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psnet.ahrq.gov/issue/sepsis-quality-safety-net-hospitals-analysis-medicares-sep-1-performance-measure
May 05, 2021 - Study
Sepsis quality in safety-net hospitals: an analysis of Medicare's SEP-1 performance measure.
Citation Text:
Barbash IJ, Kahn JM. Sepsis quality in safety-net hospitals: An analysis of Medicare's SEP-1 performance measure. J Crit Care. 2019;54:88-93. doi:10.1016/j.jcrc.2019.08.009. …
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psnet.ahrq.gov/issue/tolerance-uncertainty-and-fears-making-mistakes-among-fifth-year-medical-students
December 09, 2020 - Study
Tolerance of uncertainty and fears of making mistakes among fifth-year medical students.
Citation Text:
Nevalainen M, Kuikka L, Sjoberg L, et al. Tolerance of uncertainty and fears of making mistakes among fifth-year medical students. Fam Med. 2012;44(4):240-6.
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psnet.ahrq.gov/issue/explaining-ethnic-disparities-patient-safety-qualitative-analysis
April 14, 2021 - Study
Explaining ethnic disparities in patient safety: a qualitative analysis.
Citation Text:
Suurmond J, Uiters E, de Bruijne M, et al. Explaining ethnic disparities in patient safety: a qualitative analysis. Am J Public Health. 2010;100 Suppl 1:S113-7. doi:10.2105/AJPH.2009.167064.
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psnet.ahrq.gov/issue/implementation-antibiotic-stewardship-program-long-term-care-facilities-across-us
July 20, 2022 - Study
Implementation of an antibiotic stewardship program in long-term care facilities across the US.
Citation Text:
doi:http://www.doi.org/10.1001/jamanetworkopen.2022.0181.
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DOI BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS
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psnet.ahrq.gov/issue/patient-access-electronic-health-records-during-hospitalization
October 19, 2022 - Study
Patient access to electronic health records during hospitalization.
Citation Text:
Pell JM, Mancuso M, Limon S, et al. Patient access to electronic health records during hospitalization. JAMA Intern Med. 2015;175(5):856-858. doi:10.1001/jamainternmed.2015.121.
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psnet.ahrq.gov/node/49508/psn-pdf
January 01, 2007 - Language Barrier
April 1, 2006
Flores G. Language Barrier. PSNet [internet]. 2006.
https://psnet.ahrq.gov/web-mm/language-barrier
The Case
A previously healthy 10-month-old girl was taken to a pediatrician's office by her monolingual Spanish-
speaking parents when they noted that their daughter had generalized we…
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psnet.ahrq.gov/web-mm/sleep-deprivation-leads-medication-error-during-spinal-epidural-anesthesia
January 29, 2021 - Sleep Deprivation Leads to Medication Error During Spinal Epidural Anesthesia
Citation Text:
Bohringer C, Osborne R. Sleep Deprivation Leads to Medication Error During Spinal Epidural Anesthesia.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human…
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psnet.ahrq.gov/node/33685/psn-pdf
May 01, 2009 - If
someone tries to restrict their privileges or requests that they not admit as frequently, they may
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psnet.ahrq.gov/web-mm/dont-pick-picc
December 01, 2011 - The groups collaborated to develop a protocol to review renal function in patients who have requests
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psnet.ahrq.gov/issue/handling-polypharmacy-qualitative-study-using-focus-group-interviews-older-patients-their
August 03, 2022 - Study
Handling polypharmacy--a qualitative study using focus group interviews with older patients, their relatives, and healthcare professionals.
Citation Text:
Mikkelsen TH, Søndergaard J, Kjaer NK, et al. Handling polypharmacy –a qualitative study using focus group interviews with olde…
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psnet.ahrq.gov/issue/how-house-officers-cope-their-mistakes
June 26, 2015 - Study
Classic
How house officers cope with their mistakes.
Citation Text:
Wu AW, Folkman S, McPhee SJ, et al. How house officers cope with their mistakes. West J Med. 1993;159(5):565-569.
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psnet.ahrq.gov/issue/building-ambulatory-safety-program-academic-health-system
April 22, 2016 - Commentary
Building an ambulatory safety program at an academic health system.
Citation Text:
Desai S, Fiumara K, Kachalia A. Building an Ambulatory Safety Program at an Academic Health System. J Patient Saf. 2021;17(2):e84-e90. doi:10.1097/PTS.0000000000000594.
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Forma…
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psnet.ahrq.gov/issue/anybody-list-youre-more-worried-about-qualitative-analysis-exploring-functions-questions
January 22, 2016 - Study
"Anybody on this list that you're more worried about?" Qualitative analysis exploring the functions of questions during end of shift handoffs.
Citation Text:
O'Brien CM, Flanagan ME, Bergman AA, et al. "Anybody on this list that you're more worried about?" Qualitative analysis expl…
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psnet.ahrq.gov/web-mm/triaging-interhospital-transfers
April 12, 2023 - SPOTLIGHT CASE
Triaging Interhospital Transfers
Citation Text:
Mueller SK. Triaging Interhospital Transfers. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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psnet.ahrq.gov/issue/systematic-narrative-review-coroners-prevention-future-deaths-reports-pfds-tool-patient
October 19, 2022 - Review
A systematic narrative review of coroners’ Prevention of Future Deaths reports (PFDs): a tool for patient safety in hospitals.
Citation Text:
Bremner BT, Heneghan CJ, Aronson JK, et al. A systematic narrative review of coroners’ Prevention of Future Deaths reports (PFDs): a tool f…
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psnet.ahrq.gov/issue/high-risk-medication-errors-insight-uk-national-reporting-and-learning-system
January 12, 2022 - Study
High-risk medication errors: insight from the UK National Reporting and Learning System.
Citation Text:
Alrowily A, Alfaraidy K, Almutairi S, et al. High-risk medication errors: Insight from the UK National Reporting and learning system. Explor Res Clin Soc Pharm. 2025;17:100531. d…
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psnet.ahrq.gov/issue/our-pharmacy-meeting-patients-needs-pharmacy-health-literacy-assessment-tool-users-guide
December 24, 2008 - Measurement Tool/Indicator
Is Our Pharmacy Meeting Patients' Needs? A Pharmacy Health Literacy Assessment Tool User's Guide.
Citation Text:
Is Our Pharmacy Meeting Patients' Needs? A Pharmacy Health Literacy Assessment Tool User's Guide. Jacobson KL, Gazmararian JA, Kripalani S, et a…
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psnet.ahrq.gov/issue/partnering-patients-and-families-design-patient-and-family-centered-health-care-system
November 29, 2017 - Meeting/Conference Proceedings
Classic
Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices.
Citation Text:
Partnering with Patients and Families to Design a Patient- and Famil…
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psnet.ahrq.gov/issue/framework-classifying-patient-safety-practices-results-expert-consensus-process
September 20, 2011 - Study
A framework for classifying patient safety practices: results from an expert consensus process.
Citation Text:
Dy SM, Taylor SL, Carr LH, et al. A framework for classifying patient safety practices: results from an expert consensus process. BMJ Qual Saf. 2011;20(7):618-24. doi:10…
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psnet.ahrq.gov/issue/advancing-medication-safety-establishing-national-action-plan-adverse-drug-event-prevention
September 29, 2017 - Commentary
Advancing medication safety: establishing a National Action Plan for Adverse Drug Event Prevention.
Citation Text:
Harris Y, Hu DJ, Lee C, et al. Advancing Medication Safety: Establishing a National Action Plan for Adverse Drug Event Prevention. Jt Comm J Qual Patient Saf. 201…