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psnet.ahrq.gov/node/49398/psn-pdf
May 01, 2003 - the error in this
case to the hectic conditions, but such circumstances typically surround trauma situations … By contrast, the case at hand and other trauma situations involve
exposure to grossly bloody equipment … low in controlled settings (operating rooms and invasive
radiology suites), it is higher in trauma situations … Placement
Thoracotomy
Vascular Cutdown
Mandatory Check of All Other Equipment Used During Trauma Situations
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psnet.ahrq.gov/node/48095/psn-pdf
June 26, 2019 - operating room environments is crucial and advocate for focused education on communication in stressful
situations
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psnet.ahrq.gov/node/844775/psn-pdf
September 11, 2019 - are complex, but inappropriate prescribing of opioids (which
includes both prescribing opioids in situations
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psnet.ahrq.gov/issue/oops-sorry-wrong-patient-patient-verification-process-needed-everywhere-not-just-bedside
March 15, 2022 - This piece identifies situations in which patient verification errors occur and provides strategies to
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psnet.ahrq.gov/node/42300/psn-pdf
May 29, 2013 - music—can inhibit surgeons' auditory processing, resulting in lower quality of
communication in critical situations
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psnet.ahrq.gov/node/35324/psn-pdf
February 03, 2011 - the post-call performance of pediatric residents was diminished in heavy call
rotations compared to situations
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psnet.ahrq.gov/primer/communication-between-clinicians
September 15, 2024 - of improving communication between clinicians in the context of routine patient care and emergency situations
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psnet.ahrq.gov/issue/ucsd-doc-who-overdosed-hospital-bathroom-face-lawsuits
March 27, 2024 - institutional responsibility to monitor physicians exhibiting performance issues that put patients into unsafe situations
-
psnet.ahrq.gov/node/47921/psn-pdf
June 18, 2019 - information transfer, they are
not well suited to improving communication in clinically ambiguous situations
-
psnet.ahrq.gov/node/47875/psn-pdf
July 19, 2019 - primer/simulation-training
https://psnet.ahrq.gov/issue/measuring-teamwork-performance-teams-crisis-situations-systematic-review-assessment-tools-and
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psnet.ahrq.gov/issue/check-your-medical-records-dangerous-errors
November 03, 2021 - seemingly simple mistakes such as name misspellings and phone numbers as these errors can contribute to situations
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psnet.ahrq.gov/issue/access-clinical-information-bedside
March 16, 2022 - Patient misidentification in emergent situations can reduce the appropriateness of care delivery and
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psnet.ahrq.gov/issue/improving-patient-safety-human-factors-methods
June 12, 2019 - can be used to reduce risk through design improvements in a variety of process and interpersonal situations
-
psnet.ahrq.gov/node/33579/psn-pdf
September 15, 2024 - predictable mistakes on the part of relatively inexperienced personnel faced with
cognitively complex situations … than focusing corrective efforts on punishment or remediation, the
systems approach seeks to identify situations … Failure modes effect analysis (FMEA) attempts to prospectively identify error-prone situations, or failure
-
psnet.ahrq.gov/node/50389/psn-pdf
September 25, 2019 - 100 of these biases have been described in the
literature and, moreover, we can all easily identify situations … pattern recognition
decision-making but instead aim to consider common pitfalls in specific clinical situations
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psnet.ahrq.gov/node/38010/psn-pdf
August 27, 2008 - trigger tool approach, maintains a Web site with information on
trigger tools for a variety of clinical situations
-
psnet.ahrq.gov/node/36975/psn-pdf
March 24, 2011 - inherent to providing medical advice by telephone and strategies for minimizing patient harm in
these situations
-
psnet.ahrq.gov/node/35752/psn-pdf
December 23, 2012 - the concept of hindsight bias, and the limitation of using resources such as root cause
analysis in situations
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psnet.ahrq.gov/web-mm/unhappy-patient-leaves-against-medical-advice
January 31, 2024 - Managing Contentious Situations
Challenging patients are encountered in every setting and sometimes … By de-escalating contentious situations, it is often possible to prevent a patient from leaving AMA. … Post-event debriefing and review is also an educational opportunity to avoid potential future AMA situations … of course, impossible to eliminate AMA discharges entirely, but it is often possible to de-escalate situations
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psnet.ahrq.gov/issue/using-abcs-situational-awareness-patient-safety
November 16, 2022 - Commentary
Using the ABCs of situational awareness for patient safety.
Citation Text:
Cohen NL. Using the ABCs of situational awareness for patient safety. Nursing (Brux). 2013;43(4):64-5. doi:10.1097/01.NURSE.0000428332.23978.82.
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