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Preventing mistransfusions: an evaluation of institutional knowledge and a response. | PSNet

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June 06, 2018 - Study Preventing mistransfusions: an evaluation of institutional knowledge and a response. Citation Text: MacDougall N, Dong F, Broussard L, et al. Preventing Mistransfusions: An Evaluation of Institutional Knowledge and a Response. Anesth Analg. 2018;126(1):247-251. doi:10.1213/ANE.0000…

Ascension Health's demonstration of full disclosure protocol for unexpected events during labor and delivery shows promise. | PSNet

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January 22, 2017 - Study Ascension Health's demonstration of full disclosure protocol for unexpected events during labor and delivery shows promise. Citation Text: Hendrich A, McCoy CK, Gale J, et al. Ascension health's demonstration of full disclosure protocol for unexpected events during labor and deliv…

Introducing the patient safety professional: why, what, who, how, and where? | PSNet

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July 03, 2014 - Commentary Introducing the patient safety professional: why, what, who, how, and where? Citation Text: Saint S, Krein SL, Manojlovich M, et al. Introducing the patient safety professional: why, what, who, how, and where? J Patient Saf. 2011;7(4):175-80. doi:10.1097/PTS.0b013e318230e58…

Multiprofessional survey of protocol use in the intensive care unit. | PSNet

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August 30, 2017 - Study Multiprofessional survey of protocol use in the intensive care unit. Citation Text: LeBlanc JM, Kane-Gill SL, Pohlman AS, et al. Multiprofessional survey of protocol use in the intensive care unit. J Crit Care. 2012;27(6):738.e9-17. doi:10.1016/j.jcrc.2012.07.012. Copy Citation…

A review of the literature examining linkages between organizational factors, medical errors, and patient safety. | PSNet

psnet.ahrq.gov/issue/review-literature-examining-linkages-between-organizational-factors-medical-errors-and

June 24, 2010 - Review A review of the literature examining linkages between organizational factors, medical errors, and patient safety. Citation Text: Hoff T, Jameson L, Hannan E, et al. A review of the literature examining linkages between organizational factors, medical errors, and patient safety. …

Levels of reflective thinking and patient safety: an investigation of the mechanisms that impact on student learning in a single cohort over a 5 year curriculum. | PSNet

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January 30, 2013 - Study Levels of reflective thinking and patient safety: an investigation of the mechanisms that impact on student learning in a single cohort over a 5 year curriculum. Citation Text: Ambrose LJ, Ker J. Levels of reflective thinking and patient safety: an investigation of the mechanisms t…

A comparison of voluntarily reported medication errors in intensive care and general care units. | PSNet

psnet.ahrq.gov/issue/comparison-voluntarily-reported-medication-errors-intensive-care-and-general-care-units

October 26, 2010 - Study A comparison of voluntarily reported medication errors in intensive care and general care units. Citation Text: Kane-Gill SL, Kowiatek JG, Weber RJ. A comparison of voluntarily reported medication errors in intensive care and general care units. Qual Saf Health Care. 2010;19(1):5…

The importance of leadership in preventing healthcare–associated infection: results of a multisite qualitative study. | PSNet

psnet.ahrq.gov/issue/importance-leadership-preventing-healthcare-associated-infection-results-multisite

April 13, 2011 - Study The importance of leadership in preventing healthcare–associated infection: results of a multisite qualitative study. Citation Text: Saint S, Kowalski CP, Banaszak-Holl J, et al. The importance of leadership in preventing healthcare-associated infection: results of a multisite qu…

Making surgery as safe as it should be: a qualitative study. | PSNet

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July 02, 2014 - Study Making surgery as safe as it should be: a qualitative study. Citation Text: Robinson DJ, Beaumont G. Making surgery as safe as it should be: a qualitative study. Am J Med Qual. 2023;38(5):238-244. doi:10.1097/jmq.0000000000000139. Copy Citation Format: DOI Google Scho…

Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II. | PSNet

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April 18, 2012 - Study Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II. Citation Text: Garrouste-Orgeas M, Timsit JF, Vesin A, et al. Selected Medical Errors in the Intensive Care Unit. Am J Respir Crit Care Med. 2009;181(2):134-142. doi:10.1164/rccm.20…

Use of multidisciplinary rounds to simultaneously improve quality outcomes, enhance resident education, and shorten length of stay. | PSNet

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December 18, 2014 - Study Use of multidisciplinary rounds to simultaneously improve quality outcomes, enhance resident education, and shorten length of stay. Citation Text: O'Mahony S, Mazur E, Charney P, et al. Use of multidisciplinary rounds to simultaneously improve quality outcomes, enhance resident e…

Influence of state laws mandating reporting of healthcare-associated infections: the case of central line–associated bloodstream infections. | PSNet

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December 21, 2017 - Study Influence of state laws mandating reporting of healthcare-associated infections: the case of central line–associated bloodstream infections. Citation Text: Pakyz AL, Edmond MB. Influence of state laws mandating reporting of healthcare-associated infections: the case of central lin…

Review of patient safety incidents reported from critical care units in North-West England in 2009 and 2010. | PSNet

psnet.ahrq.gov/issue/review-patient-safety-incidents-reported-critical-care-units-north-west-england-2009-and-2010

December 02, 2009 - Study Review of patient safety incidents reported from critical care units in North-West England in 2009 and 2010. Citation Text: Thomas AN, Taylor RJ. Review of patient safety incidents reported from critical care units in North-West England in 2009 and 2010. Anaesthesia. 2012;67(7):7…

Hand hygiene and healthcare system change within multi-modal promotion: a narrative review. | PSNet

psnet.ahrq.gov/issue/hand-hygiene-and-healthcare-system-change-within-multi-modal-promotion-narrative-review

January 05, 2012 - Review Hand hygiene and healthcare system change within multi-modal promotion: a narrative review. Citation Text: Allegranzi B, Sax H, Pittet D. Hand hygiene and healthcare system change within multi-modal promotion: a narrative review. J Hosp Infect. 2013;83 Suppl 1:S3-10. doi:10.1016…

Rapid learning of adverse medical event disclosure and apology. | PSNet

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November 04, 2014 - Study Rapid learning of adverse medical event disclosure and apology. Citation Text: Raemer D, Locke S, Walzer TB, et al. Rapid Learning of Adverse Medical Event Disclosure and Apology. J Patient Saf. 2016;12(3):140-7. doi:10.1097/PTS.0000000000000080. Copy Citation Format: …

Understanding medical errors and adverse events in ICU patients. | PSNet

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March 20, 2015 - Commentary Understanding medical errors and adverse events in ICU patients. Citation Text: Garrouste-Orgeas M, Flaatten H, Moreno R. Understanding medical errors and adverse events in ICU patients. Intensive Care Med. 2016;42(1):107-9. doi:10.1007/s00134-015-3968-x. Copy Citation F…

Patient safety culture transformation in a children's hospital: an interprofessional approach. | PSNet

psnet.ahrq.gov/issue/patient-safety-culture-transformation-childrens-hospital-interprofessional-approach

January 16, 2010 - Study Patient safety culture transformation in a children's hospital: an interprofessional approach. Citation Text: Nagelkerk J, Peterson T, Pawl BL, et al. Patient safety culture transformation in a children's hospital: an interprofessional approach. J Interprof Care. 2014;28(4):358-64.…

Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2021. | PSNet

psnet.ahrq.gov/issue/surviving-sepsis-campaign-international-guidelines-management-sepsis-and-septic-shock-2021

September 25, 2013 - Clinical Guideline Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2021. Citation Text: Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med.…

The influence of organizational context on quality improvement and patient safety efforts in infection prevention: a multi-center qualitative study. | PSNet

psnet.ahrq.gov/issue/influence-organizational-context-quality-improvement-and-patient-safety-efforts-infection

May 08, 2017 - Study The influence of organizational context on quality improvement and patient safety efforts in infection prevention: a multi-center qualitative study. Citation Text: Krein SL, Damschroder LJ, Kowalski CP, et al. The influence of organizational context on quality improvement and pat…

Challenges in ethics, safety, best practices, and oversight regarding HIT vendors, their customers, and patients: a report of an AMIA special task force. | PSNet

psnet.ahrq.gov/issue/challenges-ethics-safety-best-practices-and-oversight-regarding-hit-vendors-their-customers

July 30, 2014 - Commentary Challenges in ethics, safety, best practices, and oversight regarding HIT vendors, their customers, and patients: a report of an AMIA special task force. Citation Text: Goodman KW, Berner ES, Dente MA, et al. Challenges in ethics, safety, best practices, and oversight regard…

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