.
Citation Text:
Good for You, Good for Us, Good for Everybody. Ridge K. London, England: Crown Copyright; 2021. September 22, 2021.
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