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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/849133/psn-pdf
    May 17, 2023 - The association between patient safety culture and adverse events - a scoping review. May 17, 2023 Vikan M, Haugen AS, Bjørnnes AK, et al. The association between patient safety culture and adverse events – a scoping review. BMC Health Serv Res. 2023;23(1):300. doi:10.1186/s12913-023-09332-8. https://psnet.ahrq.go…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73407/psn-pdf
    June 16, 2021 - Common Formats for Patient Safety Data Collection: Diagnostic Safety 0.1. June 16, 2021 The Agency for Healthcare Research and Quality. Fed Register. 2021;86(103): 29263-29264. https://psnet.ahrq.gov/issue/common-formats-patient-safety-data-collection-diagnostic-safety-01 Measurement of diagnostic errors is an imp…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/854625/psn-pdf
    January 01, 2024 - Remote patient monitoring improves patient falls and reduces harm. October 18, 2023 Zimbro KS, Bridges C, Bunn S, et al. Remote patient monitoring improves patient falls and reduces harm. J Nurs Care Qual. 2024;39(3):212-219. doi:10.1097/ncq.0000000000000749. https://psnet.ahrq.gov/issue/remote-patient-monitoring-…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38301/psn-pdf
    February 15, 2011 - Defining the incidence of cardiorespiratory instability in patients in step-down units using an electronic integrated monitoring system. February 15, 2011 Hravnak M, Edwards L, Clontz A, et al. Defining the incidence of cardiorespiratory instability in patients in step-down units using an electronic integrated mon…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74042/psn-pdf
    November 03, 2021 - An Investigation into the Death of Baby J at University Hospitals Bristol and Weston NHS Foundation Trust. November 3, 2021 Manchester, UK: Parliamentary and Health Service Ombudsman; October 2021. https://psnet.ahrq.gov/issue/investigation-death-baby-j-university-hospitals-bristol-and-weston-nhs- foundation-trust…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837701/psn-pdf
    July 20, 2022 - Pediatric surgical errors: a systematic scoping review. July 20, 2022 Marsh KM, Fleming MA, Turrentine FE, et al. Pediatric surgical errors: a systematic scoping review. J Pediatr Surg. 2022;57(4):616-621. doi:10.1016/j.jpedsurg.2021.07.019. https://psnet.ahrq.gov/issue/pediatric-surgical-errors-systematic-scoping-…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/845276/psn-pdf
    March 01, 2023 - Cognitive biases in surgery: systematic review. March 1, 2023 Armstrong BA, Dutescu IA, Tung A, et al. Cognitive biases in surgery: systematic review. Br J Surg. 2023;110(6):645-654. doi:10.1093/bjs/znad004. https://psnet.ahrq.gov/issue/cognitive-biases-surgery-systematic-review Cognitive biases are a known source…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44443/psn-pdf
    September 09, 2015 - Using multidisciplinary rounds to improve patient safety through venous thromboembolism prevention awareness. September 9, 2015 Karasin B, Maund C. Using Multidisciplinary Rounds to Improve Patient Safety Through Venous Thromboembolism Prevention Awareness. Jt Comm J Qual Patient Saf. 2015;41(9):428-431. https://p…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50428/psn-pdf
    September 04, 2019 - Patient safety incidents caused by poor quality surgical instruments. September 4, 2019 Dominguez ED, Rocos B. Patient Safety Incidents Caused by Poor Quality Surgical Instruments. Cureus. 2019;11(6):e4877. doi:10.7759/cureus.4877. https://psnet.ahrq.gov/issue/patient-safety-incidents-caused-poor-quality-surgical-…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72582/psn-pdf
    December 16, 2020 - Deficiencies in the Veterans Crisis Line Response to a Veteran Caller Who Died. December 16, 2020 Washington, DC: Department of Veterans Affairs, Office of Inspector General; November 17, 2020. Report No 19-08542-11. https://psnet.ahrq.gov/issue/deficiencies-veterans-crisis-line-response-veteran-caller-who-died I…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40745/psn-pdf
    September 07, 2011 - A prospective observational study of physician handoff for intensive-care-unit-to-ward patient transfers. September 7, 2011 Li P, Stelfox HT, Ghali WA. A Prospective Observational Study of Physician Handoff for Intensive-Care- Unit-to-Ward Patient Transfers. Am J Med. 2011;124(9). doi:10.1016/j.amjmed.2011.04.027. …
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43639/psn-pdf
    October 29, 2014 - Ebola case raises concern about everyday hospital safety. October 29, 2014 Rodricks D. Baltimore Sun. October 14, 2014. https://psnet.ahrq.gov/issue/ebola-case-raises-concern-about-everyday-hospital-safety Although significant progress has been made in improving patient safety over the past decade, many medical e…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45673/psn-pdf
    December 07, 2016 - Report on the Safe Use of Pick Lists in Ambulatory Care Settings. December 7, 2016 Rizk S, Oguntebi G, Graber ML, Johnston D. Research Triangle Park, NC: RTI International; 2016. https://psnet.ahrq.gov/issue/report-safe-use-pick-lists-ambulatory-care-settings Standard term selection tools—like pick lists or drop-d…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44326/psn-pdf
    October 21, 2015 - Safety first! Using a checklist for intrafacility transport of adult intensive care patients. October 21, 2015 Comeau OY, Armendariz-Batiste J, Woodby SA. Safety First! Using a Checklist for Intrafacility Transport of Adult Intensive Care Patients. Crit Care Nurse. 2015;35(5):16-25. doi:10.4037/ccn2015991. https:/…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43640/psn-pdf
    November 12, 2014 - Infection prevention in the emergency department. November 12, 2014 Liang SY, Theodoro DL, Schuur JD, et al. Infection prevention in the emergency department. Ann Emerg Med. 2014;64(3):299-313. doi:10.1016/j.annemergmed.2014.02.024. https://psnet.ahrq.gov/issue/infection-prevention-emergency-department Emergency c…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34676/psn-pdf
    December 23, 2008 - Driving improvement in patient care: lessons from Toyota. December 23, 2008 Thompson DN, Wolf GA, Spear SJ. Driving improvement in patient care: lessons from Toyota. J Nurs Adm. 2003;33(11):585-595. https://psnet.ahrq.gov/issue/driving-improvement-patient-care-lessons-toyota Representatives from University of Pit…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38663/psn-pdf
    May 27, 2009 - Prevention of retained surgical sponges: a decision- analytic model predicting relative cost-effectiveness. May 27, 2009 Regenbogen SE, Greenberg CC, Resch SC, et al. Prevention of retained surgical sponges: a decision- analytic model predicting relative cost-effectiveness. Surgery. 2009;145(5):527-35. doi:10.1016…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44002/psn-pdf
    March 25, 2015 - Preventing medication errors in transitions of care: a patient case approach. March 25, 2015 Johnson A, Guirguis E, Grace Y. Preventing medication errors in transitions of care: A patient case approach. J Am Pharm Assoc (2003). 2015;55(2):e264-276. doi:10.1331/JAPhA.2015.15509. https://psnet.ahrq.gov/issue/prevent…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49406/psn-pdf
    June 01, 2003 - Continuous observation procedures for psychiatric wards lack standardization and use inconsistent terminology
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60168/psn-pdf
    March 25, 2020 - curvature around the wrist.12 Reasons for variance in EKG systems within hospital systems include lack of standardization

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