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psnet.ahrq.gov/node/34021/psn-pdf
March 07, 2005 - Focusing on Medical Errors.
March 7, 2005
Temple WJ, ed. J Surg Oncol. 2004;88(3):111-199.
https://psnet.ahrq.gov/issue/focusing-medical-errors
This issue provides a review of medical error from a variety of perspectives, including pediatrics,
anesthesiology, pharmacy, pathology, laboratory medicine, and insurers.…
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psnet.ahrq.gov/node/33941/psn-pdf
October 11, 2016 - BMJ Quality & Safety.
October 11, 2016
Franklin BD, Thomas E, eds. BMJ Publishing Group Ltd and the Health Foundation. ISSN: 2044-5415.
https://psnet.ahrq.gov/issue/bmj-quality-safety
A monthly peer-reviewed journal that reports research, initiatives, and viewpoints in the growing area of
safety and quality improv…
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psnet.ahrq.gov/node/36248/psn-pdf
September 13, 2006 - Regulating compensation for injuries associated with
medical error.
September 13, 2006
Corbett A. Sydney Law Review. 2006;28(2):259-296.
https://psnet.ahrq.gov/issue/regulating-compensation-injuries-associated-medical-error
The author discusses developing "no-fault" systems of compensation for victims of medical e…
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psnet.ahrq.gov/node/41998/psn-pdf
January 30, 2013 - Involving Patients in Improving Safety.
January 30, 2013
London, UK: The Health Foundation; January 2013.
https://psnet.ahrq.gov/issue/involving-patients-improving-safety
This review analyzes research on engaging patients in safety improvement and details which strategies are
most effective.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/36071/psn-pdf
June 16, 2019 - ISMP medication error report analysis.
June 16, 2019
Cohen MR.
https://psnet.ahrq.gov/issue/ismp-medication-error-report-analysis-6
This monthly selection of medication error reports provides examples of nimodipine administration
mishaps, a lithium overdose, and suggested adopted drug names for review.
https://ps…
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psnet.ahrq.gov/node/40971/psn-pdf
June 01, 2012 - Iatrogenic psychological harm.
June 1, 2012
Rees C. Iatrogenic psychological harm. Arch Dis Child. 2012;97(5):440-6. doi:10.1136/archdischild-2011-
300362.
https://psnet.ahrq.gov/issue/iatrogenic-psychological-harm
This review discusses iatrogenic psychological harm, including how it may occur and how to prevent i…
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psnet.ahrq.gov/node/42725/psn-pdf
November 13, 2013 - Audit of missed or delayed antimicrobial drugs.
November 13, 2013
Wright J.
https://psnet.ahrq.gov/issue/audit-missed-or-delayed-antimicrobial-drugs
This record review study found that omitted doses of antimicrobial medications occur frequently in hospital
settings in the United Kingdom.
https://psnet.ahrq.gov/is…
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psnet.ahrq.gov/node/38703/psn-pdf
June 10, 2009 - Reduce medication errors through following metrics.
June 10, 2009
Drug Formulary Review. June 1, 2009.
https://psnet.ahrq.gov/issue/reduce-medication-errors-through-following-metrics
This news piece discusses how using measurement tools in the pharmacy setting could help reduce
medication errors.
https://psnet.a…
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psnet.ahrq.gov/node/39681/psn-pdf
July 14, 2010 - Do no harm: hospital care in Las Vegas.
July 14, 2010
Allen M; Richards A.
https://psnet.ahrq.gov/issue/do-no-harm-hospital-care-las-vegas
This news series reports on an investigation that included hospital record review and interviews with
stakeholders to explore the quality and safety of health care in Las Vegas…
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psnet.ahrq.gov/innovation/battle-buddies-rapid-deployment-psychological-resilience-intervention-health-care
September 09, 2020 - EMERGING INNOVATIONS
Battle Buddies: rapid deployment of a psychological resilience intervention for health care workers during the COVID-19 pandemic
Citation Text:
Albott CS, Wozniak JR, McGlinch BP, et al. Battle Buddies: rapid deployment of a psychological resilience intervention for health car…
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psnet.ahrq.gov/node/33575/psn-pdf
March 15, 2025 - Patient Engagement and Safety
March 15, 2025
Patient Engagement and Safety. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/patient-engagement-and-safety
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the pati…
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psnet.ahrq.gov/node/42478/psn-pdf
August 07, 2013 - A guide for HCAs on safe patient transfers.
August 7, 2013
Lees L.
https://psnet.ahrq.gov/issue/guide-hcas-safe-patient-transfers
This commentary offers practical advice for health care assistants to reduce risks during patient transfers.
https://psnet.ahrq.gov/issue/guide-hcas-safe-patient-transfers
https://psnet…
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psnet.ahrq.gov/node/41014/psn-pdf
January 01, 2012 - Safety in EMS.
December 21, 2011
Brice JH, Patterson PD, eds. Prehosp Emerg Care. 2012;16:1-108.
https://psnet.ahrq.gov/issue/safety-ems
This special issue contains articles exploring safety improvement efforts in emergency medical services.
https://psnet.ahrq.gov/issue/safety-ems
https://psnet.ahrq.gov/iss…
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psnet.ahrq.gov/node/41806/psn-pdf
October 31, 2012 - Computer viruses are "rampant" on medical devices in
hospitals.
October 31, 2012
Talbot D. MIT Technology Review. October 17, 2012.
https://psnet.ahrq.gov/issue/computer-viruses-are-rampant-medical-devices-hospitals
This article highlights risks associated with malicious software on medical equipment and how it ca…
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psnet.ahrq.gov/node/836839/psn-pdf
March 31, 2022 - Annual Perspective: Psychological Safety of Healthcare
Staff
March 31, 2022
Kingston MB, Dowell P, Mossburg SE, et al. Annual Perspective: Psychological Safety of Healthcare Staff.
PSNet [internet]. 2022.
https://psnet.ahrq.gov/perspective/annual-perspective-psychological-safety-healthcare-staff
Introduction
The…
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psnet.ahrq.gov/web-mm/perils-contrast-media
March 01, 2007 - SPOTLIGHT CASE
The Perils of Contrast Media
Citation Text:
Sadat U, Solomon R. The Perils of Contrast Media. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
Copy Citation
Format:
Google Scholar BibTeX En…
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psnet.ahrq.gov/web-mm/double-trouble
August 01, 2012 - SPOTLIGHT CASE
Double Trouble
Citation Text:
Gurwitz JH. Double Trouble. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005.
Copy Citation
Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote t…
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psnet.ahrq.gov/web-mm/hazards-distraction-ticking-all-ehr-boxes
April 09, 2014 - SPOTLIGHT CASE
The Hazards of Distraction: Ticking All the EHR Boxes
Citation Text:
Easty AC. The Hazards of Distraction: Ticking All the EHR Boxes. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
Copy Citation
…
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psnet.ahrq.gov/node/49633/psn-pdf
September 01, 2011 - The Safety and Quality of Long Term Care
September 1, 2011
Vogelsmeier AA. The Safety and Quality of Long Term Care. PSNet [internet]. 2011.
https://psnet.ahrq.gov/web-mm/safety-and-quality-long-term-care
Case Objectives
Identify commonly reported adverse events in long-term care.
Identify two to three challenges…
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psnet.ahrq.gov/web-mm/complications-vascular-access-procedures-patients-kidney-disease
November 15, 2023 - Complications of Vascular Access Procedures in Patients with Kidney Disease
Citation Text:
Young SR, Chen I. Complications of Vascular Access Procedures in Patients with Kidney Disease. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. …