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Showing results for "review of reported cases".

81. Review of medication error sources associated with inpatient subcutaneous insulin: recommendations for safe and cost-effective dispensing practices. | PSNet
    psnet.ahrq.gov/issue/review-medication-error-sources-associated-inpatient-subcutaneous-insulin-recommendations
    June 17, 2020 - Review Review of medication error sources associated with inpatient subcutaneous … Review of medication error sources associated with inpatient subcutaneous insulin: recommendations for … A systematic review and meta-analysis. … A systematic review of the literature. … A systematic review and realist synthesis of interventions to enhance patient safety.

82. Filling the gaps on the Institute for Safe Medication Practices (ISMP) Do Not Crush List for Immediate-release Products | PSNet
    psnet.ahrq.gov/issue/filling-gaps-institute-safe-medication-practices-ismp-do-not-crush-list-immediate-release
    July 21, 2021 - Potentially inappropriate prescribing for adults living with diabetes mellitus: a scoping review … July 29, 2020 Individualized medication review in older people with multimorbidity: a … December 8, 2021 A meta-review of methods of measuring and monitoring safety in primary … April 6, 2022 The impact of medication reconciliation and review in patients using oral … September 21, 2022 Economic impact of medication error: a systematic review.

83. Preventable adverse events in obstetrics: systemic assessment of their incidence and linked risk factors. | PSNet
    psnet.ahrq.gov/issue/preventable-adverse-events-obstetrics-systemic-assessment-their-incidence-and-linked-risk
    March 01, 2023 - Based on a retrospective review of obstetrical adverse events occurring at one German hospital in 2018 … June 1, 2022 Evolving factors in hospital safety: a systematic review and meta-analysis … A systematic review and meta-analysis. … March 18, 2020 Scoping review of patients' attitudes about their role and behaviours … February 2, 2022 The effect of structured medication review followed by face-to-face

84. ED handoffs: observed practices and communication errors. | PSNet
    psnet.ahrq.gov/issue/ed-handoffs-observed-practices-and-communication-errors
    October 19, 2022 - December 15, 2010 Mandatory provider review and pain clinic laws reduce the amounts of … August 4, 2021 Human factors in anaesthesia: a narrative review. … August 11, 2021 A mixed-methods systematic review of interventions to address incivility … July 15, 2020 Documenting the indication for antimicrobial prescribing: a scoping review … February 17, 2021 A systematic review of trauma crew resource management training: what

85. Unintentionally retained guidewires: a descriptive study of 73 sentinel events. | PSNet
    psnet.ahrq.gov/issue/unintentionally-retained-guidewires-descriptive-study-73-sentinel-events
    November 28, 2018 - This retrospective review examines incidents of retained guidewires reported to The Joint Commission … May 10, 2023 Community pharmacy medication review, death and re-admission after hospital … September 11, 2013 A review of verbal order policies in acute care hospitals. … June 20, 2018 Evaluating situation awareness: an integrative review. … A systematic review and thematic synthesis of qualitative studies.

86. Retrospective analysis of reported suicide deaths and attempts on Veterans Health Administration campuses and inpatient units. | PSNet
    psnet.ahrq.gov/issue/retrospective-analysis-reported-suicide-deaths-and-attempts-veterans-health-administration
    November 17, 2021 - RIS Download Citation Related Resources From the Same Author(s) Review … nature and causes of avoidable significant harm in primary care in England: retrospective case note review … October 27, 2021 Interventions targeted at reducing diagnostic error: systematic review … October 6, 2021 A scoping review of real-time automated clinical deterioration alerts … November 11, 2020 Diagnostic errors in the intensive care unit: a systematic review of

87. A Potent Medication Administered in a Not So Viable Route | PSNet
    psnet.ahrq.gov/web-mm/potent-medication-administered-not-so-viable-route
    April 24, 2024 - The case was discussed in the multi-departmental morbidity and mortality review, and a new protocol was … A colleague and I recently published a systematic review of tissue injury local to vasopressor infusion … A review of reported cases indicates that the risk of local tissue injury with peripheral infusion is … A systematic review of extravasation and local tissue injury from administration of vasopressors through … Analysis of a case and review of the literature.

88. Getting it right for patient safety: specimen collection process improvement from operating room to pathology. | PSNet
    psnet.ahrq.gov/issue/getting-it-right-patient-safety-specimen-collection-process-improvement-operating-room
    March 27, 2013 - August 11, 2021 A mixed-methods systematic review of interventions to address incivility … July 15, 2020 Documenting the indication for antimicrobial prescribing: a scoping review … 2023 Hospitalizations and deaths related to adverse drug events worldwide: systematic review … November 8, 2017 Mandatory provider review and pain clinic laws reduce the amounts of … March 14, 2018 A systematic review of interventions to follow-up test results pending

89. Effective discharge communication in the emergency department. | PSNet
    psnet.ahrq.gov/issue/effective-discharge-communication-emergency-department
    January 24, 2024 - Review Effective discharge communication in the emergency department. … This review highlights communication tactics to improve discharge in the emergency department. … April 3, 2019 The effect of structured medication review followed by face-to-face feedback … A systematic review and realist synthesis of interventions to enhance patient safety. … A review of evidence, practice and consumer perspectives.

90. Intraoperative communications between pathologists and surgeons: do we understand each other? | PSNet
    psnet.ahrq.gov/issue/intraoperative-communications-between-pathologists-and-surgeons-do-we-understand-each-other
    June 28, 2023 - October 27, 2021 Abusive supervision: a systematic review and fundamental rethink. … Experiences and perspectives of transgender youths in accessing health care: a systematic review … 31, 2024 E-prescribing and medication safety in community settings: a rapid scoping review … A scoping review. … June 21, 2023 Cognitive bias and dissonance in surgical practice: a narrative review.

91. Near misses and unsafe conditions reported in a Pediatric Emergency Research Network. | PSNet
    psnet.ahrq.gov/issue/near-misses-and-unsafe-conditions-reported-pediatric-emergency-research-network
    June 07, 2017 - August 4, 2021 Burnout in the nursing home health care aide: a systematic review. … Drug-related-problem outcomes and program satisfaction from a comprehensive brown bag medication review … A systematic review of definitions. … Using in situ simulation to identify latent safety threats in emergency medicine: a systematic review … training interventions on safety culture and patient safety in emergency departments: a systematic review

92. Fatal errors in nitrous oxide delivery. | PSNet
    psnet.ahrq.gov/issue/fatal-errors-nitrous-oxide-delivery
    March 01, 2023 - Review Fatal errors in nitrous oxide delivery. … August 26, 2020 Human factors in anaesthesia: a narrative review. … A systematic literature review. … June 14, 2023 Cognitive biases in surgery: systematic review. … March 1, 2023 Human factors in anaesthesia: a narrative review.

93. Life after death: the aftermath of perioperative catastrophes. | PSNet
    psnet.ahrq.gov/issue/life-after-death-aftermath-perioperative-catastrophes
    March 29, 2012 - Review Life after death: the aftermath of perioperative catastrophes. … A systematic review. … A scoping review. … May 24, 2023 Cognitive biases in surgery: systematic review. … March 1, 2023 Human factors in anaesthesia: a narrative review.

94. Maternal mortality: near-miss events in middle-income countries, a systematic review. | PSNet
    psnet.ahrq.gov/issue/maternal-mortality-near-miss-events-middle-income-countries-systematic-review
    October 13, 2021 - review. … A systematic review and meta-analysis. … A systematic review and meta-analysis. … A systematic literature review. … A systematic review and meta-analysis.

95. Situation, background, assessment, recommendation (SBAR) communication tool for handoff in health care- a narrative review. | PSNet
    psnet.ahrq.gov/issue/situation-background-assessment-recommendation-sbar-communication-tool-handoff-health-care
    March 03, 2021 - Review Emerging Classic Situation, background, assessment … , recommendation (SBAR) communication tool for handoff in health care- a narrative review. … This review examines the challenges and benefits associated with SBAR use and provides a comparative … A systematic review and meta-analysis. … A systematic review.

96. At VA hospital, a rogue cancer unit. | PSNet
    psnet.ahrq.gov/issue/va-hospital-rogue-cancer-unit
    February 03, 2010 - Flawed safety standards, including a lack of peer review and oversight, led to a series of errors in … clinical decision-making of people with serious mental illness and medical co-morbidities: a scoping review … 3, 2021 National and institutional trends in adverse events over time: a systematic review … and meta-analysis of longitudinal retrospective patient record review studies. … May 15, 2019 Patient safety in the NICU: a comprehensive review.

97. The contribution of labelling to safe medication administration in anaesthetic practice. | PSNet
    psnet.ahrq.gov/issue/contribution-labelling-safe-medication-administration-anaesthetic-practice
    March 17, 2021 - February 10, 2010 2018 update on pediatric medical overuse: a review. … October 10, 2012 2017 update on pediatric medical overuse: a review. … January 10, 2018 2019 update on pediatric medical overuse: a systematic review. … January 11, 2006 The missing evidence: a systematic review of patients' experiences of … March 29, 2023 Human factors in anaesthesia: a narrative review.

98. A follow-up report on preventing suicide: focus on medical/surgical units and the emergency department. | PSNet
    psnet.ahrq.gov/issue/follow-report-preventing-suicide-focus-medicalsurgical-units-and-emergency-department
    April 24, 2024 - perspective of serious incident investigations in adult community mental health services: integrative review … A systematic review at the Department of Veterans Affairs. … Patient safety strategies in psychiatry and how they construct the notion of preventable harm: a scoping review

99. Supporting recovery after adverse events: an essential component of surgeon well-being. | PSNet
    psnet.ahrq.gov/issue/supporting-recovery-after-adverse-events-essential-component-surgeon-well-being
    December 01, 2021 - April 5, 2023 Preventing patient harm via adverse event review: An APSA survey regarding … 23, 2019 Surgical safety checklists in children's surgery: surgeons' attitudes and review … March 17, 2021 Handoffs in the era of duty hours reform: a focused review and strategy … February 1, 2023 Transforming the medication regimen review process using telemedicine … May 11, 2022 Advanced medication reconciliation: a systematic review of the impact on

100. Occupational therapy utilization in veterans with dementia: a retrospective review of root cause analyses of falls leading to adverse events. | PSNet
     psnet.ahrq.gov/issue/occupational-therapy-utilization-veterans-dementia-retrospective-review-root-cause-analyses
     March 25, 2020 - Study Occupational therapy utilization in veterans with dementia: a retrospective review … Occupational therapy utilization in veterans with dementia: a retrospective review of root cause analyses … A systematic review at the Department of Veterans Affairs. … A scoping review. … September 14, 2022 Adverse event reporting priorities: an integrative review.